Pulmonary rehabilitation or PR
Pulmonary rehabilitation is a programme of exercise and education for people with a long-term lung condition
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‘Pulmonary rehabilitation is the most beneficial treatment I have received… not only for the exercise provided but more importantly for the education given’ Colin
Pulmonary rehabilitation (PR) is made up of:
- a physical exercise programme, designed for people with lung conditions and tailored for you
- information on looking after your body and your lungs, and advice on managing your condition and your symptoms, including feeling short of breath
It’s designed for people who are severely breathless. Your PR team will be made up of trained health care professionals such as physiotherapists, nurses and occupational therapists.
You’ll be in a group of about 8-16 people. A course usually lasts six to eight weeks, with two sessions of about two hours each week. PR courses are held in local hospitals, community halls, leisure centres and health centres.
Completing a course of PR is a good way to learn how to exercise safely and at the right level for you. Most people enjoy the course. It builds confidence and it’s great fun meeting others in a similar situation.
‘When I started the course, I could barely walk 500 metres before becoming too breathless to continue. By the end of six weeks, I could walk 1500 metres. It’s not about getting better - it’s about living better with my condition’ John
- improve your muscle strength so you can use the oxygen you breathe more efficiently
- help you cope better with feeling out of breath
- improve your fitness so you feel more confident to do things
- help you feel better mentally
PR helps you manage your condition and makes you feel better, but it’s not a cure. You’re unlikely to see a change in your lung function, so you may not see a difference in breathing test results. What it can do is help you make the most of the lung function that you have. There’s evidence that it improves your ability to walk further, helps you feel less tired and breathless doing day-to-day activities and reduces your risk of ending up in hospital.
‘Thank you for giving me my life back’ Val
PR is aimed at people with a lung condition whose ability to be active is affected by breathing difficulties.
Most people who go to PR have chronic obstructive pulmonary disease (COPD), but people with other long-term lung conditions can also benefit, such as bronchiectasis and pulmonary fibrosis. It’s recommended for people coming out of hospital after a COPD flare-up.
If you struggle with walking, have uncontrolled heart problems or have recently had a heart attack, PR might not be suitable for you at the moment.
You can do PR if you use oxygen
People who use oxygen to help manage their condition will be assessed to see if a portable oxygen cylinder is needed during the class. If you’ve been prescribed oxygen and told that your oxygen levels drop when you exercise, portable oxygen treatment may increase how much exercise you can do.
Your GP, practice nurse or respiratory team can refer you for PR. Ask them if PR is right for you and what’s available in your area.
Some programmes will have waiting lists, so the sooner you act, the sooner you can start. If you’re told you’re not eligible for PR, you could try other ways of being active.
“Once I started, it just got easier and easier!”
Bob was diagnosed with COPD in his 60s.
“When I first started feeling chesty, I was diagnosed with asthma. Whenever I felt worse I’d use my inhaler and my symptoms would steady off. But some years later I started to get really breathless and was re-diagnosed with COPD.
Within months my breathlessness forced me into early retirement. But then I wasn’t getting any exercise and the breathlessness started to show even more. I couldn’t take care of my allotment any more. That helped me make up my mind to do something about it.
That’s when I discovered pulmonary rehabilitation. I felt so much better straight away! I realised how easy it was to get back into shape. And once I started, it just got easier and easier!
I go to the gym three times a week now, and spend ten minutes on a bike, on a rowing machine and on a stepper. In between, I lift weights.
Starting PR isn’t easy – the initial push is really hard. But I’m so glad I took the plunge.”
A typical PR course will always start with an assessment of your health and abilities. Your PR team will ask questions to understand you and your body, so they can help you get the best out of the course.
At each session, you’ll spend about half the time on physical exercise. This will be designed to provide the right level of activity for you. You’ll get out of breath, but this is part of the therapy. You’ll always be monitored and won’t be asked to do more than you can do safely.
Information and discussion
For the rest of the time, you’ll learn about topics such as:
- why exercise is so important for people with lung conditions
- how to use breathing techniques during physical activity or when you feel anxious
- how to manage anxiety and low mood
- how to use your inhalers and other medicines
- how to eat healthily
- what to do when you’re unwell
‘I am loving this group. We do as much exercise as we can for the first hour, then a cuppa and a talk. Brilliant. It has helped so much to lift my spirits.’ Jude
For PR to really work you need to be committed, attend sessions regularly and follow the advice given by your team.
After you’ve completed your course, it’s important to continue being active by using the techniques you’ve learned. Your PR team might refer you to a follow-up exercise programme – ask them if this is an option. Or try one of the other ways we’ve suggested to keep active.
3 reasons to love pulmonary rehab
Three people with lung conditions tell us the different ways pulmonary rehab helped.