Michelle Casey

By Michelle Casey, Amy Mulkerns, Cliona O’Donnell and Tim McDonnell

This chapter will review the rationale for and the need for pulmonary rehabilitation in patients with Chronic Obstructive Pulmonary Disease (COPD). Its clinical effectiveness will be considered, including the evidence supporting a role for rehabilitation in improving exercise tolerance in COPD as measured. While the influence of pulmonary rehabilitation on dyspnoea, exercise tolerance and quality-of-life is clear, evidence for the benefits of rehabilitation on reducing healthcare utilisation such as admission to hospital or attendance at out-of-hours services is limited. The chapter will provide guidance on the setting up of a pulmonary rehabilitation programme and clinical staff required and the suitability of patients to enter such programmes will be outlined. There will be discussion on the key components of a programme including education, nutritional advice and the management of dyspnoea. Exercise is the central component of pulmonary rehabilitation. Assessment of the patient and prescription of an exercise programme will be outlined as will assessing a patient’s improvement. One key goal of pulmonary rehabilitation is ongoing lifestyle modification to encourage patients to undertake a more active lifestyle in the future. Ways of activating patients to do this will be discussed and the evidence for the use of telehealth in this area will be reviewed.

Part of the book: COPD