Our objective is to provide information to the population about various diseases related to Pulmonology, in such a way that knowledge about them improves and they can be identified in a timely manner.
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Today I will talk to you about some general aspects of pulmonary rehabilitation.
What is pulmonary rehabilitation?
Pulmonary rehabilitation (PR) are comprehensive interventions that are implemented after an assessment of the patient, to whom custom-designed therapies are applied that include:
- Muscle training
- Education and changes in lifestyle 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:
- Nursing and general physicians trained in respiratory pathology
Which patients are candidates for pulmonary rehabilitation?
Patients who have some chronic respiratory disease are considered candidates for RP, such as:
Diffuse interstitial lung disease (pulmonary fibrosis)
Pulmonary hypertension (elevated blood pressure in the lung)
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 is not a candidate for pulmonary rehabilitation?
Patients with psychiatric or behavioral disorders who do not collaborate with the program
Those with unstable cardiovascular disease
What is the evaluation process to receive pulmonary rehabilitation?
STEP 1 . The pulmonologist must perform a clinical assessment that may include various studies:
- Chest x-ray and/or tomography
- Lung function studies, such as:
- 6 minute walk
- Respiratory muscle force measurement (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, depending on each case.
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.
Programs may be supervised and home-based, with progress assessed periodically.
STEP 3. Measurement of results.
Here are the changes that can be modified:
- Shortness of breath (Dyspnea)
- Quality of life
- effort capacity
What are the components of the pulmonary rehabilitation program?
- Respiratory muscle training that may include the inspiratory and expiratory groups.
- This is done with small devices that allow you to control the workload.
- Respiratory physiotherapy . This is what we mean by:
- Respiratory reeducation techniques
- Oxygen therapy
- Appropriate use of mechanical ventilation
- Use of secretion mobilization techniques
HAND PERCUSSION TECHNIQUES ARE CURRENTLY NOT RECOMMENDED. Since they can produce adverse effects such as desaturation, bronchial spasm, increased gastroesophageal reflux and risk of rib trauma.
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 assist device can be used, mainly used when there is a decrease in the strength of this action.
What benefits can I achieve with pulmonary rehabilitation?The objectives of PR are:
- Improve dyspnea (shortness of breath)
- Improve symptoms of the disease
- Improve exercise capacity
- Reduce the need for 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.
Ced. Prof. 4829126, reg. esp. 6119468 / 7440242