Can Pulmonary Rehab Benefit COVID-19 Patients?

As a respiratory disease, COVID-19 can affect your lungs. Even people who didn’t experience serious symptoms while infected could develop long-term effects.

Pulmonary rehabilitation may help some people who are dealing with these effects.

How Does COVID-19 Affect the Lungs?

COVID-19 can affect the lungs in the short term and/or long term. Shortness of breath is one of the most common symptoms of COVID-19. Some people may develop pneumonia or scarring in the lungs. Patients with severe cases of COVID-19 may need oxygen support.

COVID-19 also can affect other parts of the respiratory system, like the heart, muscles, and blood. It may cause cardiomyopathy, muscle pain and weakness, and more.

Many people develop long-term symptoms like chronic fatigue, breathing problems, “brain fog,” heart palpitations, and other issues. Known as “long COVID,” these symptoms can linger for months after your initial illness goes away. Even people who didn’t experience symptoms when they were first sick with COVID-19 can develop long COVID.

Some patients dealing with respiratory effects from either an acute COVID-19 illness or long COVID could benefit from pulmonary rehabilitation.

What Is Pulmonary Rehabilitation?

Pulmonary rehab is an exercise and education program for patients with lung disorders. These conditions cause lung dysfunction and can affect their ability to exercise or perform daily tasks.

“In general, we consider pulmonary rehab in somebody who has activity or exertional intolerance and has underlying lung issues — has underlying COPD, pulmonary fibrosis, or cystic fibrosis,” says Frank Sciurba, MD, medical director, Pulmonary Physiology Laboratory, Division of Pulmonary, Allergy and Critical Care Medicine, UPMC. “Their lung impairment prevents them from engaging in activity, and then, downstream, they get inefficiency deconditioning in their muscles.

“If you’re short of breath and you don’t move, and you don’t exercise, you get a vicious spiral of inactivity — more deconditioning, more shortness of breath, more inactivity, more deconditioning, shortness of breath. So, we try to break this cycle.”

Pulmonary rehab tries to help patients improve their day-to-day living. Through exercise and education, they learn how to manage the effects of their lung condition.

The exercises don’t actually improve lung function, Dr. Sciurba says. But they can benefit the other parts of the respiratory system, like the blood, heart, and muscles.

“By improving the muscle and the cardiac function, it decreases the burden on the lungs so that we’re more efficient,” Dr. Sciurba says.

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How Does Pulmonary Rehab Work?

After a doctor refers you to pulmonary rehab, the pulmonary rehab team will take a medical history. You also may take a physical assessment that could include balance, cardiac, and frailty tests.

No two patients are the same. So, the pulmonary rehab team will create an individual program for you based on your medical history and physical well-being.

“Every patient has their own exercise plan, even though they’re exercising in a group session with other patients,” says Shawn McCurdy, manager, UPMC Pulmonary Rehabilitation. “They’re each following their own plan that we’ve created based on their medical history and those assessments.”

Pulmonary rehab consists of sessions that can last anywhere from 30 to 75 minutes. Patients may attend two to three sessions per week, for eight to 12 weeks.

A pulmonary rehab session may include:

  • Aerobic exercises (treadmill, recumbent bicycle, elliptical, etc.).
  • Endurance exercises for the upper or lower body.
  • Resistance training (dumbbells, resistance bands, etc.)
  • Balance exercises.
  • Stretching.

Your session may include education on how to manage your underlying condition. You may also learn breathing techniques or get nutritional tips. Because your condition may also affect your mental health, you also can seek mental health support through pulmonary rehab.

Your pulmonary rehab team may include:

  • Exercise physiologists
  • Respiratory therapists
  • Clinical psychologists
  • Nutritionists
  • Social workers
  • Your referring doctor or nurse

Benefits of Pulmonary Rehabilitation

Pulmonary rehab may not improve your actual lung function. But by targeting the other aspects of your respiratory system, it can improve your symptoms.

Many people with lung conditions have fallen into inactivity because of their breathing problems. That inactivity only makes the breathing problems worse.

The goal of pulmonary rehab is to improve your condition.

“It engages folks to gain the confidence to be active, to exercise again, which translates again into their activities of daily living and the quality of their lives,” Dr. Sciurba says. “And it decreases the symptoms and the discomfort with exercise and activity and the activities of living. That’s the key thing that we’re trying to accomplish.”

When your time in pulmonary rehab is over, McCurdy says, the goal is for you to be able to continue your exercises in a home or gym setting. If you’re able to move and perform tasks better, you may feel an emotional benefit along with a physical one.

“We use some surveys, one of them being the hospital anxiety and depression scale,” says Kayla Kline, program coordinator, UPMC Pulmonary Rehabilitation. “And a lot of patients have improved their ratings of anxiety and depression, so it’s gotten better from starting to finishing pulmonary rehab.”

Are COVID-19 Patients Candidates for Pulmonary Rehab?

Not every patient with COVID-19 or long COVID is a perfect candidate for pulmonary rehab. But many patients can benefit from it if they’re dealing with the effects of COVID.

“One of the goals for us is to help our patients build the confidence that they can still do the activities they were doing before COVID,” Kline says. “And then, we’ve actually seen a lot of them get off of oxygen after coming to us. That’s one of the benefits of coming to rehab, is that we’re going to monitor you and make sure that you’re safe with or without the oxygen.”

If you’re feeling short-term or long-term breathing effects from COVID-19, you may benefit from pulmonary rehab. Talk to your doctor to see if you’re a candidate.

For more information on UPMC Pulmonary Rehabilitation, visit our website.

Sources

American Lung Association, How Pulmonary Rehab Helps You Breathe. Link

American Lung Association, Learn About COVID-19. Link

About Pulmonology

For people with breathing problems, allergies, and other lung conditions or diseases, UPMC’s pulmonary experts can help. Our Comprehensive Lung Center provides cutting-edge diagnosis and treatment for diseases of the respiratory and pulmonary systems, whether the condition is acute or chronic. We also operate specialty centers for cystic fibrosis, asthma, COPD and emphysema, pulmonary hypertension, lung transplants, interstitial lung diseases, and sleep disorders. Find an expert near you.