It’s a catch-22. People with chronic respiratory disease are reluctant to exercise because they are afraid of becoming breathless, yet regular everyday exercise will improve their health and quality of life. Respiratory Rehabilitation helps people reduce and gain control over their symptoms through exercise training and patient education.
John Bell smoked a pack a day for 43 years. Now the 73-year old emphysema sufferer is in the maintenance program at Southlake Regional Health Centre in Newmarket. Before he started the rehabilitation program, “I was rusting-up pretty good and could hardly move. A six-minute walk was a killer and lifting 3 or 4 pounds was trouble,” said Bell.
As a result of his work in the respiratory rehabilitation program, Bell said his condition has improved 100%. He is exercising two to three times a week, increasing his time and doing two sets of each exercise: weights, walking and riding the iron bike. But improving is work. Out of the ten people who were in Bell’s original rehabilitation group, he is the only one still attending the Southlake maintenance program. Why? “Some people drop out. It is hard. You go feeling stressed because it is 1 1/2 hours of pushing yourself, but that is the only way you improve.”
Overcoming the depression is even harder. “Ten years ago I was diagnosed with emphysema and spent much of my time feeling sorry for myself. That was before I was referred to the program. It gave me something in life to aim for,” said Bell.
The group support in the maintenance program helps at keeping things positive. “We’ve all been there, we have different triggers but it is all the same problem,” said Bell. His respiratory condition can vary from day-to-day because of these triggers. “I’m what they call weather sensitive.” When the humidity is high and air pressure is heavy, it is harder for him to breathe.
This is where early detection and respiratory rehabilitation programs can help those that are having difficulty coping and in many cases reduce hospital visits. Respiratory rehabilitation intervention is personalized to address the needs of each patient and is implemented by a multidisciplinary team of health-care professionals, including Respiratory Therapists, Physiotherapists, Nurses and other health-care professionals.
Respiratory Therapists (RTs) are specifically trained to assist patients like John Bell. RTs have extensive knowledge of respiratory disease and on how to help patients manage their symptoms. As in any rehabilitation program, the patient’s self-management is the ultimate goal and RTs actively promote this through patient education in hospital and community settings. Learning about disease management helps patients become more independent.
Lise Carrière is a Respiratory Therapist who helps manage the respiratory rehabilitation program at Southlake Regional Health Centre in Newmarket. She offers her expertise in assessing, treating and teaching the patients how to cope with chronic lung disease. “I love the interaction with the patients, spending time with them, teaching them and seeing their progress,” said Carrière.
Carrière also performs a breathing test called simple spirometry, which measures the speed (flow) and volume of air movement in and out of the lungs. These measurements reflect the condition of the patient’s lungs.
Kimberlee Butcher, a Physiotherapist at Southlake develops the patient’s individualized exercise program and closely monitors the patient’s progress over the six weeks. The respiratory rehabilitation program at Southlake includes personalized exercise training and patient education around such topics as medications, correct inhaler and relaxation techniques. A Respiratory Therapist (RT) and a Physiotherapist lead the education classes.
Patients come to the centre three times a week, for approximately three hours per day, for six weeks. After that, the patients are encouraged to continue their exercise program at home or they may join the twice-weekly maintenance program at Southlake Regional. The graduates of the Respiratory Rehabilitation Program are invited to attend monthly support meetings. This enables them to keep in contact with their classmates and with other clients who share similar experiences. Often there are guest speakers to help reinforce the principles of disease self-management. Patients are followed-up by staff at six and 12 month intervals, where quality of life and exercise endurance are measured to determine the lasting effects of respiratory rehabilitation.
Patients may be referred to the respiratory rehabilitation program by their family physician or their respirologist. A pulmonary function test, a chest x-ray and an ECG are arranged and patients must see a respirologist before they are accepted into the program. Most respiratory rehabilitation programs require that patients be non-smokers or be committed to stopping smoking during the program. The reality is, respiratory rehabilitation will be of little benefit if patients continue to smoke.
Respiratory Rehabilitation Programs help people with (COPD) Chronic Obstructive Pulmonary Disease, as well as other chronic respiratory diseases.
COPD includes: chronic bronchitis and emphysemaÑdiseases that are characterized by obstruction to air flow.
The College of Respiratory Therapists of Ontario (CRTO) ensures that anyone using the title “Respiratory Therapist” (RRT) or “Respiratory Care Practitioner” (RRCP) is registered (licensed) with the CRTO and meets the profession standards.
The CRTO is one of 21 health regulatory colleges that regulate health professionals in Ontario.