1. Pulmonary Rehabilitation Why Get Your Patient Involved?
Presented by
Angela Byers BSBA, RRT

2. I have no relevant financial relationships to disclose.
Disclosure
I have no relevant financial relationships to disclose.

3. What Is Pulmonary Rehabilitation
Pulmonary Rehabilitation is a service that is designed for those who experience chronic lung problems such as:
Chronic Obstructive Pulmonary Disease (COPD)
Emphysema
Chronic Bronchitis
Sarcoidosis
Pulmonary Hypertension
Interstitial Lung Disease
Pulmonary Fibrosis
Lung Cancer and lung caner surgery
Lung volume reduction surgery
Lung transplantation

4. Pulmonary Rehabilitation includes exercise classes and education about the patient’s lung disease or condition
Pulmonary Rehabilitation may help the patient participate in activities with less shortness of breath
It will also teach the patient how to “live” better with their condition

5. Pulmonary Rehabilitation – An Individualized Patient Focused Program
Pulmonary Rehabilitation Benefits
Pulmonary Rehabilitation assists in improving the patient’s quality of life
Pulmonary Rehabilitation cannot cure the patient’s lung disease, it can be of great benefit and improvement in breathing effort and less breathing problems
Pulmonary Rehabilitation improves stamina while educating the patient reducing exacerbations

6. Pulmonary Rehabilitation – An Individualized Patient Focused Program
Additional benefits
Decrease the symptoms of the patient’s disease or condition
The patient will have the ability to function better in their daily lives
Increased exercise tolerance
Decrease in symptoms and better management of anxiety and depression
Pulmonary Rehabilitation allows the patient to make the most of the limited lung function they have

7. Additional Education
Reduce and control breathing difficulties and other symptoms
Targeted toward the patient’s specific lung disease
Treatment options
Chronic disease coping strategies
The patient is taught self management strategies for their disease reducing their dependency on costly medical resources, leading a more independent life
Maintenance of healthy behaviors such as:
Smoking cessation
Good nutrition
The Importance of exercise

8. Educational Programs Offered
The education classes focus on various lung pathologies individualized to provide the patient with information about:
Inhaled medications
Proper use of inhalers
Side effects
Self care techniques
Diet, nutrition, weight management
Breathing retaining
Importance of exercise
Strategies for managing breathing problems
Self-management tool for symptom assessment and knowledge about when to seek early medical treatment minimizing hospitalizations

9. Educational Programs Offered
Monitored and supervised exercise
A physical activity plan is tailored to the patient’s needs
Exercise will help improve their endurance and muscle strength
This helps the patient to be able to carry out daily activities
Psychosocial support
Patients who have chronic lung diseases are more prone to:
Depression
Anxiety
Other emotional problems
Pulmonary Rehabilitation programs offer counseling or support groups

10. AACVPR Certification
Founded in 1985, The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) is a multidisciplinary professional association comprised of health professionals who serve in the field of cardiac and pulmonary rehabilitation
Program certification sponsored by the AACVPR for Cardiac and Pulmonary programs, is the only peer-reviewed accreditation process designed to review individual facilities for adherence to standards and guidelines developed and published by the AACVPR and other professional societies

11. AACVPR
AACVPR certification is done every two years based on patient outcomes and standards that are set forth by the AACVPR based on staff competencies in
Diseases not related to COPD
Exercise testing
Exercise training
Psychosocial management
Tobacco cessation
Emergency response for patient
and program personnel
Universal standards and
precaution
Patient assessment
Dyspnea assessment and management
Oxygen assessment, management and titration
Collaborative self management
Medication and therapeutics

12. Individualized Treatment Plan
The Individualized Treatment Plan (ITP), is a summary of the care planned for each patient from initial assessment to completion of the Pulmonary Rehabilitation program
In accordance with CMS Guidelines, a physician’s signature is required at initial ITP assessment and at least every 30 calendar days thereafter, including their completion of the Pulmonary Rehabilitation program
The initial ITP includes the initial exercise prescription based on METS determination from
History
CAT Assessment
PHQ9
6 Minute Walk Test
Arm Curls
Chair stands

13. ITP Required Elements
In all AACVPR Program Certified programs, an ITP must be developed and completed for each patient in the program and must include all of the following
Exercise tolerance
Nutrition needs
Psychosocial support
Oxygen requirements
Other Core components
Tobacco cessation
Diabetes
Environmental
Inhaled medications
Management of exacerbations

14. Questions Angela Byers BSBA, RRT, Program Coordinator 317-528-4973

15. References
American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), 330 N. Wabash Avenue , Suite 2000, Chicago, IL 60611
Efficacy of supervised maintenance exercise following pulmonary rehabilitation on health care use: a systematic review and meta-analysis.
Jenkins AR, Gowler H, Curtis F, Holden NS, Bridle C, Jones AW.
Int J Chron Obstruct Pulmon Dis Jan 10;13: doi
: /COPD.S eCollection 2018.
Personalized pulmonary rehabilitation in COPD.
Wouters EFM, Wouters BBREF, Augustin IML, Houben-Wilke S,
Vanfleteren LEGW, Franssen FME.
Eur Respir Rev Mar 28;27(147). pii: doi: / Print 2018 Mar 31.

16. References
Survival following pulmonary rehabilitation in patients with COPD: the effect of program completion and change in incremental shuttle walking test distance.
Houchen-Wolloff L, Williams JE, Green RH, Woltmann G, Steiner MC, Sewell L, Morgan MD, Singh SJ. Int J Chron Obstruct Pulmon Dis.
2017 Dec 20;13: doi: /COPD.S eCollection 2018.