The inactivity leads to deconditioning and reduction in muscle strength and cardiac function, which exacerbate activity-provoked dyspnea. This anxiety leads to an increased heart and respiratory rate, which in turn increases dyspnea. Anxiety and limitations on activity commonly lead to depression. Pulmonary rehabilitation programs are designed to break the vicious circle of dyspnea by lessening each symptom in the circle. Patient Selection Comprehensive pulmonary rehabilitation programs are effective for patients with significant impairment despite maximal medical therapy.
Education is a key component.
Although some elements of pulmonary rehabilitation may be successfully carried out by a single health care professional, the wide range of services needed often requires the skills of a variety of health care professionals. For example, patients may need exercise training, education, pharmacotherapy, psychosocial counseling, and nutritional guidance, which often require the expertise of a respiratory or physical therapist, a nurse, a physician, a psychologist or social worker, and a dietitian. Communication among team members and with the patient is paramount, and one team member is usually designated as the leader to ensure effective communication and coordination of services. For example, an elderly patient may desire to travel by air to visit a grandchild. Continued encouragement by staff is essential.