Overview
Pulmonary Rehabilitation (PR) is an established exercise and education programme designed specifically for people with confirmed diagnosis of COPD, bronchiectasis or intestinal lung disease who experience symptoms of breathlessness.
The idea of exercising may seem daunting especially if you are experiencing breathlessness in your usual daily activities however pulmonary rehabilitation has been extensively researched and evidence shows that by undertaking the course it can:
- – Improve your quality of life
- – Increase confidence with self-management due to an increased knowledge on your condition.
- – Helps you to recognise and self-manage future chest infection/flare-ups.
- – Improved muscle strength and endurance enabling you to walk further and feel less tired and breathless when carrying out everyday tasks such as housework or day-to-day activities.
- – Improves your understanding and technique of taking medications and inhalers.
- – Great way to socialise and meet others.
Using this service
How can I be referred to the service?
In most circumstances you will be referred by your GP, Respiratory Consultant or Respiratory/practice nurse. However, we do accept self-referrals back to the service if we have seen you in the last 12 months.
Once referred, your referral will be triaged by one of our clinicians and you will receive a letter confirming if you have been accepted onto the waiting list.
How long will I have to wait to be seen?
Each referral is triaged on an individual basis. Whilst we are a planned-care service, waiting times can vary. Your confirmation letter you receive after triage will advise you on approximate waiting times for each venue.
Our aim is to assess all patients within three months of receipt of referral. Urgent referrals for patients following an admission to hospital following a chest infection, will be processed within four weeks.
Classes
If assessed as suitable for pulmonary rehabilitation you will be invited to attend a six-week course delivered twice a week (12 sessions)
Where is the class held?
The classes are held at either:
Orpington
Hulbert Hall, Orpington Methodist Church, Sevenoaks Road, Orpington, BR6 9JH
Or;
Beckenham
Ground Floor Group Room, Beckenham Beacon, 379 Croydon Road, Beckenham, BR3 9QL.
What do I bring to the class?
- – GTN spray if you suffer from angina
- – Reliever inhaler such as Salbutamol if you have one prescribed
- – Ambulatory oxygen if prescribed
- – Sensible shoes and loose fitting clothes
- – Reading glasses if you need them
- – Bottle of water
- – A light snack if you are diabetic
- – Please wear trousers or bring some long socks to the class
You will contacted by a member of the admin team to book an assessment at your preferred venue. On the day of the assessment please bring your inhalers, a list of current medications and a recent blood pressure reading, if possible. The assessment will take approximately 1 hour, and will comprise of the clinician asking you about your past medical history including your respiratory condition, some outcome measures and what you wish to achieve while on the course.
Classes are run by specialist respiratory physiotherapists and rehabilitation assistants, who will oversee the class. An individualised physical exercise programme will be devised from the start which will be tailored to individuals’ capabilities with the aim of a gradual progression of both aerobic exercise and resistance training over the following six weeks. Agreed goals will be set.
Following an hour of exercise the group will then receive a 30 minute talk on a variety of subjects including lifestyle support / advice on lung condition and self-management techniques. Topics include:
- – How the lungs work and overview of lung disease
- – Inhaled medication and other medication
- – Breathlessness
- – Nutrition
- – ACBT
- – Self-management plans
- – Exercise /physical activity
- – Talking Therapies
- – Relaxation
The sessions are relaxed, friendly and informal.
You can also bring a spouse or carer for the education sessions.
Interpreters are available.
Airways clearance
Airway clearance is a physiotherapy run service delivering specialist airway clearance advice. Patients referred have an underlying respiratory diagnosis and a main symptom or Sputum Retention.
Treatment options offered include:
- – Active cycle of breathing techniques
- – Autogenic drainage
- – Postural drainage (In conjunction with other airway clearance techniques)
- – Adjuncts (Prescribed by the GP)
- – Nebulised 0.9% saline (Prescribed by the GP
You will need speak to your GP if you feel you need a referral to the service, once referred we will aim to see you for an initial assessment within 4 weeks. Please be aware that waiting times can vary. Once you have been discharged a letter is sent back to your GP and you are able to self-refer back to the service within 12 months.
Location: The Willows Clinic, Red Hill, Chislehurst, BR7 6DA
For professionals
Patients can be referred via EMIS.
Inclusion criteria
- – Patients must be over 18 and have a confirmed diagnosis of a respiratory condition such as chronic obstructive airways disease, chronic asthma, bronchiectasis or interstitial lung disease.
- – The patient is committed and motivated to attend 12 sessions, twice weekly.
- – MRC breathlessness score of 3-5.
- – MRC breathlessness score of 2 will be accepted if affected by breathlessness and frequent exacerbations due to poor management or deconditioning.
Exclusion criteria
*This is not an exhaustive list
- – Unstable cardiac disease
- – Recent myocardial infarction (would require cardiac rehabilitation first)
- – Unstable aneurysms
- – Aortic stenosis
- – Unstable angina
- – Unstable cardiac arrhythmia
- – Uncontrolled blood pressure (diastolic above 100 and Systolic above 180)
- – Poorly controlled diabetes
- – Unable to walk 10m
- – Uncontrolled pain
Other factors to be considered (which may lead to exclusion)
- – Very frail, high risk of falls
- – Low BMI (under 18)
- – Significant and limiting musculoskeletal conditions
- – Recent cataract surgery
- – Recent surgeries (within last 3 months) which may require restrictions to exercise
- – Already attends an intensive exercise class
- – Cognitive impairment where unable to follow instruction / be safe in class
More information
Leaflets
Pulmonary Rehabilitation service
Useful websites
Bromley Well have several useful videos that inform you about their services including What is Bromley Well? and a Long term conditions video
Asthma + Lung UK have produced the following free leaflets that you can read through for extra information:
– Living with Chronic Obstructive Pulmonary Disease (COPD) | Asthma + Lung UK
– First steps to living with COPD | Asthma + Lung UK
– Living with Pulmonary Fibrosis | Asthma + Lung UK
– Idiopathic Pulmonary Fibrosis (IPF) | Asthma + Lung UK
– Living with Bronchiectasis | Asthma + Lung UK
– Breathlessness | Asthma + Lung UK
– Breathlessness management – St Christopher’s Hospice (stchristophers.org.uk)
– Eating well for healthier lungs | Asthma + Lung UK
– How to stop smoking | Asthma + Lung UK
– Home oxygen therapy | Asthma + Lung UK
– RightBreathe provides information and video demonstrations on inhaler prescribing and how to use inhalers correctly.
Video: Active cycle of breathing techniques to help with sputum removal:
Heatwave
– Beat the Heat – Staying Safe in Hot Weather | GOV.UK
– Supporting vulnerable people before and during hot weather | GOV.UK
– Adverse weather and health plan | GOV.UK
– Looking after your lungs in hot weather | Asthma + Lung UK
Air pollution
Advice for the general population: Anyone experiencing discomfort such as sore eyes, cough or sore throat, should consider reducing activity, particularly outdoors.
Advice for at risk individuals: Adults and children with lung problems, and adults with heart problems, should reduce strenuous physical exertion, particularly outdoors *, and particularly if they experience symptoms. People with asthma may find they need to use their reliever inhaler more often. Older people should also reduce physical exertion.
Support group
Asthma +Lung Support Group
Meets on the 3rd Tuesday of every month at 2pm to 4pm at the Victor Childs Room, St Paul’s Church, Crofton Road, (A232), Orpington BR6 8JE
You are welcome to join meetings featuring guest speakers and refreshments.
Calls are recorded for training and quality purposes. To find out more, visit Personal information – Bromley Healthcare.