A Review of Non-Pharmacological Pulmonary Rehabilitation for Patients Receiving Palliative Care

Abstract

Introduction: Dyspnea is common in patients experiencing chronic and malignant lung conditions. It is a very distressing symptom that often results in anxiety and depression. Pulmonary rehabilitation together with palliative care can provide physical, psychological, and quality of life (QoL) improvements in patients that receive it. Methods: This literature review examined articles published in the last 5 years to give a current summary of the scientific literature regarding pulmonary rehabilitation for persons receiving palliative care treatment. Focus was placed on patients with chronic obstructive pulmonary disease, cancer, interstitial lung disease, and Huntington's disease. From an initial 218 articles, 56 met the inclusion criteria for this review. Results: Prominent themes that emerged were the beneficial effects of pulmonary rehabilitation, even in late stages of lung disease, and the positive impact palliative care can have on the patient. Simultaneously, there were considerable barriers to access mentioned throughout the literature, which prevents patients from receiving either pulmonary rehabilitation and/or palliative care at the end-of life. Educating health care providers on the benefits of pulmonary rehabilitation, and providing timely referrals to pulmonary rehabilitation and palliative care is important. Understanding factors which may prompt a patient to attend and complete, or discontinue, pulmonary rehabilitation treatment is important. Conclusion: Although, pulmonary rehabilitation itself is beneficial, meeting the patient where they are at and pairing rehabilitation with patient empowerment and motivating therapies such as mindfulness-based therapy may improve the patient's QoL and care at the end-of-life. Most pulmonary rehabilitation programs are focused and tailored to patients with chronic obstructive pulmonary disease. Exploring how tailored pulmonary rehabilitation programs may be effective in other populations, such as patients with interstitial lung disease, Huntington's disease, and end-stage cancer, is warranted.