Pulmonary rehabilitation

Our objective is to provide information to the population on various diseases related to Pneumology, in such a way that knowledge about them improves and they can be identified in a timely manner.
 
At the end of the post you can leave us your comments and questions, or if you wish directly to our email: neumologo.oc@breathbaja.com .
 
 
Today I will talk to you about some general aspects of pulmonary rehabilitation.
 
What is pulmonary rehabilitation?
 
Pulmonary rehabilitation (RP) are comprehensive interventions that are implemented after an assessment of the patient, to whom custom-designed therapies are applied, including:
- Muscle training
- Education and changes in life habits
 
This with the aim of improving the physical condition of people with chronic respiratory disease.
 
Members of the pulmonary rehabilitation team
 
The Breathbaja pulmonary rehabilitation team is made up of:
- Pulmonologist
- Physiotherapists
- Nursing and general practitioners trained in respiratory pathology
 
 
 
Which patients are candidates for pulmonary rehabilitation?
 
RP candidates are considered those patients who have some chronic respiratory disease, such as:
  • Diffuse Interstitial Lung Disease (Pulmonary Fibrosis)
  • Pulmonary hypertension (high blood pressure in the lungs)
  • Chronic obstructive pulmonary disease (COPD) and shortness of breath (dyspnea)
  • Patients who produce excess phlegm
  • Diseases such as cystic fibrosis and bronchiectasis
  • Patients with neuromuscular disease and ineffective cough
  • Patients requiring chest surgery
 
 
 
 
The important thing to mention is that PR should be available to all patients with chronic respiratory disease regardless of age or degree of disease.
 
Who are not candidates for pulmonary rehabilitation?
 
  • Patients with psychiatric or behavioral disorders who do not collaborate with the program
  • Those with unstable cardiovascular disease
 
How is the assessment process to receive pulmonary rehabilitation?
 
STEP 1 . The pulmonologist must perform a clinical assessment that may include various studies:
- X-ray and/or tomography of the thorax
- Pulmonary function studies, such as:
or Spirometry
or 6 minute walk
o Measurement of respiratory muscle strength (PiMax/PeMax)
 
 
 
 
In this step, it is important to optimize the patient's treatment, adjust the use of supplemental oxygen, and possibly refer the patient for evaluation by other specialists, on a case-by-case basis.
 
STEP 2 . A pulmonary rehabilitation program is established that may include muscle training, education, and nutrition intervention.
 
A minimum duration of 8 weeks or 20 sessions is recommended, with a frequency of 2-5 sessions per week.
 
The programs may be supervised and home-based, with periodic evaluation of the evolution.
 
 
 
STEP 3. Measurement of results.
 
Here the changes that are likely to modify are quantified:
 
- Shortness of breath (dyspnea)
- Quality of life
- Effort capacity
 
 
What are the components of the pulmonary rehabilitation program?
 
- Respiratory muscle training that can include the inspiratory and expiratory groups.
o This is done with small devices that allow controlling the workload.
 
 
 
- Respiratory physiotherapy. This is what we mean by:
o Respiratory reeducation techniques
o Oxygen therapy
o Appropriate use of mechanical ventilation
o Use of secretion mobilization techniques
 
HAND PERCUSSION TECHNIQUES ARE NOT RECOMMENDED AT PRESENT. Since they can produce adverse effects such as desaturation, bronchial spasm, increased gastroesophageal reflux and risk of rib trauma.
 
 
 
§ Use of devices that help modify secretions and facilitate expectoration
§ Use of vibrating devices that are placed on the chest that help modify secretions but also modify a lung volume called "residual functional capacity"
§ In appropriate cases a cough assistant device can be used , used mainly when there is a decrease in the force of this action.
 
 
 
 
What benefits can I achieve with pulmonary rehabilitation?
 
The objectives of the PR are:
- Improve dyspnea (lack of air)
- Improve the symptoms of the disease
- Improve exercise capacity
- Reduce the need to enter hospitalizations
- Stabilize the disease and in some cases reverse the manifestations.
 
 
 
 
I am Dr. Cecilio Omar Ceballos Zuñiga, specialist in pulmonology and internal medicine [National Institute of Respiratory Diseases (UNAM) and General Hospital of the State of Sonora (UNAM)] and basic training at the Mexicali School of Medicine (UABC) . Co-founder of Breathbaja.
Yield. Prof. 4829126, reg. esp. 6119468 / 7440242
 
We are members of:
  • American Academy of Sleep Medicine
  • Mexican Academy of Sleep Medicine
  • Mexican Society of Pulmonology and Thoracic Surgery
  • European Respiratory Society
  • American Thoracic Society
  • Latin American Thoracic Association
  • Latin American Society of Respiratory Physiology
  • Mexican Society of Internal Medicine. Chapter Mexicali
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