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Physical Medicine Rehabilitation & Clinical Neurophysiology

Pulmonary Rehabilitation

Thanks to the advancement of rehabilitation treatments, chronic respiratory diseases are also included in the scope of rehabilitation and non-pharmacological therapies have gained prominence.Chronic respiratory diseases have become common disorders especially due to the extension of average lifespan. COPD, chronic obstructive pulmonary disease, (including chronic bronchitis, emphysema and asthma) also known as “habitual bronchitis” occurs due to bronchoconstriction. Secondary to the constriction of airways, the patient starts experiencing difficulties in breathing. COPD the is the 5th most common cause of death among pulmonary diseases and the 2nd most common cause of long term disability. Especially smoking cigarette is one of the primary causes of COPD. Other than COPD, lung cancer is also one of the most common reasons for pulmonary diseases. Although not so common, the diseases that scar lung tissues (interstitial lung disease) and cystic fibrosis also cause pulmonary distress, impairing quality of patient’s lives. Cystic fibrosis is a genetic disease with thick, sticky mucus on the secretory gland instead of thin and fluid mucus. This makes expectorating and excreting other secretions difficult to obstruct the airways. In the cases of obstructed bronchi, the patient experience pulmonary problems and frequent infections. Although the primary treatment for these conditions is drug therapy, these medications can only provide limited efficacy. For the last decade, in addition to drug therapies, pulmonary rehabilitation has also started to gain prominence and new therapies have been developed as a result of studies conducted. Pulmonary rehabilitation refers to non-pharmocological therapies administered to maximize the functional capacity of patients with COPD or similar chronic pulmonary diseases. Breathing difficulty and anoxia due to constriction of the airways cause distress and chronic fatigue. The effort to get sufficient levels of oxygen into blood causes respiratory muscle fatigue and weakness.Then, breathing difficulty leads to limitations on daily activities, reduces exercising capacity and induces dependency even for performing simple daily activities. In such cases, pharmacological therapies may fail to provide benefit, emphasizing the importance of pulmonary rehabilitation. COPD, asthma, cystic fibrosis, bronchiectasis and many other chronic lung diseases may be treated in scope of pulmonary rehabilitation. Scientific studies show that pulmonary rehabilitation provides efficacy to increase daily activities for patients with chronic breathing difficulty (dyspnea) and more importantly it significantly reduces dyspnea attacks and the frequency and duration of hospitalization.

Watch Pulmonary Rehabilitation Video

How to Perform Pulmonary Rehabilitation

The patient is assessed by a lung diseasespecialist. If found to be eligible for pulmonary rehabilitation as per the pulmonary function test, an aerobic exercise test is performed. A physiotherapist experienced in pulmonary rehabilitation applies various physical therapy methods (effective coughing, bronchial hygiene, bronchial drainage, postural drainage) and teaches breathing and relaxing techniques. In addition to these therapies, patient is prescribed with strengthening and fitness exercises depending on aerobic exercise capacity.  The treatment program is composed of 10 to 30 usually daily sessions, depending on the functionality of the patient.  The patient is closely monitored throughout the treatment period with computer assisted devices that monitor heart rhythm, ECG, oxygen saturation level and blood pressure.

Novel Treatments

Time consuming and challenging operations by physiotherapists are now carried out efficiently and quickly via computer assisted advanced devices. One of these is “The Vest” which can perform physical therapy by simultaneously pressurizing and vibrating at high frequencies. This device assists patients in airway clearance by excreting secretions accumulated in bronchi. For this therapy, the patient wears the specially designed inflatable vest. The device sends air pressure oscillations to the vest pressuring chest wall and vibrating at high frequencies. This way, it assists patient in excreting mucus retained. The Vest device can provide high efficacy in almost all chronic lung diseases including COPD and cystic fibrosis. Combination of conventional pulmonary rehabilitation methods and novel devices, e.g. The Vest, can reduce pulmonary problems, minimize new infections and the frequency of hospitalization, increase saturation level, improve exercise tolerance, improve patient’s condition and decrease depression symptoms. All of these effects lead to a significant increase in quality of life.


(Pulmonary rehabilitation costs are substantially covered by SSI and special insurance companies.)