Pulmonary Rehabilitation

Breathing comes naturally for most people, but those with chronic lung disease may struggle with every breath. Chronic obstructive pulmonary diseases such as asthma, chronic bronchitis or emphysema affect more than 12 million Americans and are the fourth leading cause of death in the United States. Treatment for the condition often includes pulmonary rehabilitation to help patients control symptoms and improve their quality of life. A pulmonary rehab program also may benefit patients needing lung transplants or other lung surgeries and those suffering from other lung conditions, including cystic fibrosis, bronchiectasis, abnormalities of the thoracic cage and neuromuscular disorders.

Pulmonary rehab usually lasts eight to 12 weeks. It may involve several components, including exercise training, psychosocial support, educational programs and nutrition counseling. Pulmonary rehab is a team effort in which patients may work with physicians, nurses, respiratory, physical and occupational therapists, psychologists, exercise specialists and dietitians. The primary goals of a pulmonary rehab program are to help patients feel more comfortable so they can better handle day-to-day activities and maintain their independence. As an additional benefit, pulmonary rehab also may reduce the need for hospital visits.

Pulmonary Exercise

The exercise portion of the program is designed to improve heart and lung function and strengthen muscles involved in breathing. Lower body training, such as walking or riding a stationary bicycle, can help increase muscle tone and flexibility so it is easier for patients to move around. Upper body training can help strengthen the arm and shoulder muscles that support the ribcage to allow for easier breathing. These exercises also help patients manage daily activities, such as making a bed, carrying groceries or combing hair. Ventilatory muscle training may be recommended for some patients who have weak respiratory muscles that cause breathing problems and impede exercise.

Psychosocial Support

Psychosocial support helps patients deal with emotional stress that may be associated with chronic lung disease. Some patients could become depressed or anxious about their health and have growing concerns about body image, loneliness, low self-esteem, lack of social support or relationships with others. Patients may be taught relaxation skills or encouraged to talk about their feelings to help deal with these issues.

Pulmonary Educational Programs

Educational programs for pulmonary rehab can cover a variety of topics. Information may range from breathing retraining and strategies for managing breathing problems, to how the lungs work and how to travel with lung disease. Patients can learn through one-on-one instruction, group classes, written materials or audio/visual aides. Educational sessions and counseling also may be available to help patients stop smoking.


Information about nutrition is typically given to pulmonary rehab patients because fatigue, difficulty swallowing or poor appetite could hinder their ability to follow a balanced diet. Nutritional counseling also helps with weight management and teaches patients how to prepare and time meals so they do not experience increased shortness of breath. For more information about pulmonary rehabilitation and how it can benefit you, talk with your doctor or call 561-637-5318 for a free referral to a physician near you.

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Bladder Leakage After Childbirth


During pregnancy and after childbirth, many women experience at least some degree of involuntary urination, called urinary incontinence.

“The pelvic floor is a band of muscles that span the entire pelvis to the sacrum supporting the bladder, uterus and rectum. When you’re pregnant, the baby rests on these hammock-like muscles. As the baby grows, the muscles stretch and dip to accommodate the weight. Add in a vaginal birth and there’s a lot of stress and stretch put on those muscles leading to potential forms of incontinence,” says Dr. Hsin Wang, general OB/GYN with a special emphasis in urogynecology at the DMC Huron Valley Sinai Hospital.

Incontinence can mean a leaky bladder with certain situations such as sneezing or activities like jumping or walking or sometimes just with the urge. It can happen every now and than, or daily and it can be compounded by weight gain, other conditions or diseases. Issues can show up right after childbirth or years later.

Many women may feel shame or embarrassment about this change in their bodies, and assume there is no solution. However, incontinence is not only very common, but also responds to a number of noninvasive treatment options.

“As moms and women, we tend to put our needs last. So, when you sneeze and wet yourself, you say, ‘I’ll just deal with it.’ A few years go by and now you wet yourself while working out or gardening… again, you just deal with it. The next thing you know, you’re buying pads because you’re wet daily and you just deal with it. But, you don’t have to. Physical therapy is a great way to correct your leaky bladder at any age or stage,” says Dr. Wang.

At the DMC Rehabilitation Institute of Michigan, certified pelvic floor physical therapists work with you on how to improve your pelvic floor muscle control. Therapists train you on how to properly do Kegel exercises and evaluate and strengthen any other potential orthopedic issues that may contribute to your leaky bladder.

“Within six months, I have such a high percentage of my patients that see a reversal in bladder dysfunction because of physical therapy, I always tell my patients, it’s never too late.”

Urinary incontinence is recognized as a preventive care measure and is covered by insurance. Contact the Rehabilitation Institute of Michigan to schedule an evaluation at one of their outpatient facilities by visiting RIM Rehab Incontinence Therapy.