If a drug is withdrawn too early, it loses its effect – the patient’s condition deteriorates again. Things are similar with chronic lung patients and training of the lungs: If after inpatient rehabilitation the training is canceled again, deterioration reoccurs – the laboriously developed positive effect dissipates. Therefore, holistic, individual, and above all continuous rehabilitation and therapy are important in lung diseases.
What elements does pulmonological rehabilitation comprise?
Pulmonological rehabilitation links elements of general physical training with program points specifically targeted to the lung. This includes:
- Medical training therapy (strength, endurance)
- Inspiratory training of the respiratory muscles (respiratory physiotherapy)
- Cessation of smoking
- Physical therapy
- Dietary consultation
- Psychological care
- Patient education (for the period after the rehabilitation)
- Regular examinations of the general physical and pulmonary condition
When do I need pulmonological rehabilitation?
Pulmonological rehabilitation is useful when a serious or chronic lung condition has restricted the functioning of the lungs. Typical indications for pulmonological rehabilitation are:
- Chronic obstructive pulmonary disease (COPD, “smoker’s lung”)
- Bronchial asthma
- Chronic bronchitis
- Interstitial lung disease (e.g. pulmonary fibrosis, sarcoidosis, cystic fibrosis)
- Lung cancer
- Pulmonary hypertension (pulmonary hypertension)
- Lung transplantation (before and after)
Ultimately, the attending physician decides whether pulmonological rehabilitation is actually appropriate for the individual patient and correspondingly makes an application to the competent insurance provider.
How is pulmonological rehabilitation structured?
In Austria, in accordance with the recommendations of the World Health Organization (WHO), there is a 4-phase system for pulmonological rehabilitation. Uniquely, however, a large part of this program can be completed on an outpatient basis. This allows patients not only to be at home with their families despite their rehabilitation, but also to go to work, if their health permits it.
Phase I is rehabilitation in the acute care hospital. Here first steps will be taken e.g. after a surgery or a bout-like deterioration of COPD. What we commonly call “rehabilitation” is carried out in Phase II. This may take three to four weeks on an inpatient or six weeks on an outpatient basis. The patient has the option to continue treatment on an outpatient basis in Phase III. Phase III usually takes six to twelve months, depending on the health of the patient.
Previously, rehabilitation was completed with the end of Phase III, and the patient left to himself/herself from that time on. A common result: Exercises were increasingly neglected, lung function deteriorated again. Today there is the option of taking “maintenance therapy” in Phase IV in order to maintain lung function and performance with professional help. Phase IV services are easily and unbureaucratically available to patients thanks to partners such as the Sports Union. This type of rehabilitation has proven particularly sustainable, helping patients to learn health-promoting behaviors that ensure their quality of life in the long term.
Which treatment is better – inpatient or outpatient?
Both inpatient and outpatient rehabilitation has advantages and disadvantages. While hospitalization in a rehabilitation facility ensures a calm and stress-free environment, optimal care, and best medical care, many people still feel most comfortable in their own homes. Many people who have small children or are self-employed and thus would risk a loss of earnings prefer outpatient treatment. In some cases, hospitalization can be shortened if necessary and be continued on an outpatient basis.
Here it is important to consider, together with the attending physician, which setting is most suitable.
How does pulmonological rehabilitation help me?
Today, numerous studies confirm the positive effect of a lung-specific rehabilitation program. Facts considered proven include decreased mortality, improvements in physical performance, reduction of dyspnea, restoration of the quality of life and reduction of the number of hospitalizations needed, thanks to these improvements. Another benefit: The rehabilitation gives patients security and alleviates the fear of their own condition – which makes itself felt in the lower rate of depression and anxiety in patients with COPD, too.
These articles might also interest you:
+ "Asthma, COPD - what is this?"- from Dr. Ralf Harun Zwick
+ "Sports & respiratory training in pulmonological Rehabilitation" - from Dr. Ralf Harun Zwick
+ "Muscle relaxation in persistent vegetative state patients in the hammock" - from Mag. Barbara Seidel, BSc
+ "The Orpheus Program" - from Prim. Univ. Prof. Dr. Michael Musalek