“Getting people with COPD into a pulmonary rehab program with a medically observed and formalized exercise regimen is something that can help really improve their quality of life,” says Jason Turowski, MD, a pulmonologist at the Cleveland Clinic in Cleveland. According to the National Heart, Lung, and Blood Institute, pulmonary rehab may include any or all of the following elements:
Exercise trainingNutritional counselingEducation on COPDEnergy-conserving techniquesBreathing strategiesPsychological counseling and group support
Before beginning pulmonary rehab, each person is given an assessment so that the care team can set goals that are safe and attainable. “I try to get every COPD patient I see started in pulmonary rehab if they’ve never been in a program before, and then we keep them in a maintenance program thereafter,” says Dr. Turowski. The aerobic exercise portion of the program typically involves walking on a treadmill at a very low setting or riding a stationary bike. “To the average person, this might not seem like a lot, but for someone with COPD, this might be the most exercise they’ve gotten in years,” says Turowski. Pulmonary rehabilitation can also provide much-needed emotional support to people with COPD. “It’s beneficial to be around other people and get positive peer support,” says Turowski. “People getting out and exercising together has benefits that go beyond just getting on a treadmill, which can be hard to do by yourself.” Once a pulmonary rehab program is completed, people with COPD face the challenge of continuing with their prescribed routines. Research has shown that pulmonary rehab programs lasting for at least six months have been more successful in maintaining outcomes than shorter programs.
A Pulmonary Rehab Success Story
Turowski recently treated a man in his fifties who is the lead singer in a band. “He noticed that his fitness while performing onstage was declining, and he’d been seen by our lung transplant group about five years ago,” says Turowski. At the time, the man decided not to pursue a transplant or undergo further treatment. “He continued to live his life as before until about a year ago when he came back to see me,” he says. Turowski proposed pulmonary rehabilitation. “Soon after starting the program, he noticed a stabilization in his breathing,” he says. “He was less winded when performing onstage.” The man’s performance in medical screenings improved as well. “His six-minute walk distance increased dramatically,” says Turowski. Doctors use the six-minute walk test to measure what’s called “functional capacity” by counting how many feet a person can walk in six minutes by going back and forth between two cones placed 98 feet apart. “Before he started rehab, his walk distance was in the 500-foot range, which is below par for someone in his age bracket,” says Turowski. “Shortly after he began pulmonary rehab, his walk distance blasted off into the 1,200- to 1,300-foot range.” Turowski finds that when people commit themselves to pulmonary rehab they tend to have better energy, sleep better at night, and are able to walk further. “People find out that COPD doesn’t have to define their life,” he says.