PULMONARY REHABILITATION

PULMONARY REHABILITATION

TRI DAMIATI .P, Dr.Sp RMPHYSICAL MEDICINE AND

REHABILITATIONFKUP/RSHS

2011

DEFINITION

COMPREHENSIVE TEAM APPROACH THAT PROVIDE PATIENTS WITH THE ABILITY TO ADOPT TO THEIR CHRONIC LUNG DISEASE, IT INCLUDES MEDICAL MANAGEMENT, TRAINING AND COPING SKILLS AND EXERCISE RECONDITIONING

AGUSTA ALBA ;CONCEPT IN PULMONARY REHABILITATION, BRADDOM

DEFINITION OF RESPIRATION

1. PROCESS OF MOVING OXYGEN FROM THE AIR TO ALVEOLI OF THE LUNGS BY A MASS MOVEMENT OF AIR AND REMOVING CARBON DIOXYDE FROM ALVEOLI BY THE SAME MOVEMENT

2. THE CIRCULATORY SYSTEM PROVIDE THE TRANSPORT OF OXYGEN BETWEEN LUNG AND THE TISSUE

H.FREDERIC HELMHOZ,JR, HENRY H.STONNINGTON

PULMONARY REHABILITATION, KRUSEN

PHYSIOLOGICAL BASIC OF DISORDERS OF RESPIRATION

1. INADEQUATE TRANSPORT OF OXYGEN IN AND CARBON DIOXYDE OUT OF THE LUNG

2. RETENTION OF CARBON DIOXYDE

3. LACK OF OXYGEN

THE CAUSE OF THE RESPIRATORY DISORDERS

1. MUSCLE WEAKNESS OR INEFFICIENCY OR INCREASING OF ELASTIC COMPONEN

2. INCREASE RESISTANCE TO AIRFLOW THROUGH THE TRACHEOBRONCHIAL TREE

ELASTIC COMPONENTS ARE

LUNGS THORACIC CAGE DIAPHRAGM ABDOMINAL COMPLEX ACCESSORY MUSCLES

THE RESPIRATORY DISORDERS ARE CLASSIFIED AS

1. RESTRICTIVE DISORDER

2. OBSTRUCTIVE DISORDER

RESTRICTIVE DISORDERS ARE CHARACTERIZED BY

1. AN INCREASE IN ENERGY REQUIREMENT TO OVERCOME ELASTIC RECOIL OF LUNG OR CHEST STRUCTURES AT ANY GIVEN VENTILATION

2. REDUCED VITAL CAPACITY

OBSTRUCTIVE DISORDER CHARACTERIZED BY

1. RESISTANCE TO AIRFLOW --- AIRFLOW STOP BEFORE EMPTYING IS COMPLETE --- AIR TRAPPING

2. FIXATION THE CHEST IN A POSITION LARGER THAN THE NORMAL END-EXPIRATION LEVEL

3. INCREASE IN THE FUNCTIONAL RESIDUAL CAPACITY AND RESIDUAL VOLUME

OBSTRUCTIVE DISORDER CHARACTERIZED BY

4. FLATTENING OF THE DIAPHRAGM

5. LESSEN THE USE FULLNESS OF THIS MUSCLE IN INSPIRATION

PULMONARY REHABILITATION GOALS

1. IMPROVEMENT IN CARDIOPULMONARY FUNCTION

2. PREVENTION AND TREATMENT OF COMPLICATION

3. RECOGNITION AND TREATMENT OF STRESS AND DEPRESSION, WHICH CAN INTERFERE WITH COPING MECHANISM AND INDEPENDANCE


4. FACILITATION OF COPING MECHANISM TO OVERCOME ANY SENSE OF LOSS, LOSS OF CONTROL OF PERSONAL AND SOCIAL RELATIONSHIP, SELF ESTEEM, OR SENSE OF SELF WORTH

5. PROMOTION OF INCREASING PATIENT RESPONSIBILITY FOR HIS OR HER OWN CARE AND WELL-BEING

6. DECREASE NUMBER OF EXACERBATION , EMERGENCY ROOM VISIT AND HOSPITALIZATION

7. TO UNDERSTANDING THE DISEASE SO THAT PATIENTS AND FAMILLY CAN CONFRONT IT REALISTICALLY


8. RETURN TO WORK AND/OR A MORE ACTIVE , PRODUCTIVE, AND EMOTIONALLY SATISFYING LIFE FOR THE PATIENT AND HIS FAMILY

COMPONENT OF PULMONARY REHABILITATION FOR OBSTRUCTIVE

DISORDERS

1. MEDICATION (MOST OF THEM ARE DONE BY PULMONOLOGIST)

2. EDUCATION3. CHEST PHYSICAL THERAPY4. UPPER EXTREMITY EXERCISES5. RECONDITIONING6. PSYCHOSOCIAL SUPPORT


DISORDERS

2. EDUCATION- THE MOST IMPORTANT IS SMOKING

CESSATION- CHANGING IN LIFESTYLE TO ADAPT THE DISEASE- UNDERSTAND THE DISEASE- UNDERSTAND THE GOALS AND THE BENEFIT OF

THE REHABILITATION PROGRAM


DISORDERS

3. CHEST PHYSICAL THERAPYA. APPLICATION OF PHYSICAL METHOD TO THE RESPIRATORY CARE OF PATIENS WITH

PULMONARY DISEASE

B. THE COMPONENTS ARE1. CONTROL BREATHING

- RELAX POSITION- BREATHING EXERCISE

PURSEDLIPS BREATHINGSLOW DEEP BREATHINGDIAPHRAGMATIC BREATHINGSEGMENTAL BREATHING

The Aim of Control Breathing:A. HELP THE PATIENTS RELIEVE AND

CON- TROL BREATHLESSNESSB. IMPROVE VENTILATORY PATTERNC. PREVENT DYNAMIC AIRWAY

COMPRESSIOND. IMPROVE GAS EXCHANGE

The aim of Pursed-lips and Diaphragmatic Breathing:

A. SLOW EXPIRATORY PHASEB. MAINTAIN THE AIRWAY PRESSUREC. DECREASE THE RRD. INCREASE TIDAL VOL


DISORDERS

2. CLEARENCE OF SECRETION- POSTURAL DRAINAGE- CHEST PERCUSION AND VIBRATION- CONTROL COUGHING

3. TRUNK FLEXIBILITY- NECK- COMPONENT SHOULDER GIRDLE- TRUNK


DISORDERS

4. UPPER EXTRIMITY EXERCISES

A. STRENGTHENING OF THE UPPER BACK MUSCLES

B. STRENGTHENING OF THE UPPER EXTRIMITY MUSCLES

C. RANGE OF MOTION EXERCISE OF THE SHOULDER-GIRDLE COMPLEX


DISORDERS

5. RECONDITIONING AEROBIC EXERCISES

1. INTENSITY DEPENDS ON THE EXERCISE TESTING

2. DURATION 20 – 30 MINUTES3. FREQUENCY 3 – 4 TIMES AWEEK

WALKING, JOGGING, CYCLING, ERGOCYCLE,TREADMEAL,SWIMMING, ETC

6. PSYCHOSOCIAL SUPPORT

1. IS PROVIDED BY WARM AND ENTHUSIASTIC STAFF WHO CAN COMMUNICATE EFFECTIVELY WITH PATIENTS AND DEVOTE THE TIME AND EFFORT NECESSARY TO UNDERSTAND AND MOTIVATED THEM

FAMILY MEMBER SHOULD ALSO BE INCLUDE SO THAT THEY CAN UNDERSTAND THE DISEASE AND HELP THE PATIENT TO COPE

PATIENT SELECTION1. SYMPTOMATIC LUNG DISEASE2. STABLE ON STANDARD THERAPY3. FUNCTION LIMITATION BECAUSE OF

DISEASE4. MOTIVATED TO BE ACTIVELY

INVOLVED IN AND TAKE RESPONSIBILITY FOR OWN HEALTH CARE

1. NO OTHER INTERFERING ON UNSTABLE MEDICAL CONDITION

2. NO ARBITRARY LUNG FUNCTION OR AGE CRITERIA

WHEN ARE THE PATIENTS REFERED TO THE PULMONARY REHABILITATION?

MOSTLY:1. PATIENTS WITH DIFFICULTY IN CLEARING

SECRETION2. PATIENTS WITH DYSPNEA AND HYPOXIC PANNIC3. PATIENT WITH PULMONARY CHRONIC DISEASE4. PRE AND POST THORACIC SURGERY

DON’T PANIC : CONTROL YOUR BREATHING

DON’T PANIC :RELAX YOURSELF

CONTROLED BREATHING ACTIVITY

ACCESSORIES MUSCLES RELAXATION

1. Neck muscles2. Shoulder

muscles3. Chest flexibility

Abdominal Muscles Exercises

Upper Extremity Exercises

Postural Drainage

Documents

PULMONARY REHABILITATION