There is well-established evidence that a pulmonary rehabilitation program can help patients with COPD in many ways.  However, before going further I want to be clear that pulmonary rehabilitation does not correct or improve lung dysfunction.   Pulmonary rehabilitation helps to improve overall musculoskeletal and cardiovascular function which, in turn, helps to improve overall functional ability.

            Patients undergoing pulmonary rehabilitation can expect to increase their exercise capacity, the loss of which is usually the most frustrating symptom for most patients.  A reduction in hospital readmissions can also be seen in many patients who have completed a rehabilitation program.  There is also a measured improvement in quality of life, and it is this last benefit I wish to comment on today.

            Patients with advanced COPD often experience anxiety and depression.  In fact, these psychological issues often prevent patients from seeking the help they need.  Psychological problems, such as anxiety and depression, occur with higher incidence in patients with severe lung disease than in the normal population.  It has been shown that pulmonary rehabilitation may confer beneficial effects on this disease group.  The mechanism for this beneficial effect is not fully understood, but is felt to be related to improvement in exercise capacity, shortness of breath, and overall improvement in health status.

            There are obvious barriers to having patients participate in formal pulmonary rehabilitation programs including insurance issues, travel, and other physical limiting factors such as cardiac issues and orthopedic problems but, if you can, you should make the effort.