8&9-Feb Phases of pulmonary Rehabilitation

 

Phases of PR

Impatient phase

1. Check vitals
2. Management of pressure sore
   1. Maintain hygiene
   2. Change bedsheet
   3. Change position
3. Secretion & manipulation
   1. Postural drainage

Chest Physiotherapy

1. Auscultation
2. ACBT (active cycle breathing technique)
3. Thoracic expansion
4. Suctioning
   1. Manual hyperinflation.
   2. Normal breathing exercise
      1. Diaphragmatic breathing
      2. Segmental breathing
      3. Pursed lip breathing
      4. Rectangle breathing
      5. Glossopharyngeal
      6. Breathe hold technique

PEP (positive expiratory pressure)

To maintain normal breathing: -

1. Spirometer
2. Peripheral joint movement
3. Walking (with/without support)
4. Early mobilization (chest pt., breathing exercise, etc.)
5. In the case of angina, early mobilization is not given
6. Ventilator muscle training, respiratory muscle training.
7. Inspiratory & expiratory
8. Patients who can tolerate moderate to severe exercise intensity can do resistance & aerobic training under supervision 
9. Mild to moderate breathing exercises and mobility exercises are prescribed for patients who are not independent enough.

Outpatient phase

1. Increase intensity.
2. Normal breathing exercises with moderate to severe intensity.
3. Resistance exercises than aerobic exercise (cycling, swimming, jogging)
4. Active exercise
5. Ventilator muscle training with mild to moderate intensity
6. Pranayama

Community phase/ pulmonary rehab

1. Patient education- a 30-minute interactive session focusing on the causes, manifestation & management of respiratory diseases.
2. Exercise training- Leg exercise- patients were advised to walk on level ground at a pace not resulting in dyspnea for at least 20min, at least 5 times a week.
3. Respiratory exercise- patients were advised to inhale maximally through a spirometer 20 times daily.
4. Breathing exercise – patients were advised to perform diaphragmatic breathing & pursed lip breathing for 10 minutes daily.
5. Education regarding ADLs.
6. Nutritional support.
7. Physiological support
8. Self-assessment.
9. Home exercise programs