Rehabilitation includes all measures needed to enable patients with chronic disease (permanent) to lead as normal a life as possible (rehabilitation = restore to health). It is meant to complement the treatment given by your GP, specialist or acute-care hospital.

 

Pulmonary (= lung) rehabilitation
The outpatient (in outpatient treatment the patient can spend the night at home) or inpatient (in a rehabilitation center) pulmonary rehabilitation is recommended by all major treatment guidelines for COPD patients with alpha-1 antitrypsin deficiency and for patients with moderate COPD.

 

Rehabilitation is recommended in patients with alpha-1 antitrypsin deficiency:

• if symptoms persist despite outpatient treatment
• after treatment of the respiratory disease in an acute-care hospital (rehabilitation)
• if their work capacity is impaired or jeopardized
• in cases of imminent need of care and assistance
• in cases of mental disorders (depression, anxiety, social withdrawal)
• in cases where treatment methods typical of rehabilitation are required and cannot be sufficiently provided on an outpatient basis, e.g. training therapy, cessation of smoking
  

 

Applications for rehabilitation treatments must be made to the appropriate institution (pension or health insurance).

 

Rehabilitation law
Anyone who pays national insurance contributions has a right to the measures required to protect, maintain, improve or restore their health and work capacity as well as their financial security in case of sickness or impairment of earning capacity (German law: Article 4, SGB I). With the 2007 Health Reform Act, rehabilitation became a duty of care for health insurance schemes (German law: Article 20, section 2, SGB V). Further information on rehabilitation can be found here.

 

Rehabilitation for alpha-1 antitrypsin deficiency and pulmonary diseases includes:

• Education (understanding the disease)
• Breathing exercises
• Physical training to increase performance and decrease shortness of breath
• Psychological help (coping with disease)
• Nutritional advice
• Help to stop smoking
• Social support (at the workplace, questions about disability and early retirement)

 

Effects of pulmonary rehabilitation
The efficacy of pulmonary rehabilitation has been demonstrated in many research studies.

 

It leads to:

• Increased physical capacity
• Improvement of shortness of breath
• Enhanced quality of life
• Reduction in the number and duration of hospital stays
• Reduction in disease-related anxiety and depression

 

However, alpha-1 and pulmonary emphysema patients tend not to take full advantage of rehabilitation measures. Inpatient rehabilitation should be complemented by outpatient measures, e.g. lung sport, to maintain the success of rehabilitation in the long term.