Pulmonary Rehabilitation

April 7, 2013 | By | Reply

- Dr. Soma Jaldhari

Pulmonary Rehab

Pulmonary rehabilitation (PR) is an integral part of physiotherapy which involves dealing with patients having cardio – pulmonary (heart and lungs) problems.

Who requires PR?

It involves handling the patient who has undergone a heart or lung surgery and also for maintenance of patients suffering the following conditions:

  • Pneumonia
  • Bronchiectasis (COPD)
  • Cystic fibrosis
  • Asthma
  • Cardiac bypass surgery
  • Atelectasis
  • Lung abscess
  • Interstitial lung disease

Aims of PR:

It is important to do PR when suffering from any of the above listed conditions because the aim of PR is to maintain bronchial hygiene in terms of:

  • mobilizing and loosening the sputum in the lungs
  • improve lung capacity
  • maintain the heart’s function
  • improving chest mobility
  • endurance & fitness training and
  • improving quality of life

A physiotherapist also plays an important role in the multidisciplinary team of ICU. Rehab is important to prevent the de-conditioning and weakness due to immobility in the ICU, improve oxygenation, prevent pulmonary complications like lung collapse.

What does PR consist of?

CPT consists of external manual manoeuvres like chest percussion and vibration, huffing & coughing techniques, patient positioning, postural drainage, deep breathing exercises, active cycle of breathing technique (ACBT), thoracic expansion exercises, spirometer, endurance & fitness training.

  • Percussion & vibration – The patient is positioned in a gravity assisted position and manual clapping is done on the patient’s chest so as to remove the sputum

Percussion & vibration

  • Huffing & coughing – These are techniques to further loosen the secretions. Huffing is a minor form of coughing in which patient fills air in his lungs and then breathe out saying a “huh”. This is then followed by coughing to remove the sputum out.
  • Postural drainage – This involves the adoption of different positions which will assist for the sputum to come out. For different sections of the lung the patient is positioned in different positions.

Postural Drainage

  • Deep breathing exercises – These are the exercises to improve the lung function. This involves different types of breathing like “pursed-lip breathing”, “diaphragmatic breathing” which helps the bronchioles to expand for better air exchange.

Deep breathing exercises

  • Active cycle of breathing technique (ACBT) – This is a specialized technique which involves a cycle of – breathing control, deep breathing & huffing. Breathing control is gentle breathing just to relax the airways. Deep breathing is expanding your ribcage while you inhale and emptying the ribcage while you exhale. The picture below shows the cycle of doing it.

Active Cycle of Breathing Technique (ACBT)

  • Thoracic expansion exercises – These are exercises to improve the mobility and expansion of the chest which ultimately helps for better air – entry into the lungs. They involve a combination of deep breathing and upper limbs movements to enhance the ribcage expansion. These exercises are further advanced by the usage of Therabands or weights to start with resistance training for the upper body.
  • Spirometer – It is a device used to perform deep breathing exercises. The advantage of it is that it gives a visual feedback of the performance to the patient and motivates to perform better.


  • Endurance & Fitness training – It is an important part of rehab as the person’s fitness levels reduce to a significant level after having a heart/lung issue. Fitness training involves increasing the activities like walking, static cycling. Endurance training is to train your heart/lungs to perform an activity for a prolonged amount of time so that you can carry out your routine activities without feeling tired, giddy, or falling short of breath.

At PhysioRehab we are all experienced and skilled to deal with the above mentioned conditions and perform the techniques for your betterment.

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