Exam 2: Pulmonary Rehab Flashcards
What is definition of pulmonary rehab?
evidence based practice, multidisciplinary, and comprehensive intervention for patients with chronic respiratory diseases
What is pulm rehab designed to do?
reduce symptoms, optimize functional status, increase participation and reduce health care costs
Why do we pulmonary rehab?
designed to break up the vicious cycle of deconditioning, to decrease SOB with fnxl activity
What are the benefits of pulm rehab?
decreased DOE, increased aerobic capacity, improved QOL
What is important to remember about pulm rehab?
We are not changing lung function!
What are we changing?
improving the efficiency of the muscles, aerobically training muscles so they can utilize O2 better
What is general duration of pulm rehab?
4-18 weeks
2x a week for 4 weeks has shown great improvement
What are major components of pulm rehab?
aerobic conditioning, whole body strengthening, breathing pattern training, inspiratory muscle training, airway clearance, Education
In chronic obstructive diseases what are two major etiologies of impairment?
- gas exchange impairments
- ventilation impairments
- cardiovascular impairments
What are the gas exchange impairments?
decreased surface of alveoli for gas exchange
What are ventilation impairments?
increased work of breathing from flattened diaphragm and weak inspiratory muscles
What will the CP screen look like in these patients?
higher RR, decreased O2 sat, less PaO2, higher resting HR
What are the cardiovascular impairments?
deconditioning from inactivity, decreased pulmonary blood flow due to hypoxia
What does this hypoxia do physiologically?
due to low gas exchange there will be vasoconstriction of the capillaries under the alveoli
What are other etiologies of impairments in patients with obstructive disease?
- muscular impairments- reconditioning and wasting (predinisone)
- symptomatic limitations- dyspnea
- psychological limitations
What are modes of exercise for pulm rehab?
large muscle groups, walking. cycling, swimming, elliptical, NuStep
things to stabilize trunk to increase ventilation
What is the intensity for PR based off?
patients symptoms from initial exercise test
RPE: 11-13
DOE: 1-4
for treadmill walking usually 75-85% of 6MWT
What is general guideline for heart rate intensity?
60-85% of max
What is goal for duration of PR?
15-20 mins, increase duration before intensity
What is frequency for PR?
3 times per week at least, total program should be 4-18 weeks
What should strengths number be for PR?
50-85% of 1 RM, 2-4 sets, 6-12 reps
2-3 x per week
coordinate breathing with this
What is important with pt education?
this engages them in their treatment and are more likely to be proactive with their treatment this also educates them about their disease
What are two types of breathing patterns for pts to learn?
diaphragmatic and pursed lip breathing
What is the benefit of diaphragm breathing?
improve oxygenation, improve ventilation (Vt), reduce work of breathing, alleviate dyspnea at rest, not activity
