Guidelines for Pulmonary Rehabilitation Programs 6th Edition

Provide high-quality pulmonary rehabilitation to patients

Guidelines for Pulmonary Rehabilitation Programs, Sixth Edition, presents the best clinical practice for pulmonary rehabilitation based on current scientific evidence and expert opinion. The newest edition offers guidelines for patient care and serves as the must-have resource for programs to prepare for the AACVPR pulmonary rehabilitation program certification.

Written by an expert team of nationally and internationally recognized authors, Guidelines for Pulmonary Rehabilitation Programs, Sixth Edition, explores the individuated and interrelated components of pulmonary rehabilitation, including initial and ongoing assessment, collaborative patient education, exercise training, psychosocial support, outcome measurement, and disease-specific approaches. Highlighted guidelines are included throughout the book, giving readers easy-to-find guidance for implementing treatment programs and helping patients stay on track.

The updated sixth edition includes two new chapters:

• Pulmonary Rehabilitation Reimbursement explores billing and reimbursement options in the ever-evolving landscape of health insurance.
• Alternative Modes of Pulmonary Rehabilitation discusses alternative rehabilitative service offerings that meet current patient needs and improve program attendance rates.

Incorporating the latest information in nursing, medicine, respiratory therapy, exercise physiology, physical therapy, psychology, and nutrition, the sixth edition of Guidelines for Pulmonary Rehabilitation Programs will assist respiratory practitioners in remaining up to date on the best practices in the field. This text supports practitioners in understanding the components of pulmonary rehabilitation and applying best practices as well as updating and improving their programs to meet AACVPR certification requirements.

Audience

A certification guide and program development tool for AACVPR member pulmonary rehabilitation departments as well as specialists, pulmonary program directors, and nonaffiliated professionals.

Chapter 1. Overview of Pulmonary Rehabilitation
Brian Carlin
Definition
Rationale for Pulmonary Rehabilitation
Pulmonary Rehabilitation and Integrated Care of the Respiratory Patient
History of Pulmonary Rehabilitation
Evidence-Based Guidelines on Pulmonary Rehabilitation
Positioning Pulmonary Rehabilitation Within the GOLD 2025 Guidelines
Telehealth and Telerehabilitation
Summary

Chapter 2. Selecting and Assessing the Pulmonary Rehabilitation Candidate
Connie Paladenech and Jill Ohar
Patient Selection
Patient Assessment
Summary

Chapter 3. Exercise Assessment and Training
Ash Walker, Erik Ostrowksi, and Candace Langston
Rationale for Exercise Training in Chronic Lung Disease
Mechanisms of Exercise Intolerance in Chronic Respiratory Disease
Exercise Assessment
Field Tests (Walking Tests)
Graded Exercise Test and Cardiopulmonary Exercise Tests
Functional Performance Assessment
Exercise Prescription
Volume, Pattern, and Progression of Exercise Training
Resistance Exercise Testing
Other Tests of Muscular Fitness
Inspiratory Muscle Training
Flexibility Training
Patient Safety
Pulmonary Hypertension
COVID-19 and Long COVID
Exercise-Induced Hypoxemia
Home Exercise Considerations
Emergency Procedures
Documentation of the Evaluation and Treatment Session
Summary

Chapter 4. Collaborative Self-Management and Patient Education
Debbie Koehl and Karen A. Edwards
Developing an Individualized Self-Management Program
Implementing Self-Management Training
Summary

Chapter 5. Psychosocial Assessment and Intervention
Sharon Y. Lee and Megan Hays
Assessment of Psychosocial Functioning
Interventions to Improve Psychosocial Functioning
Partnering With a Behavioral Health Provider
Summary

Chapter 6. Nutritional Intervention
Ellen Aberegg, Kelly Ellington, Carolyn Feibig, Wendy, Johnson, and Lauren Trahan
Compromised Nutritional Status in Pulmonary Disease
Diet Intake and Pulmonary Disease
Assessment of Nutritional Status
Referral to Registered Dietitian Nutritionist (RDN)
Nutritional Interventions
Behavior Change Strategies
Education Programming
Summary

Chapter 7. Program Performance and Patient-Centered Evidence-Based Outcomes
Gerene Bauldoff and Brian Carlin
Program Performance Measures
Patient-Centered Outcomes
Timing and Analyzing Outcomes
Patient-Centered Outcome Measures 
Summary

Chapter 8. Disease-Specific Approaches in Pulmonary Rehabilitation
Katherine Menson, Kimberly Hardin, Carolyn Garcia, and Nisha Gidwani
Obstructive Lung Diseases
Restrictive Pulmonary Diseases
Pulmonary Hypertension
Postacute Sequelae of SARS-CoV-2 (PASC)
Lung Cancer
Pulmonary Rehabilitation and the Surgical Patient
Summary

Chapter 9. Program Management
Aimee Kizziar and Karen A. Edwards
Interdisciplinary Team
Staffing Requirements
Program Content and Structure
Administrative Aspects of Program Management
Postrehabilitation Maintenance
Infection Prevention and Control in PR
Strategies for Program Success
Summary

Chapter 10. Pulmonary Rehabilitation Reimbursement
Susan Flack and Chris Garvey
Pulmonary Rehabilitation, Outpatient Respiratory Services, and Medicare
PR, ORS, and Other Insurance Payers
Billing Tools, Guidance, and Resources for Providers
Advanced Beneficiary Notice of Noncoverage (ABN) and Commercial Waiver of Noncoverage (CWN)
Physician Supervision, the Role of Nonphysician Providers (NPP), and Virtual Supervision
Virtual Pulmonary Rehabilitation Models in the United States
Home Health Care (HHC) and Simultaneous Pulmonary Rehabilitation Considerations
Billing Lung Transplant Patients
Pulmonary Rehabilitation Resources
Summary

Chapter 11. Alternative Modes of Pulmonary Rehabilitation
Kariann Drwal, Maria Benzo, and Roberto Benzo
Alternative Models of Pulmonary Rehabilitation
Patient Assessment
Exercise Prescription
Previous Research
Education and Counseling in Alternative Models
Patient Engagement and Behavior Change
Quality Assurance
Staffing and Professional Development
Outcomes and Performance Measures
Policies and Procedures
Summary

Chapter 12. Putting It All Together
Anne M. Gavic, Mark Stout, Dianne V. Jewell, and Ashley Wishman
Measuring the Quality of Patient Care
AACVPR Outpatient Pulmonary Rehabilitation Registry
Pulmonary Rehabilitation Professional Certificate
Pulmonary Rehabilitation Program Certification
Summary

Appendix A: Forms, Questionnaires, and Assessments
Appendix B: Excerpts from Pulmonary Rehabilitation for Adults With Chronic Respiratory Disease
Appendix C: Clinical Competency Guidelines for Pulmonary Rehabilitation Professionals
Appendix D: Example of a Typical Pulmonary Rehabilitation Facility and Examples of Pulmonary Rehabilitation Programs That Meet 2, 3, and 5 Days a Week
Appendix E: Summary of Additional Recommended Guidelines for Pulmonary Rehabilitation
Appendix F: Consensus Statement on the Virtual and Remote Delivery of Cardiac and Pulmonary Rehabilitation and Their Components
 

The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) is dedicated to improving the quality of life for patients and their families by reducing morbidity, mortality, and disability from cardiovascular and pulmonary disease through education, prevention, rehabilitation, research, and disease management. AACVPR is a multidisciplinary professional association composed of health professionals who serve in the field of cardiac and pulmonary rehabilitation. AACVPR also provides educational and professional development opportunities to its members, including cardiovascular and pulmonary physicians, nurses, exercise physiologists, physical therapists, behavioral scientists, respiratory therapists, and nutritionists.