Frequently Asked Questions

To attend Pulmonary Rehabilitation, patients must fulfill the following criteria:

• Have a respiratory diagnosis such as Chronic Obstructive Pulmonary Disease (COPD), Bronchiectasis or Interstitial Lung Disease (ILD).
• Find themselves limited by breathlessness (e.g. climbing stairs or walking up a slight hill).

A referral can be made by your GP or hospital consultant, hospital staff, respiratory/practice nurse or community matron.

For more information about PR referrals you can contact us directly on 0151 514 2246 and speak to one of the team.

Pulmonary Rehabilitation (PR) is run 2 times a week for 6 weeks. Each session consists of 1 hour exercise and 1 hour of education. The programmes are available at the following venues:- 

Arrowe Park Hospital, Physiotherapy department.

• Monday's and Thursday's from 2.00pm to 4.00pm. 

Clatterbridge Hospital, Physiotherapy department.

• Monday's and Thursday's from 11.00am to 1.00pm.

Guinea Gap Leisure Centre.

• Tuesday's and Friday's from 14.00pm to 16.00pm

St Catherines Hospital, Heart Support Unit.

• Monday's and Wednesday's from 10.15am to 12.15pm

The first assessment lasts for half an hour. A specialised physiotherapist will have a discussion with you and ask you questions about your condition, any relevant past medical history and talk about what medication you take (inhalers & tablets). Your resting oxygen reading and pulse will be taken as well as blood pressure. 

The 2nd part involves completing a questionnaire and a walking test.

The walking test. We carry out a walking test with every assessment. This is to give us an initial recording of your exercise capacity and we also test your heart rate and oxygen reading during the test to ensure you're safe to complete the exercises. The walking test and questionnaire is also completed at the end of the programme.  

Pulmonary Rehabilitation classes are welcoming and friendly. Each session is led by a specialist physiotherapist who is happy to answer any questions you may have. Everything will be explained and demonstrated so that you feel comfortable and safe. At all times during the exercise you are monitored closely by the physiotherapist and assistant.

The class begins with a gentle 'warm-up' for a couple of minutes.

You'll then complete a range of different exercises to help improve your fitness at a level that suits your own needs. The exercises include:-

• Exercise bike
• Step ups
• Ball throw
• Treadmill
• Arm curls
• Walking

At the end of the exercise period a 'cool-down' is completed. 

Don't worry if you have other health problems that you think might stop you from exercising. The physiotherapist has lots of experience in adapting exercises for patients with various medical conditions. 

The education part of the programme is very important. It will help you to understand how to manage your condition so that you can live a more active and fulfilling life. The talks are given by physiotherapists, nurses, dieticians and other members of staff linked to the NHS. 

The topics covered include:- 

• Anatomy and Physiology - How the lungs work and what they look like
• What is COPD & other respiratory conditions? 
• Sputum clearance - How to effectively clear sputum from the lungs
• Managing breathlessness - Advice and guidance
• Respiratory medications - What do the inhalers and tablets do
• Inhaler technique - How to best use inhalers
• Early warning signs of chest infection and what to do  
• Diet
• The benefits of exercise 

The education takes place following the exercise session and refreshments are provided. 

When a patient has a long-term breathing problem, such as chronic obstructive pulmonary disease (COPD) or another lung condition, they can find it difficult to do their normal daily activities without getting breathless.  They may also find that they get tired very easily and often feel exhausted.

Pulmonary Rehabilitation (PR) is designed to help the patient cope with being short of breath and feel stronger and fitter at the same time.

Getting out of breath can be very frightening, which can make breathing worse.  In trying to avoid this, people often reduce the amount of activity they do.  However, this does not help, as over time they become unfit, tired and even more breathless.  PR can help by breaking that cycle.

It is normal for everyone, including athletes, to be short of breath when exercising, but this is part of the therapy.  A patient will always be monitored and will never be asked to do more than their physiotherapist thinks they can or more than is safe and possible for them.

The people who do best from PR are likely to be those who really want to help themselves, who want to learn and who have a positive attitude.

Comments from Pulmonary Rehabilitation attendees - 

Arrowe Park Class

"I can honestly say I can feel the benefits both physically and mentally."

"The Pulmonary Rehabilitation course is excellent. It is very beneficial with exercise and formative talks. It improves our future lives."

Clatterbridge Class

"Really helpful exercise and extremely helpful with education about medications and how to use them."

"Really helpful, told me things I didnt know. Staff are really helpful with time for you if you require information." 

Albert Lodge, Victoria Central Hospital Class

"I would recommend this service because of the help and advice I have received myself."

"Brilliant dedicated staff who have definitely improved my quality of life.  I'm very grateful and thankful."

"I just wish I could come every week.  Thank you, I really have been helped.  I don't feel so helpless."

You are welcome to bring a family member or friend along to the sessions. They will not be able to take part in the exercise session but are more than welcome to listen to the education talks. 

The first part is exercise therefore clothes that you feel comfortable in, loose fitting trousers, flat comfortable shoes (doesn't have to be sports trainers) and a t-shirt / jumper. 

We advise you to have something to eat and drink before you come to the class. We do provide water at each venue but feel free to bring a drink of your choice to keep refreshed. We also ask that you always have you blue (reliever) inhaler present at the class if you have one (just incase). 

The COPD nurses based at the service are able to help patients with:

• Information about their condition
• Information about inhalers and inhaler technique
• Information and assessment for nebulisers
• What to do when a patient has a flare up (exacerbation) and how to spot the early warning signs of an infection
• Support with their COPD
• Optimising their medication
• Can refer to other health care professionals and to Pulmonary Rehabilitation if appropriate

The COPD nurses are available Monday to Friday 9am until 5pm to take calls and answer any queries or concerns in regards to a patient's COPD.  If there isn't a nurse available when the patient calls, the nurse will always call back.

An exacerbation is a flare up of COPD symptoms.  The signs can include:

• Increased breathlessness (more than usual)
• Reduced walking distance
• Increase in coughing
• Changes in the amount/colour/thickness of phlegm
• Chest feeling tight
• New or increased wheeze

If there two or more of these symptoms are present in the patient, they need to act quickly to treat the flare up.  Treatment is usually with antibiotics and steroids, increased use of reliever inhalers and/or nebulisers, to help their chest to recover from the exacerbation.

The patient must take it easy when they have a flare up and balance out activity with periods of rest.

Most patients will be encouraged to have a self management plan and a 'stand-by' or 'rescue' pack of antibiotics and prednisolone that they can start taking when they have these symptoms.  However, if none of these measures are in place, then the GP or practice nurse must be contacted as soon as possible to arrange for a review and appropriate treatment.

More serious symptoms that may need emergency medical attention are:

• Difficulty in breathing
• The patient is no better after two days of treatment
• The patient is drowsy, confused or agitated
• There is chest pain
• There is a high fever
• The patient has increased swelling of the ankles
• The patient feels they cannot cope at home

Emergency medical attention may come in the form of an urgent consultation with a GP or calling 999 for an ambulance.

If the patient has any concerns in regards to their symptoms, they can contact the service

GPs, practice nurses, community nurses and hospital staff are the main people who will ask us to see patient's with COPD for help and advice.  This will usually be discussed with you before the referral is made.

Many patient's with COPD have been admitted to hospital with an exacerbation and the hospital may automatically 'alert' us of this.  If this happens we will be in touch to offer an appointment with the specialist nurse or physiotherapist for an assessment to see if we can help with treatment or advice to try and prevent another admission.

If any patient receives an appointment and is not sure why, please call us.