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Breathing Lessons: Why Pulmonary Rehab Works


Medically Reviewed On: November 02, 2004

You probably don't expect to ever have to take classes to learn how to breathe. But that is exactly what participants in pulmonary rehabilitation do in order to once again climb stairs, pick up their grandchildren and generally be as active as possible despite living with chronic lung disease that causes shortness of breath and fatigue.

More than 35 million American are currently living with lung diseases such as chronic obstructive pulmonary disease, which includes emphysema, chronic bronchitis, bronchiectasis and asthma, as well as restrictive lung conditions such as interstitial lung disease. These diseases are incurable and tend to worsen over time, so treatments are given to ease symptoms and slow the progression of the disease. But while pulmonary rehab does not have an impact on the lungs themselves, it can have a dramatic effect on how well people can function with limited lung capacity. Rehab can help participants feel less out of breath and get them into better physical and emotional shape, so they spend less time sitting in hospitals and doctors' offices. Instead, many participants are able to spend their time cooking for themselves or walking next store to chat with a neighbor.

"Pulmonary rehab can improve someone's life by changing what they are able to do," says Lana Hilling, a fellow of the American Association of Cardiac and Pulmonary Rehabilitation (AACVPR) and coordinator of the John Muir/Mt. Diablo Health Systems pulmonary rehabilitation programs in Concord, Calif. "It can mean difference between staying at home and becoming socially isolated and becoming an active participant in life again."

Pulmonary rehabilitation generally consists of six to 12 weeks of group classes led by a respiratory therapist. Pulmonary rehab teams usually include health professionals from different fields: You may find a physician, a physical therapist, an occupational therapist, a nurse, a psychologist and a dietician. Programs are generally, but not always, covered by insurance.

Breathing Basics
Classes often start out with the training designed to help people breathe better. "Most patients breathe very inefficiently," explains Trina Limberg, an AACVPR board member and the director of the pulmonary rehabilitation program at the University of California, San Diego.

People with COPD, for example, have trouble getting air out of their lungs. When airways are damaged, they lose their elasticity and may collapse when someone exhales, trapping air. The trapped air makes it hard to breathe and limits the amount of oxygen that one can inhale. In rehab, patients are taught a technique called pursed-lip breathing, where someone breathes in through their nose for two to three counts and then exhales through pursed lips as if they were blowing out a candle. This technique puts pressure on the airways so they stay open longer, and helps force trapped air out.

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