Pulmonary rehabilitation in Australia: a national survey

Objective: To determine the current structure and content of pulmonary rehabilitation programs in Australia. Design: A cross sectional, observational design using a purpose designed anonymous written survey. Setting and participants: The National database of Pulmonary Rehabilitation Programs maintained by the Australian Lung Foundation was used to identify all known programs in all states and territories of Australia (n = 193). All pulmonary rehabilitation programs listed on the database were included. Respondents were health professionals who coordinated programs. Results: The response rate was 83% (161/193). Programs were coordinated by physiotherapists (75/147, 51%) and/or nurses (49/147, 33%), were hospital based (97/147, 66%) and ran for 8 weeks or longer (95/147, 65%). Pre (145/147, 99%) and post (137/147, 93%) program assessment was undertaken using a variety of measures. The Six Minute Walk Test (138/147, 94%) was the most commonly used test of exercise capacity. Exercise training was included in 145 programs (99%). Most patients attended at least two supervised exercise sessions per week (106/147, 72%) and exercised for at least 20 minutes (135/147, 92%). Lower limb endurance, upper limb endurance, strength training, and stretching/flexibility exercises were the most commonly included modes of exercise. Intensity prescription for exercise training was variable. Many respondents (93/147, 63%) indicated that they perceived a gap between their clinical practice and current evidence. Conclusions: Pulmonary rehabilitation programs in Australia generally meet the broad recommendations for practice in terms of components, program length, assessment and exercise training. The prescription of exercise training intensity is an area requiring deeper exploration