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Барвиха
Клинический санаторий

Pulmonary rehabilitation

Pulmonary rehabilitation is one of the core programmes of the sanatorium. During 14-21 days of the programme, you will get deep diagnostics of the pulmonary system. Multidisciplinary team of highly qualified professionals using modern techniques and special equipment will provide maximum therapeutic effect with the improvement of the functions of breathing, increase tolerance to physical exercise by 15-20%, normalizing the amount of oxygen in blood. This part of the program uses the recreational facilities of the sanatorium.

This program is for those who:

  • Recently suffered severe pneumonia, acute bronchitis, exacerbation of chronic bronchitis or asthma.
  • Suffer shortness of breath during usual daily activities.
  • Suffer allergic asthma.

This is especially true if:

  • There is increase in the demand of medical care (frequent emergency calls, rehospitalization).

Why "Barviha"?

  • Experienced doctors and medical personnel carry out the programme;
  • The sanatorium has the most modern diagnostic base, in addition to doctors with the highest level of qualification, that ensures the most safe and effective treatment.
  • 24-hour medical and nursing observation of patients. We have all the necessary resources for emergency assistance;
  • Here, we developed unique methods of physical rehabilitation, allowing to increase the level of physical activity as soon as possible and with maximum security.
  • Multidisciplinary medical team works with each patient, i.e. doctors of different specialties: pulmonologist, consulting physician, exercise therapy doctor, physical therapist, nutritionist, neuropsychiatrist, functional diagnostics physician, and laboratory doctor develop and maintain an individual rehabilitation programme. This allows you achieve the best possible results.
  • In the process of rehabilitation our doctors conduct permanent monitoring of patient's condition that provides safety of the medical program, and its maximum effectiveness.
  • The most comfortable conditions for a stay, good food with high standards of restaurant service, great area for walking.

Duration: 18 days optimal, 14 days- minimum.

What is pulmonary rehabilitation?

1st STAGE

General clinical examination performed by your consulting doctor. Study of medical history, identifying risk factors of the disease' development, survey, evaluation of the physical loads tolerance, the state of psycho-emotional status. Survey for further diagnosis and evaluation of the clinical and functional status (3-4 days).

Mandatory examinations and consultations:

  • Blood test clinical;
  • Biochemical blood test (glucose, total cholesterol, triglycerides, a-cholesterol, urea, potassium, sodium, protein, AST, ALT);
  • Electrocardiography;
  • Spirometry and bodypletizmography;
  • Load tolerance test (VEM or treadmill test or 6-minute walking test) under the control of a pulse oximetry;
  • Echocardiography;
  • Chest x-ray;
  • Non-invasive study of hemoglobin saturation of arterial blood with oxygen (saturation-SpO2) with the usage of pulse-oximeter during the day while resting;
  • Computer monitoring pulse oximetry during the night sleep (analysis of more than 20000 measurements per night);
  • Definition of breathlessness on-scale MMRC [9];
  • Borg Dyspnoea index;
  • Consultation by physiotherapist;
  • Consultation by pulmonologist;
  • Consultation by physical therapist;
  • Consultation by phychotherapist;
  • Consultation by nutritionist.

Examinations and consultations due to indications:

  • Coagulogram (with polycytemia);
  • General analysis of sputum (if available);
  • Sputum culture (with purulent or abundant sputum);
  • Bronchodilatory test, diffusing lung capacity (with pathological results of spirometry);
  • Holter ECG (in case of cardiac arrhythmia or ischemic heart disease;
  • Daily monitoring of arterial preassure (in case of arterial hypertension);
  • Polysomnography (if there is a violation of SpO2 during the night basing on this pulse oximetry data);
  • High resolution CT (if diagnosis is unclear with the x-rays);
  • Consultation by a neurologist (if there are neurological symptoms);
  • Consultation by a doctor of restorative sleep unit (in case of sleep-disordered breathing);

BODE index is calculated according the results of the examination.

2d STAGE

Procedure of pulmonary rehabilitation due to individual programme (14-18 days):
  • Physical rehabilitation (dynamic and power load), training of the respiratory muscles;
  • Smoking cessation program;
  • Physiotherapy treatment aimed at improving the drainage function of the lungs: aerosol therapy, intro-pulmonary percussion, nebuliser, chest massage (in the absence of contraindications), electrotherapy of thorax organs (rehabilitation after acute respiratory infections);
  • Oxygen therapy. Long-term oxygen therapy with application of the oxygen concentrator up to 15 hrs per day (having clinically significant respiratory failure of 2nd degree);
  • Non-invasive auxiliary ventilation by continuous positive pressure (CPAP-therapy) or bi-level positive pressure (BiLevel therapy) in the respiratory tract if a patient has obstructive sleep apnea syndrome or chronic night alveolar hypoventilation;
  • Patient education on the basics of physiology and pathology of respiration, training in self-evaluation of respiratory physiology, disease information, self-monitoring for respiratory function, protocol of the exacerbations control, methods of symptoms improvement of the breathlessness, drainage function of the lungs, nutrition rules, training on application of the oxygen concentrator or noninvasive ventilation systems;
  • Psychological rehabilitation. Includes group and individual psychotherapy. Treatment is aimed at the development of the patient's sense of optimism, self-confidence, ability to cope with attack of the disease;
  • Medication;
  • Walking in the fresh air, in vitalizing environment of the pine forest.
  • 3d STAGE

    Evaluation of the effectiveness of the treatment (2-3 days): Follow-up examination to assess the dynamics of the patient’s state, repeated calculation of BODE index, definition of the further treatment and issue of the recommendations on outpatient treatment:
    • Clinical test blood.
    • Electrocardiography.
    • SpO2 monitoring at rest and during a night's sleep.
    • Spirometry.

    Indications for rehabilitation:

    • Chronic obstructive disease without exacerbation;
    • Bronchial asthma;
    • Acute pneumonia (after a course of antibiotics and follow-up x-ray);
    • Often recurrent pneumonia;
    • Breathing disorders during sleep (obstructive sleep apnea syndrome, syndrome of the central sleep apnea, central alveolar hyperventilation during sleep);
    • Condition after resection of a lung;
    • Severe form of obesity;
    • Neurological disorders (spinal muscular atrophy, paralysis of the diaphragm, poliomyelitis, hereditary neuropathy, damage of the spinal cord);
    • Myopathy;
    • Pronounced deformation of thorax (kyphoscoliosis, Bechterew's disease).

    Contraindications:

    • Acute infectious diseases;
    • The presence of comorbidities that may impede pulmonary rehabilitation (severe arthritis, visual impairment, hearing and speech, severe neurological, cognitive or psychiatric disorders);
    • The presence of comorbidities that significantly increase risk of complications in physical training (unstable cardiac angina or old myocardial infarction, severe pulmonary hypertension, pulmonary heart refractory to treatment, unconscious syndrome on exertion, refractory to treatment congestive heart failure, terminal kidney and liver failure, tumor with metastasis);
    • Heavy dependence on drugs, alcohol or other substances and reluctance to stop using them;
    • Terminal stage of the chronic respiratory insufficiency (3d degree);
    • Refusal of the patient from active cooperation (desire to conduct only drug therapy).

    Rodomanchenko Tatyana Vladimirovna, Head of the 2d therapeutic branch, a physician of higher category oversees pulmonary rehabilitation in the sanatorium.

    We invite everyone wishing to undergo pulmonary rehabilitation programme in "Barviha", the best sanatorium of the Moscow region for the treatment of the respiratory system.

    Our best experts have developed an integrated treatment program designed to alleviate the symptoms of lung diseases, prevention of failure or retardation of the respiratory system.

    In sanatorium "Barviha" where diseases of lungs are treated, we created all conditions for recovery and rehabilitation, combined with comfortable rest. We accept all patients, regardless place of residence and social class. Today, this Kremlin health service is available to everyone who needs qualified diagnostics and medical help.

    Treatment of lungs at the sanatorium does not suit to everyone. You should consult a doctor at your place of residence about contraindications. In "Barviha" we developed a complex of recreational programs for patients with chronic pneumonia, bronchial asthma, chronic bronchitis, tuberculosis of the lungs and many other respiratory diseases.

    One of the most important profiles of «Barviha» is the treatment of the respiratory tract. Sanatoriums of this profile are not so rare in our country, but "Barviha" occupies the top position in this and other fields of medicine for many years. We have a complex of the most modern and efficient treatment methods and programs that encourage at least a stable and long-lasting remission if not full recovery.

    Patients with lung diseases come from all regions of our country and other states to our sanatorium. Along with the profile treatment, we have developed a number of physiotherapy medical programs providing opportunities for full recovery of the body and comfortable rest.

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