Post Exacerbation Pulmonary Rehabilitation

What is an exacerbation?

When the symptoms of your lung condition suddenly get worse, it is called an exacerbation. This if often treated in hospital as an inpatient or by a change in your medicine (such as steroids or antibiotics).

What is Pulmonary Rehabilitation (PR)?

Pulmonary Rehabilitation (PR) is a course involving individually tailored exercises to help you manage your breathlessness, gradually increase your fitness level, and understand your lung condition more.

Classes are face to face, twice a week, for six weeks. Each session is up to two hours and involves both education and exercise.

Where are the classes?

We run our PR sessions at Cossham Hospital, Kingswood, Bristol. Sirona community team provide classes in various locations including Bradley Stoke Leisure Centre and the Greenway Centre in Southmead.

Your referral will be sent to the nearest location to where you live. You can tell us if you would prefer to go to another location.

Getting to classes: If you do not have your own transport and are unable to use public transport, please ask a member of the team for advice.

Why am I being offered PR now?

When you have an exacerbation, you may become less active. Even when you are starting to feel better, you may still find it harder to do your daily activities. Doctors have found that starting PR within four weeks of being in hospital after an exacerbation can help patients in the following ways:

• Reduce your chances of going back into hospital.
• Make it easer to do daily activities like walking, climbing stairs, or getting dressed.
• Improve your quality of life.
• Reduce the risk of another exacerbation.
• Help you get back to how fit you were before going into hospital.
• Improve your survival.

It is safe for me?

Your healthcare professional will refer you to PR if they feel it is appropriate for you at this time. The pulmonary rehabilitation specialists will then do a full medical review to check you are safe to participate, and to identify any precautions that need to be taken with you.

How do I get referred?

Your doctor, nurse, or physiotherapist may recommend PR while you are in hospital. If you are not sure if you have been referred please call us.

You should expect a phone call within one to two weeks from being referred to talk about the programme and book an assessment.

Please let us know if you have any questions about PR or why you were referred.

You can have the assessment even if your symptoms are worse than usual; the first part of this is normally done on the phone.

What happens at the assessment?

A specialist physiotherapist will arrange a time to call you. The call will include checking:

• How your lung condition affects your walking and daily activities.
• Your medical history and medications.

After the phone assessment you will be invited to a face-face assessment. The appointment will involve things like taking your blood pressure, completing a walking test, and filling in some questionnaires. You can bring a relative, friend, or carer with you to the appointment.

Once the PR team are happy that you are safe to participate, you will be given a date to start PR within one to two weeks.

We aim to get you started on PR within one month of your hospital admission as research suggests you get the most benefits by participating sooner.

What happens during the classes?

You will exercise alongside other patients with a lung condition. You will be fully supervised to make sure you are confident, safe, and progressing as you should.

Each two hour class is split into one hour of exercise and up to one hour of education about self-managing your condition. You will be required to attend the sessions twice a week for the six week course duration.

Exercise

The specialist physiotherapist and exercise specialists will design a programme specifically for you. This will be based on your goals, medical history, and physical ability from your assessment.

Your programme will include arm and leg exercises using exercise equipment like dumbbells. It will also include aerobic exercises such as walking or step-ups.

Education

The education sessions are designed to give you tools to better manage your condition. Topics include:

• Information about how to manage your lung disease.
• Breathlessness management.
• Inhaler technique and medications.
• How to manage a chest infection.
• Benefits of exercise and how to exercise at home.
• Managing your sputum.

Who can I contact for more information?

You can contact the Pulmonary Rehabilitation Team (LEEP):

• Phone: 0117 414 2010
• Email: leepinfo@nbt.nhs.uk
• Visit our webpage: Lung Exercise & Education Programme (LEEP)

Asthma and Lung UK

• Website: www.asthmaandlung.org.uk
• Phone: 0300 222 5800

Further resources

Do you have any questions or comments about your care?

© North Bristol NHS Trust. This edition published May 2025. Review due May 2028. NBT003628