The pulmonary rehabilitation for treatment of COPD has multidisciplinary team and can consist of a physiatrist and pulmonologist; respiratory, physical, and occupational therapists; an exercise physiologist; a psychiatrist or psychologist; a social worker; a vocational counselor; and a dietitian. However, in the present fiscal environment, an effective small program may have only one specifically trained therapist or nurse under physician supervision.
Treatment for COPD (a review for Physiotherapists)
Chronic obstructive pulmonary disease
Medication and Prognosis:
Favorable, patient on stable self-medication program and non smoking
Bronchodilators include beta 2-agonists, anticholinergics, and theophyllines
Other medications, such as corticosteroids, expectorants, mucolytics, and antibiotics, are used along with humidification, ample fluid intake, oxygen therapy and facilitated airway secretion elimination as warranted
Improve endurance and efficiency
Optimize oxygen needs and control of secretions
Increase independence in ambulation and self-care activities
Reduce anxiety and improve self-esteem through enhanced body awareness
Supplemental oxygen needed during exercise
Discontinue and notify physician if patients becomes severely dyspneic or develops chest pain with exercise
Conduct ear oximetry at rest and during exercise to determine portable oxygen flow rate needed to maintain oxygen saturation higher than 90%
Instruct patient in diaphragmatic and pursed-lip breathing
Instruct patient and family in postural drainage techniques
Instruct patient and family in portable oxygen use
Instruct in use of metered-dose inhaler before exercise
Instruct in use of nocturnal bilevel positive airway pressure
Assess baseline endurance, using 12-minute walk test
Begin incremental exercise program to improve endurance through ambulation and stair climbing. Begin with 5-minute sessions, followed by rest periods between sessions. When patient tolerates 20 minutes of total exercise per day, begin consolidating the sessions.
Initial treatments on daily basis during weeks 1 and 2, taper to three times per week over weeks 3 and 4, and then taper to home program with self-monitoring in weeks 5 and 6.
Review proper body mechanics and coordinate with breathing patterns, using diaphragmatic and pursed-lip breathing when appropriate
Assess upper-extremity mobility, strength, and endurance
Evaluate basic and advanced self-care activities, and provide adaptive aids to improve independence with dressing, hygiene, bathing, cooking, and other chores
Train the patient in energy conservation and work simplification techniques
Evaluate home environment and make recommendations for workspace modifications and equipment to improve safety, efficiency, and independence
Provide relaxation exercise training with visual imagery techniques
Physical Therapist at Winner Regional Healthcare Center, South Dakota, USA. Former HOD Physiotherapy & Fitness center, NIMT Hospital, Greater Noida. Former Physio ISIC Hospital. MPT (neuro), MIAP, cert. manual therapist, Medical Neuroscience (USA). Licensed Physical Therapist in Texas & South Dakota, USA.