Pulmonary rehabilitation can be tweaked to safely accommodate patients with heart disease and other common co-morbidities, a leading physiotherapy academic has told the conference.
The presence of co-morbidities including metabolic syndrome, muscular skeletal dysfunction, osteoporosis, chronic pain, anxiety and depression is increasingly common in patients with chronic obstructive pulmonary disease, and research has shown this group are more likely to drop out, or never start, rehabilitation, Dr Annemarie Lee from Monash University told delegates attending TSANZSRS 2018.
But research has also shown that not only can standard pulmonary rehabilitation be safely delivered to this sub-group, programmes can be tailored to individual patient’s needs to further improve their outcomes.
“When it comes to pulmonary rehabilitation, there has traditionally been a one-size-fits-all approach,” Dr Lee told the limbic in an interview.
But with most people now showing up with at least one other chronic condition, a standard exercise prescription that would just accommodate a respiratory condition is “no longer what’s done in clinical practice”.
“We need to be looking at the whole person in front of us and see them, not just as a respiratory condition,” she says.
“We need to be able to accommodate a rehab program in terms of exercise and education component to address what is most significant for them, how it fits in with their goals and the management of their overall health problems.”
The modifications will vary depending on the co-existing conditions.
For example, modifications to address pain during exercise may include the use of heat therapy, TENS (transcutaneous electrical nerve stimulation) or substituting traditional exercise for water-based activities.