Pulmonary rehabilitation

Respiratory disorders are varied; they can be caused by problems with the lungs, but can also be induced by posture disorders, muscular deficits and/or neurological deficits. Respiratory rehabilitation includes all measures aimed at restoring optimal functioning of the respiratory organs.

Symptoms

When the respiratory system is affected, patients may experience the following symptoms in particular:

  • Shortness of breath: dyspnoea at rest and/or on exertion
  • Sensations of tightness in the chest area
  • Bluish lips, nose and fingertips: a sign of oxygen deficiency
  • Pathological bronchial congestion
  • Difficulty breathing out: obstructive syndrome
  • Difficulty breathing in: restrictive syndrome
  • Abnormal breathing sounds
  • Cough
  • Need for supplemental oxygen

Treatment

Our rehabilitation programmes last from three to six weeks, depending on the therapeutic objectives and the patient's clinical condition, and aim to restore respiratory, motor and cognitive skills.
The therapeutic objectives are defined by a multidisciplinary team made up of specialist doctors, physiotherapists, occupational therapists, speech therapists, neuropsychologists and nurses. They may be :

  • Recovering or improving a degree of independence and quality of life
  • Recover physiological breathing that requires less energy
  • Facilitate inhalation and/or exhalation
  • Preventing or stopping bronchial congestion in order to reduce the risk of respiratory infection
  • Maintain stable oxygenation to encourage the body and all its organs to function properly
  • Act as a link between acute care and the home and provide the necessary equipment at home, in partnership with external organisations.

Physiotherapy for breathing

Physiotherapy plays an important role in pulmonary rehabilitation. Special breathing techniques are used to train patients how to increase their breathing volume. Special techniques are also used to stimulate coughing so that secretions can be expelled.

In the event of cardiorespiratory problems, when the organs and muscles are not supplied with enough oxygen, various mobilisation and strengthening exercises are carried out in order to regain the necessary stamina.

On the basis of a medical prescription, the physiotherapist's assessment and the patient's auscultation, the physiotherapist will be able to offer :

  • Pure respiratory physiotherapy techniques chosen according to the location of the problem in the bronchial tree, e.g. directed ventilation, inspiratory and expiratory techniques, etc.
  • Work with external aids (inspirex, acapella, etc.)
  • Work on posture to encourage breathing
  • Research into physiological respiratory movement
  • Work on the tissues to reduce any tension
  • Work on the diaphragm, the key muscle in breathing
  • Re-training for exercise with or without oxygen
  • Physical activity adapted to the patient's problems

Covid-19

While most patients do not suffer any sequelae following infection with Covid-19, some patients with a medical history or age-related fragility of the respiratory tract require a specific therapeutic programme to boost the capacity of the organs concerned. Other sequelae may also occur, such as musculoskeletal disorders, slipped joint syndrome, brain damage, peripheral polyneuropathy (peripheral nerve damage) or fatigue.

In addition to respiratory physiotherapy, occupational therapy, speech therapy and neuropsychology sessions may be necessary.

Occupational therapy

Occupational therapy aims to help the patient gradually regain independence in activities of daily living.

Goals of occupational therapy:

  • Regaining as much independence as possible in mobility and activities of daily living, for example, washing, dressing, cooking and shopping
  • Restoring motor processes after a loss or reduction of sensitivity
  • Training balance, for example with the Wii Balance Board
  • Helping the patient to resume normal life outside the hospital

Speech therapy and neuropsychology

After a long stay in hospital, some patients suffer from cognitive disorders, such as memory, concentration and speech difficulties.

Our neuropsychological examinations and individual care are part of the therapy to restore the impaired cognitive functions as far as possible.

This enables the patient to resume activities of daily living after returning home.

If intubation was performed due to Covid-19, secondary symptoms such as swallowing and voice disorders may occur.  In this case, speech therapy is carried out. The aim is to restore the patient's swallowing reflex and normal voice.

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