Pulmonary Rehabilitation in Elderly Patients

Pulmonary rehabilitation is a comprehensive, patient-tailored intervention, that can be started at any stage of a respiratory disorder. Patients with chronic obstructive pulmonary disease are the biggest referred group, but almost every patient with other chronic lung disorder will benefit from pulmonary rehabilitation program. Contraindications for rehabilitation are sparse: severe cognitive dysfunction, mental illness, unstable comorbidity and dyspnoea at rest. The multidisciplinary care consists of a team of specialists, including pulmonologist, physiotherapist, nurse, clinical psychologist and dietitian. Pulmonary rehabilitation programs include exercise training, education, dietary counselling and psychological support. The basis of respiratory rehabilitation is broadly defined physiotherapy, which increases muscle strength and improves aerobic fitness. Each patient requires an individualized treatment plan. Pulmonary rehabilitation consists of endurance exercises, strength training, interval training, exercises of the chest wall motion, inspiratory muscle training and, in case of neurological disorders, percutaneous neuromuscular electrostimulation (NSE). The effectiveness of rehabilitation should be assessed, which might be difficult in elderly patients. In summary, pulmonary rehabilitation is beneficial in many aspects, as it reduces clinical symptoms, improves physical performance, mental status and patients’ quality of life.