THIS PRESENTATION INCLUDES DEFINITION, INDICATIONS, CONTRAINDICATIONS, AIMS, GOALS, PR TEAM, AND COMPONENTS OF THE PULMONARY REHABILITATION. THIS PRESENTATION IS MADE ONLY FOR LEARNING AND GUIDANCE PURPOSE.

1. PULMONARY
REHABILITATION
DR.SAMIR JADAV (PT)

2. DEFINITION
• Pulmonary rehabilitation is a multidisciplinary
services to persons with pulmonary disease and their
families usually by achieving and maintain the
individual’s maximum level of independence and
functioning in the community.

3. INDICATIONS
Obstructive pulmonary disease
 COPD, Asthma, etc.
Restrictive pulmonary disease
 Pleural effusion, Pneumonia, etc.
Pulmonary vascular disease
Lung resection
Lung transplantation
Chest wall surgeries
Intra thoracic surgeries

4. CONTRAINDICATIONS
• Ischemic heart disease
• Severe pulmonary hypertension
• Significant hepatic dysfunction
• Renal failure
• Impaired hearing
• Unstable angina
• Recent MI

5. AIMS OF P.R.
1. Reduce dyspnoea
2. Increase muscle endurance (peripheral and respiratory)
3. Improve muscle strength (peripheral and respiratory)
4. Capacity to carry out their ADL

6. COMMON GOALS
• Control respiratory infection
• Airway management
• Improve ventilation and cardiac status
• Decrease medical cost
• Decrease hospitalization
• Pt. and family education/ counselling
• Occupational retraining

7. PR TEAM
• Medical team
• Physical therapist
• Nurse
• Dietician
• Occupational therapist
• Pharmacist
• Social worker

8. COMPONENTS OF PR
1. Education
2. General care
3. Pulmonary care
4. Psychosocial management
5. Exercise and functional training

9. 1) EDUCATION
 To provide knowledge and instruction to their family
members in patient regarding disease, its effect, treatment,
etc.
2) PSYCHOSOCIAL MANAGEMENT
 It’s important as chronic disease places stress on family
member as well as for patient.
 So to provide stress reduction management technique and
behavioral strategies management.

10. 3) GENERAL CARE
 Prescription of medicine and oxygen support
 Preventive care (smoking cessation, adequate hydration,
proper nutrition, etc.
4)PULMONARY CARE
A)Airway clearance techniques
 Forced expiration technique (FET)
 ACBT (Active cycle of breathing technique)

11.  PD (Postural drainage)
 Autogenic drainage (AD)
 Positive expiratory pressure (PEP)
 High frequency chest wall compression
 Flutter valve therapy
B)Lung inflation technique
 Chest expansion/Breathing exs.
• Diaphragmatic
• Pursed lip breathing
• Segmental
• Incentive spirometry

12. Positioning
C) Respiratory therapy equipment
 Humidifiers
 Nebulizer
 Suction
 Oxygen supplement
 CPAP (Continuous positive airway pressure)
D) Ventilatory muscle training
 Focus on increased respiratory muscle strength and
endurance.

13. Strength :- High inspiratory resistance exercise
Endurance :- Low to moderate inspiratory resistance for 15-30
minutes.
5) Exercise and functional training
 its depends on what exercise are to be prescribed for strength
and endurance.
 It is based on four components : FITT principle
a) frequency of training
b) intensity of training
c) time/duration of training
d) type/mode of training

14. Instruction for energy conservation, activity pacing (regulation
of activity level and/or rate in the service of an adaptive goal or
goals) and use of adaptive equipment to optimize the pt. ability
for daily activities.
Exercise prescription :- FITT
Frequency : 3-4 times/week
Intensity : High intensity training
Mode : continuous/interval
Length : 40-60 minutes

15. ANY QUESTIONS ???