Table 1. Special considerations for pulmonary rehabilitation in people with conditions other than chronic obstructive pulmonary disease.
Exercise training | Non-exercise components | |
Asthma | Assess for exercise-induced bronchospasm If present, pre-medicate with a rapid-acting inhaled β2-agonist prior to exercise and include a gradual warm-up | Consider breathing retraining techniques with known efficacy in asthma Self-management training includes education, goal setting, a personalised written action plan, self-monitoring of key symptoms and a review of asthma control, treatment and skills |
ILD | Ensure supplemental oxygen is available Provide close supervision for individuals with severe disease and marked exercise-induced desaturation In connective tissue-related ILD, consider modifications to avoid joint pain | Consider addressing management of mood disorders, optimising activities of daily living, use of oxygen therapy, lung transplantation and advance care planning Consider linking with support groups and education services appropriate to underlying diagnosis (e.g. rheumatoid arthritis) |
PAH | A recent history of syncope on exertion is a contraindication to exercise training Monitor PAH-specific symptoms during exercise, e.g. palpitations, chest pain, light-headedness and dizziness | Education regarding self-monitoring of PAH symptoms during exercise |
Non-CF bronchiectasis | Consider inspiratory muscle training | Initiate or review airway clearance techniques |
NSCLC | Duration of pre-operative rehabilitation programme may be shorter than normal so as not to delay cancer treatment Consider alternative forms of exercise training to enhance participation in people undergoing chemotherapy | Ensure a comprehensive interdisciplinary approach Consider nutritional and psychosocial counselling, behavioural change, occupational therapy and progressive relaxation techniques |
ILD: interstitial lung disease; PAH: pulmonary arterial hypertension; CF: cystic fibrosis; NSCLC: nonsmall cell lung cancer.