Q: 65 year old male is now recovering in ICU after COPD exacerbation. Pulmonary rehabilitation is recommended by pulmonary service.  Out of the following, all are part of the pulmonary rehabilitation in severe COPD patients except? 

A) Lower and upper extremity exercises
B) High dose steroid with tapering
C) Breathing training 
D) Psychological support 
E) Education


Answer: B

Pulmonary rehabilitation along with medical management found to be very effective in patients with COPD who requires hospitalizations due to exacerbations. It consists of four components:

• conditioning, 
• breathing retraining, 
• education, and 
• psychological support 

The Goal of pulmonary rehabilitation is to potentially prevent exacerbations of COPD and use of steroids.



References:

Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013; 188:e13.