If you or someone you love has COPD, then you might have heard about a treatment known as pulmonary rehabilitation. This treatment is essentially a breathing and exercise training program specifically designed for people with COPD and other respiratory problems that make it difficult to breathe.
Traditional pulmonary rehabilitation programs come in a lot of different forms, including group classes and one-on-one instruction. You can also do pulmonary rehabilitation by yourself at home, an option that many patients choose instead of—or in addition to—taking a traditional class.
This is a great option for anyone who needs the flexibility, convenience, and easy accessibility that you get from practicing pulmonary rehabilitation at home. If you live in a rural area or lack the physical ability to take classes outside the home, home pulmonary rehab might be the only option that is realistic for you.
That's why we created this practical guide for practicing pulmonary rehabilitation at home. Whether you are simply interested in learning about the treatment or you're ready to try it out yourself, this guide will give you just about everything you need to get started, including direct links to all kinds of useful expert resources.
We'll start by explaining how both traditional and home pulmonary rehabilitation works, and why it's such an important therapy for people with COPD. Then, we'll explain all the elements you need to set up your own home-based pulmonary rehab program, including how to find the materials and resources you need.
What Pulmonary Rehabilitation Can Do for You
Pulmonary rehabilitation is a versatile, multi-faceted program that teaches practical strategies for managing everyday life with COPD and other serious respiratory conditions. It teaches you how to manage your breathing better, exercise more effectively, and stay active in spite of reduced lung function and uncomfortable respiratory symptoms.
As the Merck Manual puts it: “Pulmonary rehabilitation is the use of exercise, education, and behavioral intervention to improve how well people with chronic lung disease can function in daily life and to enhance their quality of life.”
Research shows that pulmonary rehab is a very effective treatment for COPD, offering a wide range of physical, mental, and educational benefits. Doctors often recommend pulmonary rehabilitation as a way to build physical endurance and learn how to manage the disease more effectively.
Pulmonary rehabilitation is particularly helpful for those who suffer from severe shortness of breath or have trouble keeping their symptoms under control. However, even people with well-controlled COPD symptoms can benefit from learning how to live a healthier life with their disease.
Here are some of the major health benefits of pulmonary rehabilitation for people with COPD:
- Reduced shortness of breath
- Improved exercise tolerance and endurance
- Improved physical strength
- Fewer COPD exacerbations
- Fewer hospitalizations
- Improved mental health
- Improved sense of well-being
- Greater knowledge and ability to manage COPD symptoms
- Greater knowledge and ability to make healthy diet and lifestyle choices
The main feature of pulmonary rehabilitation is a series of exercise training sessions designed to build physical strength and endurance. These sessions teach you exercises for improving respiratory health along with helpful breathing techniques to help you manage shortness of breath.
Pulmonary rehabilitation classes are a great way to begin exercising if you're used to being inactive or you struggle to exercise because of your symptoms. They help you learn to cope with physical exertion, gradually work up to more exercise, and teach you strategies to help you better manage everyday life activities.
This makes pulmonary rehabilitation particularly helpful for those with reduced physical mobility and endurance who want to learn how to exercise more effectively within the constraints of their disease. However, pulmonary rehabilitation offers more than just physical benefits; it also includes education on a variety of topics related to managing COPD.
A huge part of pulmonary rehabilitation is education and training on diet, lifestyle, COPD treatment, and general respiratory health. They include lessons about diet and nutrition, medications, and how to deal with the emotional hardships of living with COPD.
After completing pulmonary rehab, you'll have more of the skills that you need to get around better, do more, and live the best life you can in spite of your disease. These factors alone can do wonders for your mental health and your ability to live a good quality of life.
Whether you have mild COPD or a later stage of the disease, taking a pulmonary rehabilitation class can make a significant difference in your health and everyday life. Even after the course is over, doing pulmonary rehab at home can help you stay active, informed, and motivated about your health.
Pulmonary rehabilitation is helpful for everyone with COPD, but this treatment can be particularly helpful in certain circumstances. You might want to give it extra serious consideration if:
- You have severe COPD symptoms
- You are having trouble adjusting to life with COPD
- You are recovering from a COPD exacerbation or hospitalization
- You live an inactive or sedentary lifestyle
- You are too weak or breathless to exercise on your own
- You struggle with light physical activities like walking and going up stairs
- You want to work toward a specific physical goal (e.g. being able to walk around the grocery store or make it up a full flight of stairs on your own)
However, people with COPD are not the only ones who can benefit from pulmonary rehabilitation. It can treat a variety of different health conditions that affect your ability to breathe, including asthma, pulmonary fibrosis, severe pneumonia, and serious cardiovascular diseases like heart failure (especially coexisting COPD and heart failure).
What is Home Pulmonary Rehabilitation?
Most traditional pulmonary rehabilitation classes are group classes held in hospitals, medical clinics, and pulmonary rehabilitation centers. The class is run by a team of instructors—which often includes specialists like physical trainers and respiratory therapists—who conduct educational lectures, exercise classes, and hands-on skill workshops.
Home pulmonary rehabilitation, on the other hand, packages many of the same types of lessons and training that you'd get from a traditional pulmonary rehabilitation class into a format you can do at home. It's almost like taking an online or self-driven course; you gather the information and materials you need for each main topic, and complete the lessons on your own time.
Unfortunately, you may not be able to get the same kind of expert instruction and interaction that many group classes offer if you practice pulmonary rehabilitation at home. However, you can still get many of the same physical and mental benefits through self-driven lessons and activities.
This requires some planning and self-discipline, but it certainly doesn't mean that you will be completely on your own. You will be able to access to a wide variety of helpful resources and expert advice as you prepare for and work through the program at home.
You can work with your doctor to put together a personalized plan, or you can simply learn from existing guides. Either way, you will likely draw from a variety of different educational tools and materials as you go through your home pulmonary rehab program.
In the following sections, we'll introduce you to many resources you can use, including instructional videos, educational guides, and tele-health support. First, though, let's take a look at some of the benefits of doing pulmonary rehab at home, as well as some of the major reasons why you might choose to do a home-based program instead of—or in addition to—a traditional pulmonary rehab class.
Why Do Pulmonary Rehabilitation at Home?
Traditional in-person classes are the most studied form of pulmonary rehabilitation, but research suggests that home pulmonary rehabilitation programs may be just as effective, even if you only have minimal resources. Most experts also agree that home-based pulmonary rehabilitation offers many of the same benefits as in-person classes.
But even if traditional classes were the best option, there are many reasons why someone with COPD might choose to do pulmonary rehabilitation at home.
First of all, many people do pulmonary rehabilitation at home after completing a group class; it's a great way to continue practicing important skills and techniques. Second, many people simply don't have access to a traditional in-person class.
Pulmonary rehabilitation classes aren't offered everywhere, and they tend to be particularly sparse in rural areas. Because of this, many patients don't have any nearby pulmonary rehab options, or would have to drive hours to make it to the nearest class.
In areas where you can find a local pulmonary rehab program, there is often a very high demand for only a small number of classes. In fact, one 2019 study found that there were only 831 pulmonary rehabilitation centers in the US, which is far too few to serve the more than 16 million people in the US who have COPD.
The result is that many pulmonary rehabilitation centers have long waiting lists to get into classes. This forces some patients to wait weeks or months before they can begin getting the treatment they need.
Because of this, some people with COPD are better off starting with a home pulmonary rehabilitation program. It allows you to skip the wait and begin treatment right away, and it's certainly better than doing nothing at all.
Additionally, traditional in-person classes simply aren't the best option for every patient. Some people, for example, are too sick to leave their home for multiple weekly classes, while others find it impossible to fit it into their lives or budget.
You also need a doctor's recommendation to attend most traditional pulmonary rehabilitation classes, and sometimes these classes are reserved for highest-priority patients. In those cases, you might not even be eligible for a class unless you have very advanced COPD or serious complications.
For all of these reasons and more, researchers are increasingly recommending home-based pulmonary rehab, especially for patients who have trouble accessing traditional classes.
You might want to consider doing pulmonary rehabilitation at home if:
- You are not eligible to attend a traditional class
- You cannot find a class in your local area
- You are on a waiting list or all local classes are full
- You are unable to afford the cost of attending a traditional pulmonary rehabilitation class
- You are unable to get transportation to and from a local class
- Your physical condition prevents you from attending an in-person class (because of severe COPD symptoms or another health problem)
- You are unable to attend a class because of travel distance, time commitment, or another scheduling issue
- You will be attending an in-person class soon, and want to prepare by practicing ahead of time
- You are anxious about attending a group class and would like to try it out on your own first
- You have already taken a pulmonary rehabilitation class and want to continue building on the skills and benefits by practicing at home
How to Create Your Own Home Pulmonary Rehabilitation Program
In these next sections, we're going explain all the different components that a pulmonary rehabilitation class is made up of and how you can recreate each of these lessons at home. We'll start with a brief overview of the major topics and activities, and then we'll show you how to get the equipment, educational materials, and all the other information you need to begin your own home-based program.
The Basic Components of Pulmonary Rehabilitation
All pulmonary rehabilitation classes are different, but they all have the same basic makeup. Specific lessons and activities vary, but all pulmonary rehab programs aim to teach a similar set of practical, evidence-based skills for managing respiratory diseases.
These are the major components of a pulmonary rehabilitation class:
- Exercise training
- Breathing muscles training
- Nutritional counseling
- Education on proper medication use
- Psychological counseling and support
Your home pulmonary rehab program should address each of these topics, but how you approach them may depend on what kinds of resources you have. Because you may lack the specialized equipment and access to experts that traditional programs have, your home pulmonary rehabilitation programs may benefit from a couple of extra components:
- Working closely with your primary care doctor
- Tele-health support
Now, lets take a closer look at each of these components and how you can re-create them for your pulmonary rehabilitation program at home. For each of these topics, we've included links to a variety of helpful, high-quality resources you can use to get started right away.
Working With Your Doctor
Traditional in-person pulmonary rehabilitation classes are usually staffed with doctors, trainers, and specialists that facilitate each class. Since you won't have access to these experts at home, it is vital to work with your doctor—and any other members of your COPD treatment team—as you plan your home pulmonary rehabilitation program.
Your doctor can help you determine your primary health and lifestyle goals, and help you make a plan to get you there. It's also important to tell your doctor before you make any major changes to your lifestyle or exercise routine; this is not only for safety, but also so you can ask your doctor for advice—for example, on what kinds of exercises are appropriate for your physical condition.
Working with your doctor is also a great way to learn about lesser-known resources that you might not otherwise find. Your doctor might be able to give you helpful guides or pulmonary rehabilitation tools, or even refer you to a telehealth program.
It's certainly possible to do pulmonary rehabilitation successfully on your own with the guidance of your primary care doctor. However, it's always good to have some extra guidance and support along the way.
Luckily, modern technology makes it possible to work with doctors and other medical experts remotely without ever leaving your home. These are known as telehealth services, and they allow you to communicate with specialists and trainers from home using phone calls, text messages, and/or online platforms.
Research shows that home pulmonary rehabilitation supported by telehealth can be very effective at reducing hospital re-admissions and may work just as well as in-person, institution-based pulmonary rehabilitation programs. Unfortunately, it can be somewhat tricky to find a telehealth service that is both available in your area and suited to your needs.
The best place to start looking is local hospitals and pulmonary rehab centers, which sometimes offer their own telehealth programs and services. You can also ask your doctor to help you locate any other telehealth resources in your area.
Exercise training is one of the largest and most important components of an effective pulmonary rehabilitation program. It helps you build strength and endurance by teaching you movements and techniques that are specifically tailored for people with respiratory diseases.
To get the best results, your home exercise training program should be as comprehensive as possible, including both cardiovascular and strength training components. You should do exercises that target all the major muscle groups in your body, including your arms, shoulders, back, legs, abdomen, and chest.
Arm exercises, leg exercises, and walking are cornerstones of most COPD exercise programs, because they work the muscles you need the most to function in everyday life. Start small and work your way up gradually, slowly adding more steps and repetitions to your routine as you go.
Even though you won't have an in-person trainer while exercising at home, you can get a similar experience from following exercise videos and DVDs. You can choose from a variety of high-quality instructional videos for exercising with COPD, some of which are specifically tailored for pulmonary rehabilitation.
In general, it is safe to exercise with COPD as long as your doctor says it is okay. However, you should still take care not to overexert yourself and to take breaks to catch your breath when needed.
If you experience any of the following symptoms when exercising, you should stop and rest:
- Severe shortness of breath that is worse than usual
- Excessive fatigue
- Dizziness or lightheadedness
- Pain in the chest, neck, or arm
- Irregular heartbeat or palpitations
Here are some tips for including exercise training in your home pulmonary rehab program:
- Find instructional videos (and other materials) for exercise techniques suited to your skill level, including videos made for pulmonary rehabilitation.
- Practice doing the exercises yourself step by step, modifying them to your ability if needed (e.g. try a lower-impact version of an exercise, or find exercises you can do while seated in a chair).
- Take regular walks to improve your endurance, trying to make it a little bit farther every day.
- Practice aerobic and strength training exercises in 15-30 minute long sessions; ideally, you should exercise 4-5 days per week
- Do not exercise if you are sick or experiencing a COPD symptom flare-up (ask your doctor if you are not sure)
Resources and Guides for Exercising with COPD
Exercise Training Videos for Pulmonary Rehabilitation
- Exercise and COPD Guide (PDF Download Link) from the Lung Association (Canada): This 16-page manual includes instructions for performing specific exercises and guides you through the process of starting a COPD exercise program.
- The Toronto Western Hospital Pulmonary Rehabilitation Home Exercise DVD (You can watch this instructional video on YouTube)
- Pulmonary Rehab Exercise Video from NHS Forth Valley
- Upper Body Exercises for COPD Treatment and Rehab from Burke Rehabilitation
- Arm Exercises for Pulmonary Rehab from Burke Rehabilitation
Text Resources for Exercising with COPD:
- Tips for Exercising at Home (for Pulmonary Rehabilitation) from Wexner Medical Center
- COPD Exercise and Activity Guide from the Cleveland Clinic
- Integrating an Exercise Program Into Your Life (PDF Link) from Living Well with COPD
Exercise Guides from Our Respiratory Resource Center:
- How to Exercise at Home with COPD
- Tips and Tricks for Exercising on Oxygen Therapy
- What Exercise Tests Can Tell You About Your COPD
Breathing Muscles Training
Another major component of pulmonary rehabilitation is strengthening and training the muscles in your chest that help you breathe. This is known as inspiratory muscle training, and research shows that it can both reduce shortness of breath and improve exercise endurance by reducing the amount of effort it takes to breathe.
In pulmonary rehabilitation, inspiratory muscle training is done through a combination of exercises and breathing techniques that target certain muscles in your chest. In order for these exercises to be effective, you'll need to practice them regularly and use proper technique.
Just like with exercise training, video lessons can be an effective substitute for in-person instruction. Luckily, there are plenty of step-by-step instructional videos online that demonstrate COPD breathing techniques and exercises.
Resources and Guides for Practicing Breathing Techniques
Here are some tips for including inspiratory muscle training in your home pulmonary rehab program:
- Watch instructional videos on a variety of different COPD breathing exercises and techniques.
- Follow the instructions for each one carefully as you practice them on your own.
- Use breathing techniques to control your breathing during physical activities and exercise training.
- Continue to practice these breathing techniques every day.
Instructional Videos for Learning and Practicing Breathing Techniques:
- Top 3 Breathing Exercises for COPD from physical therapists Bob Schrupp and Brad Heineck
- How to Clear Your Chest with Breathing Exercises (e.g. expel mucus) from NHS Forth Valley
- Respiratory Muscles Training Video from Lorraine Martelli-Reid, MN, RN(EC)
- Instructional Video for Pursed Lips Breathing from Burke Rehabilitation
- Instructions for Diaphragmatic Breathing from Burke Rehabilitation
- Instructions for Acapella Breathing Techniques from Burke Rehabilitation
More Resources for Information on COPD Breathing Techniques:
- COPD Breathing Techniques Guide with step-by-step instructions and practical tips for putting them to use
- Advice and Tips for Practicing Breathing Techniques from the Pulmonary Education and Research Foundation
- Managing Breathlessness with COPD (PDF Download Link): A 4-page guide with instructions for practicing breathing techniques along with other practical tips for managing shortness of breath.
Nutritional training focused on healthy eating habits is an important component of pulmonary rehabilitation. Diet, after all, is a vital part of living a healthy lifestyle, and it can make a significant difference in your quality of life with COPD.
Nutritional training in pulmonary rehab includes learning what a healthy, well-balanced diet should looks like for someone of your age. It also includes learning practical techniques for shopping, meal planning, and making healthy food choices in general.
These skills will helping you manage your weight and reduce the number of unhealthy foods you eat. It also helps you ensure that your diet includes all the vital nutrients you need to fuel your lungs and keep your body strong.
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Since you won't have access to a dietitian or nutritionist when you do pulmonary rehabilitation at home, you will need to use other resources, instead. This can include advice from your primary care doctor and self-driven study using videos and educational guides.
Here are some tips for including nutritional training in your home pulmonary rehab program:
- Find practical educational resources about the various components of a healthy diet, including macronutrients (e.g. protein, carbohydrates, and fats) and micronutrients (e.g. vitamins and minerals).
- Learn how to recognize healthy versus unhealthy foods and ingredients (it might be trickier than you think!).
- Track and evaluate your eating habits and discuss them with your doctor for advice on how you can improve.
- Spend some time learning about meal planning, portion sizes, and techniques for preparing healthy, balanced meals.
Resources for Learning About Proper Nutrition for COPD
Educational Resources about Nutrition for Older Adults and People with COPD:
- Pulmonary Rehab Nutrition Video Guide from Burke Rehabilitation
- Micronutrient Recommendations for Older Adults: learn how much of each vitamin and mineral you should get from your diet daily
- Nutritional Guidelines for People with COPD from the Cleveland Clinic
- Meal Planning Tips for People with COPD from COPD.net
- Sample Recipes and Meal Plans for People with COPD (PDF Link)
- Diet Tips for People with COPD from Healthline
Helpful Guides about Diet & Nutrition from Our Respiratory Resource Center:
Education on Proper Medication Use
COPD medication regimens can be complicated, burdensome, and difficult to follow correctly. Because of this, improper medication use is extremely common among people with COPD and other respiratory illnesses.
This is worsened by the fact that many patients are never fully trained or informed about how to use their medications properly. Pulmonary rehabilitation attempts to bridge that gap by teaching the essentials of proper medication use and showing you how to avoid common mistakes.
As part of your home pulmonary rehabilitation program, you should dedicate some time to learn more about your medications. Make sure you understand what each of them is for and how to take them as prescribed.
In particular, pay special attention to your inhalers, which require a specific series of steps in order to deliver the right dose of medicine. This is also a great time to discuss your treatment plan with your doctor and bring up any questions you might have.
Here are some tips for including medication training in your home pulmonary rehab program:
- Learn everything you can about your medications and how to use them correctly.
- Review your COPD treatment plan and refresh your memory on the correct dosage, frequency, and timing for each medication.
- Write down any questions and concerns about your medications so you can discuss with your doctor.
- If you don't have one already, work with your doctor to put together a clear COPD action plan and a personal medication schedule
- Read and/or view instructions to refresh your knowledge on the proper technique for each type of inhaler you use.
- Confirm that you are using your inhaler properly by practicing in front of your doctor or pharmacist.
Resources for Learning About Proper COPD Medication Use
Instructions for Proper Inhaler Use:
- Video Instructions for Proper Inhaler Use from The Lung Association (Canada): includes text and video instructions for using a variety of different inhaler types and brands
- Simple Video Instructions for Using a Metered Dose Inhaler from Katie Aguirre, M.D. And Nathan Bertsch, PharmD
- Inhaler Tips from WebMD: Includes all kinds of helpful information on using inhalers, including how to use spacers, rescue inhalers, metered dose inhalers, dry powder inhalers, and how to clean your inhaler.
Resources, Advice, and Instructions for Taking COPD Medications Correctly:
- Tips for Managing COPD Medications from the American Lung Association
- COPD Treatments Guide from the COPD Foundation: Learn more about all the different types of COPD medications and what they are used for
- Sample COPD Action Plan (PDF Link) from the American Lung Association
- Managing COPD Medications and Symptoms (PDF download link): A 6-page guide with tips for taking medications properly, reducing symptoms, and managing COPD flare-ups, including instructions and resources for making a practical COPD action plan you can use.
- How to Reach Your Treatment Goals with Your COPD Action Plan from our Respiratory Resource Center
Psychological Counseling and Support
Living with COPD can have a significant effect on your mental health, causing stress, anxiety, and even psychological illnesses like depression. Because of this, every pulmonary rehabilitation program should include some kind of mental health support.
Traditional pulmonary rehabilitation programs often include include lessons on self-care and practical relaxation methods. Some also offer mental health counseling in the form of therapy or group support sessions.
If you're practicing pulmonary rehabilitation at home, you can still find lots of instruction on relaxation techniques, which are a great way to reduce anxiety and stress. Mindfulness meditation, progressive muscle relaxation, and deep breathing, for example, are just a few of the proven methods you can try.
Another way to get psychological support from home is to join an online support group for people with COPD where you can share thoughts and advice with your peers. You could also choose to work with a therapist or another mental health professional via phone and/or internet counseling sessions.
Here are some tips for including mental health support in your pulmonary rehab program:
- Spend some time thinking and talking about your emotional needs, especially as they relate to your health and disease treatment.
- Find some instructional videos and/or guides for relaxation techniques, self-care strategies, and other activities you can use to reduce anxiety and fulfill your emotional needs.
- Find a source of social and/or psychological support, either online or in-person.
- Use your support system to discuss your thoughts, feelings, and worries; don't be afraid to ask for social support.
- Make a self-care plan to help you manage stress and look after your mental health.
- Set aside time to practice relaxation techniques and self-care activities.
Resources for Psychological Counseling and Support
Online & Phone Support Groups for People with COPD:
- Inspire Community Online Support Groups: An online community for people with COPD (and other respiratory diseases) to talk with and support one another.
- COPD 360 Social from the COPD Foundation: A casual online community for asking questions, seeking support, and finding helpful information (more than 40,000 members).
- The American Lung Association's Lung HelpLine (1-800-LUNGUSA): Call to get information about COPD resources, including help quitting smoking.
Resources for Relaxation and Self-Care for Mental Health:
- Tips for Managing Stress from the American Lung Association
- Instructional Guide for Deep Breathing from Harvard Health Publishing
- Instructional Guide for Progressive Muscle Relaxation from the University of Michigan
- How to Practice Mindfulness Meditation from Psychology Today
- Guided Meditation Audio Instruction from the University of Massachusetts
- Tips for Developing a Self-Care Plan from the University of Buffalo
Helpful Guides about Mental Health & COPD from Our Respiratory Resource Center:
Additional Resources for Home Pulmonary Rehab
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Along with the links we've provided throughout this post, you can find many other helpful resources online. You can also ask your doctor or a local pulmonary rehabilitation facility if they can recommend any helpful videos, guides, or other learning tools.
Here are some additional resources you might want to use for your home pulmonary rehabilitation program:
General Guides for Pulmonary Rehabilitation:
- Take Control of Your COPD: A Guide to Better Living: This is a paid DVD that you can order from the American Association of Cardiovascular and Pulmonary Rehabilitation. It includes a variety of pulmonary rehabilitation strategies you can practice at home, as well as tips for working with your COPD treatment team.
- Guidelines and Tips for Starting Pulmonary Rehabilitation at Home from the Emphysema Foundation For Our Right to Survive
- Visit Live Better with Pulmonary Rehab's Website for a variety of tips and resources related to pulmonary rehabilitation.
Helpful Guides You Can Download:
- Essentials of Pulmonary Rehabilitation: A Do It Yourself Guide (PDF Download Link) from the Pulmonary Education and Research Foundation
- The COPD BreathWorks Plan Guide (PDF Dowload Link): This 40-page guide tells you everything you need to know about COPD, including helpful advice on lifestyle, nutrition, exercise, medications, exacerbations, and symptom management.
- Managing Energy with COPD: A 4-page guide with practical tips for doing household chores, planning activities, and conserving energy throughout the day.
Whether you struggle with severe breathing symptoms or simply need help to build physical endurance, a home pulmonary rehab program is a great place to start living a better life with COPD. It not only gives you many of the physical and mental benefits of a traditional pulmonary rehab class, but also gives you the opportunity to work on key skills for managing your disease
These includes skills for building physical strength, improving your respiratory endurance, and living a more active life. You'll also learn a variety of techniques for staying healthy and managing your COPD symptoms through diet, self-care, physical activity, and proper medication use.
Doing pulmonary rehab at home can teach you how to breathe better, get around better, cope with negative mental symptoms, and better manage daily activities. All of these skills are vital for living the best life possible with a chronic respiratory disease.