pulmonary rehabilitation

Understanding Pulmonary Rehabilitation

Patients with chronic respiratory conditions such as Asthma, Chronic Obstructive Pulmonary Disease (COPD) or Interstitial Lung Disease (ILD) often have difficulty with their activities of daily living due to shortness of breath. If you have been newly diagnosed with a chronic respiratory condition or suffer from other conditions such as pulmonary hypertension, cystic fibrosis, or have upcoming lung surgery​​​ your health care provider may have suggested Pulmonary Rehabilitation (PR). Like other respiratory conditions, COVID-19 can cause respiratory complications and lasting lung damage. Some people may also develop “long COVID,” which occurs when COVID-19 symptoms linger for weeks or months after acquiring the initial infection. Some people refer to this group as “long haulers.”

What is Pulmonary Rehabilitation (PR)?

Pulmonary Rehabilitation (PR) is a comprehensive rehabilitation program designed specifically for patients with lung disease that has been shown to improve quality of life and relieve shortness of breath. PR is a two-step program that includes education and exercise to help you learn more about your lungs and your disease.

Your rehab team will often include:
  • Doctor
  • Nurse
  • Respiratory therapist
  • Physical therapist
  • Exercise Specialist
  • Dietitian

Overall, you will learn how to manage your breathing problems, increase your energy, and decrease your breathlessness. Typically, a PR program will be offered in a group setting, allowing you the opportunity to meet others suffering from similar conditions. A community environment allows you to speak with others with similar lung problems, get useful tips, and discuss topics that arise when dealing with a chronic condition.

What is the role of PR in the Treatment of COVID-19?

Some people who recover from COVID-19 may need pulmonary rehabilitation to help them resume normal activities after staying in the hospital, or following periods of prolonged isolation. Pulmonary rehabilitation can help those with decreased strength begin to move more, gradually building up their stamina. PR for those recovering from COVID-19 can help:

  • Restore function to the muscles
  • Reduce the likelihood of mental health conditions that may occur as a result of limited mobility
  • Enable people to return to their normal lives

Step ONE: Education

PR programs help patients to improve their exercise capacity which helps them get back to daily life. The education portion of the program will help you gain a better understanding on how to best manage your breathing problems so that your breathing is not in charge of you. You will also learn things such as how to pace your breathing with your activities, take your medications, and what questions to ask your healthcare provider.

Step TWO: Exercise

Step TWO is the exercise component. PR provides education on breathing techniques to help you cope with the symptom of breathlessness The exercise program is led by the PR staff; they will monitor you as you exercise to ensure your safety. The exercises are designed for your specific needs and will start at a level that you can handle. The amount of time you exercise will be increased in time and the level of difficulty will change based on your ability. As your muscles get stronger, you will be able to exercise longer, be less tired, and have less shortness of breath.


What you learn during PR should be used throughout life to avoid hospitalizations, complications, and other issues. Most importantly, it provides a support system by allowing patients to meet other people with the same experience. Pulmonary Rehabilitation forms an integral part of the comprehensive care of patients with respiratory conditions. Always consult with your doctor before starting a new exercise routine. People recovering from COVID-19 should also seek help if their symptoms are severe or suddenly worsen.



National Institues of Health

American Lung Association

Lungs and the Respiratory System

Lungs are very important since every cell in our body needs oxygen to function. Oxygen is inhaled into your lungs and then moves throughout your body via the bloodstream. Carbon dioxide is then expelled from your body when you breathe out.

The respiratory system also performs other vital roles in your body, such as moisturizing the air you breathe to be the right temperature and humidity level. It also acts as a filter to protect you from harmful substances through sneezing, coughing and swallowing. Let us break down what the respiratory system is and what it does.

Diagram of the Respiratory System

The nose is the main entryway for air into the body. Your nose hairs act as a filter to stop particles that should not enter your body. The mouth is an alternate entryway, especially when the nose is blocked or you are breathing heavily, like during a workout.

The sinuses, or hollow spaces located around the eyes and nose, fill with air and are responsible for regulating the temperature of the air you inhale, as well as humidity.

Inhaled air collects in your throat, which then passes through your windpipe, or trachea. The windpipe splits into 2 separate airways called bronchial tubes— one located in each lung. These 2 bronchial tubes split again into the 5 different lobes in your lungs. Openings in bronchial tubes are supported by cartilage, which is a thick tissue. The end of the tubes split further into bronchioles.

Lining the bronchial tubes are cilia, which are tiny hairs that move mucus out to your throat.

At the end of the bronchioles, there are air sacs, or alveoli. Gas exchange occurs in these tiny air sacs, and according to National Heart, Lung, and Blood Institute, your lungs have around 150 million of them. The air sacs are elastic, so they can expand and contract, allowing them to take in oxygen and expel carbon dioxide.

Capillaries are blood vessels located in the walls of the air sacs. Blood with carbon dioxide is pumped from the right ventricle through the pulmonary artery to the air sacs where the carbon dioxide is released into the lungs. Simultaneously, oxygen from the air within the air sacs diffuses into capillaries that are connected to the pulmonary vein which brings oxygenated blood to the left atrium of the heart to later be pumped throughout the body.

The right lung has 3 different sections called lobes, and the left lung has 2. The lobes contain sponge-like tissue, and it travels through the bronchial tubes in and out of the lobes. The pleura is a pair of membranes around each lobe and acts as a lining between your chest wall and lungs.

The diaphragm is a large muscle that separates your abdominal cavity and your chest cavity. It plays a major role in the inflation of the lungs.

Ribs are the bones protecting everything in your chest cavity. They also help the lungs with expansion and contraction.


Together, your respiratory system is responsible for your breathing without you even realizing it. Each of these smaller parts work together to make up something that is quite complex and fascinating. Staying in good health and taking care of your lungs will ensure your respiratory system functions as it should.




5 Tips to Control Your COPD Symptoms This Fall

Happy Fall! As the weather begins to get colder, breathing can become more difficult. The dry air you are exposed to in the winter can cause flare-ups, also called exacerbations, if you have chronic obstructive pulmonary disease (COPD). Luckily, there are steps that can be taken to reduce the chances of flare-ups and take on the colder months this fall.

Limit your time outdoors.

Being outside in cold and harsh wind can increase your chance of catching a cold, and colds are even worse when you are suffering from COPD.

Patients with COPD

Controlling your COPD this Fall

Practice nasal breathing.

When air travels through the nose, it has time to warm up and humidify before moving to the lungs. Mouth breathing does not have this warming effect, and it results in cold, dry air entering your lungs. To make breathing through your nose easier, be sure to regularly moisturize your nostrils with spray or gel, which is available over the counter at any drug store.

Keep your home at a comfortable temperature.

Dr. Bohdan Pichurk, a Pulmonary physician at Cleveland Clinic in Ohio, recommends keeping your thermostat between 68 and 72 degrees Fahrenheit. A humidifier set at 45 to 50 percent can help reduce your nasal dryness. Adding moisture into the air helps the colder air you breathe not be so dry.

Cover your face with a scarf or blanket when you are exposed to cold, dry air.

This will help warm the air as it enters your body. If you are on oxygen, keeping your portable oxygen concentrator under your coat or warm clothing will help the cannula warm up, allowing the air that enters your body to be warmer and less harsh.

Be mindful of fires.

The fumes from indoor fireplaces or outdoor fires can further irritate your lungs, causing your symptoms to worsen.

Be sure to follow your prescribed medications as directed.

Doctors may alter your medications with extreme weather changes. Taking your medications when you’re supposed to will help your symptoms from worsening.


These small and mindful tips will help cold you conquer the cold weather this season. Belluscura wishes you a happy and healthy fall!



Five breathing exercises for COPD

COPD affects your ability to breathe well, with symptoms including wheezing, shortness of breath and chest tightness. These symptoms can worsen over time, but there are breathing exercises that can help you manage them. Practicing breathing exercises regularly can help reduce your exertion during daily activities and even aid in returning to exercising. The five breathing exercises that are especially useful for people with COPD are:

-Pursed lip breathing

-Coordinated breathing

-Deep breathing

-Huff cough

-Diaphragmatic breathing

Learn how to do these exercises and how they can help people with COPD breathe easier