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Pulmonary Rehabilitation: What is it and who would benefit?

Medically reviewed by Kelly Fan, MD, Susan Kerrigan, MD and Marianne Madsen

Breathing is one of those things we rarely think about––until it becomes an unexpected struggle. Shortness of breath, wheezing, coughing––they can all affect your quality of life. Because COVID-19 is primarily a respiratory illness, the pandemic brought new focus to lung health. For asthmatics, those dealing with chronic obstructive pulmonary disease (COPD), or COVID-19 survivors coping with the virus’s lingering effect on their lungs, there are innovative therapies available. One of these is pulmonary rehabilitation. So what is it and who would benefit?


Helping Your Lungs Help You 


A pair of organs within your chest, the lungs transport oxygen from the air we inhale into your blood. Carbon dioxide travels from our blood to our lungs, where we exhale it out. It’s a simple, elegant process––when it works properly. For older adults, one of the most common breathing challenges is COPD. Usually caused by smoking or exposure to toxic gases, the condition damages the natural elasticity of the bronchial tubes and air sacs which can cause them to over-expand. This leaves air in your lungs after you inhale.  Emphysema and chronic bronchitis are the most common contributors to COPD, which is marked by everything from shortness of breath and wheezing in its early stages to weight loss and ankle swelling in the later stages.


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COPD - Severity

COPD - Severity

How Pulmonary Rehabilitation Can Help


Although physical rehabilitation is often conducted one-on-one with the patient and the therapist, participants in pulmonary rehabilitation often do so in a group. Just as several people can improve and alter the dynamics of therapy and fitness, by struggling and learning together, those dealing with debilitating lung issues often find the environment to be supportive and encouraging. 


Pulmonary rehabilitation classes are first about learning new ways to breathe. Pursed lips breathing can improve airflow, as do certain types of coughing. When someone has trouble breathing, they often enter a vicious cycle. Unable to draw a restorative breath provokes anxiety which in turn makes it even harder to breathe. In rehab classes, techniques are taught to manage anxiety. The goal is to be in charge of your breathing rather than let it control you. Some exercise while sitting; others walk on a treadmill. A recent study showed that patients who had been hospitalized for COPD were less likely to be readmitted over the next three months if they participated in pulmonary rehabilitation. They were also more likely to still be alive one year later.

Kelly Fan, MD

I have a low threshold to refer my patients to pulmonary rehabilitation. It's equally important for patients to continue practicing the exercises and breathing techniques after completion of the program for sustained results.

Although last year’s lockdowns and shutdowns affected group classes of every type, many are coming back. Those most vulnerable to COVID-19 have often been vaccinated––and that definitely includes people with lung issues no matter their age. However, most facilities still recommend mask wearing even for those dealing with COPD or other lung issues. One study suggested that dyspnea or shortness of breath can be triggered by masks––with a higher risk among those with COPD. You should definitely discuss this with your healthcare provider.


Speaking of health care, pulmonary rehabilitation classes are covered by Medicaid along with most insurance carriers. If you are unable to take the classes, you may consider enlisting a personal trainer at a local fitness facility. It’s generally recommended that you take several classes a week. However, just as you’ll never become proficient with a musical instrument if you only play during lessons, the best way to get lasting benefits from rehab is to practice the techniques and exercises on your own. Many say the program has allowed them to not only complete ordinary tasks without shortness of breath but enjoy exercise as well. There’s no question that committing to a program of pulmonary rehabilitation can help you breathe a little easier.


Written by John Bankston

Doctor Profile

Kelly Fan, MD


Dr. Fan is a pulmonologist and critical care attending physician with clinical expertise in advanced asthma, bronchiectasis, bronchoscopy, COPD, interstitial lung disease, lung cancer, lung infections, pleural disease, and pulmonary vascular disease. Dr. Fan is a Doctorpedia Founding Medical Partner and the Chief Medical Officer of Doctorpedia's Lung Health channel.

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