Pulmonary Disease
Patients with pulmonary disease include a wide variety of different medical conditions including chronic obstructive pulmonary disease (COPD), chronic bronchitis, chronic emphysema, asthma and asthmatic bronchitis, pulmonary fibrosis, bronchiectasis, cystic fibrosis, pulmonary edema, pneumonia, interstitial diseases (such as interstitial fibrosis), lung cancer, primary pulmonary hypertension and lung transplantation.

Because of their impact on the pulmonary system, other medical conditions such as chest wall disease (spondylitis and kyphoscoliosis) and neuromuscular diseases (such as multiple sclerosis and post polio syndrome) are often appropriate for pulmonary rehabilitation.

Pulmonary Rehabilitation Approach
Following a diagnosis of a pulmonary disease or a decline in overall health and level of function due to a pulmonary disease, it is important to ensure that you or your loved one receives good medical and physical rehabilitation. The pulmonary rehabilitation program at New England Rehabilitation Hospital of Portland is designed for individuals with pulmonary related diagnoses to maximize functional abilities and promote optimal physiologic and emotional adjustment. The team is able to accomplish these goals by:

• Individual assessments of pulmonary and cardiovascular response to exercise by a trained physical and occupational therapist.
• Development of a patient-specific progressive exercise/activities program by the therapy team.
• Providing breathing strategies, airway clearance techniques and tools (such as "chest PT") by therapy and nursing.
• Providing supplemental oxygen education.
• Comprehensive medical management by physician specialists (i.e., internal medicine, pulmonology, physiatry).
• Daily Nursing assessment for all patient needs.
• Dietary consult and education for eating a heart healthy diet.
• Smoking cessation support services.
• Neurobehavioral consult for emotional adjustment or counseling as needed.
• Case Management to assist patients and families to plan for discharge while communicating with medical staff the patients' need for out-patient cardio-pulmonary rehabilitation after discharge from NERHP.
• Patient and family education about the pulmonary disease process and lifestyle modifications will take place on a daily basis or can be scheduled into formal education sessions as needed.

Pulmonary Rehabilitation Goals
With collaboration between the patient and family, the goals of this multidisciplinary program include:

• Independent ambulation with or without an assistive device, such as a walker.
• Independent bathing and dressing with adaptive equipment.
• Improved patient pulmonary exercise tolerance.
• Improved patient airway clearance.
• Ability to pace activity throughout the day so as to not tire easily with one task.
• Ability to use breathing strategies to improve breathing pattern and effectiveness such as pursed-lip and diaphragmatic breathing.
• Proper diet with necessary modifications per pulmonary disease nutritional guidelines.
• Taking all medications as directed by the physician with a basic understanding of the medicines use and effects.
• Ability of the patient to recognize warning signs of pulmonary disease distress with a basic understanding of medication use and effects.
• Ability to utilize strategies to manage stress and anxiety.
• The patient's understanding his or her pulmonary disease and nhow it can be managed within the patient's capability.

The Cardio-Pulmonary Specialty Program
NERHP's Cardiao-Pulmonary Rehabilitation Program adheres to standards established by the American Association of Cardiovascular and Pulmonary Rehabilitation. It is comprised of multidisciplinary team members and uses an outcomes-based approach to rehabilitation. This team meets monthly to continue to develop and improve upon the cardiac rehab program by addressing the ever-changing patient and hospital needs.

Team Members Include:

• Physiatrist
• Program Leader
• Physical Therapist
• Occupational Therapist
• Speech Therapist
• Nurse
• Dietician
• Pharmacist
• Case Manager