Pulmonary Rehabilitation

Pulmonary rehabilitation (PR) is a comprehensive, individualized program for symptomatic patients with chronic respiratory disease, integrating exercise training, education, breathing techniques, nutritional optimization, psychosocial support and self-management training. It is a Class A recommendation for COPD with high-quality evidence reducing dyspnea, improving exercise tolerance, decreasing hospitalization and improving health-related quality of life.

Core components include endurance training (treadmill or cycle ergometer at 60-80% peak VO2 or 4-6 modified Borg dyspnea), strength training of upper and lower limbs, inspiratory muscle training, breathing retraining (pursed-lip and diaphragmatic breathing), airway clearance techniques (active cycle of breathing technique, autogenic drainage), energy conservation, oxygen titration during exercise and education on inhaler technique, smoking cessation, action plans and vaccinations.

Indications include COPD (most evidence), interstitial lung disease, bronchiectasis, asthma, pulmonary hypertension, pre/post-lung transplantation, lung volume reduction surgery, post-thoracic surgery, neuromuscular disease and post-COVID-19 long syndrome. Programs typically run 6-12 weeks with 2-3 sessions weekly, supervised by physiotherapists with pulmonologist oversight.