Pulmonary rehabilitation is a supervised program that includes exercise training, health education, and breathing techniques for people who have certain lung conditions or lung problems due to other conditions. Discover more about the power of pulmonary rehabilitation.
Deep Breath
Image by TheVisualMD
What Is
Pulmonary Rehabilitation
Image by TheVisualMD
Pulmonary Rehabilitation
Pulmonary Rehabilitation
Image by TheVisualMD
What Is Pulmonary Rehabilitation?
Your doctor may recommend pulmonary rehabilitation to help you breathe easier and improve your quality of life for certain lung conditions such as chronic obstructive pulmonary disease (COPD), asthma, pulmonary hypertension, and cystic fibrosis. It can also improve daily life for people who have scoliosis or other health problems that limit lung function. Your doctor may also recommend pulmonary rehabilitation before and after surgery for a lung transplant or lung cancer.
Pulmonary rehabilitation can help you gain strength, reduce symptoms of anxiety or depression, and make it easier to manage routine activities, work, and outings or social activities that you enjoy.
You may have pulmonary rehabilitation in the hospital or a clinic, or you may learn physical therapy or breathing exercises to do at home. You may also use activity monitors or smartphone-based lessons or monitoring. Your team of healthcare providers will design a personal pulmonary rehabilitation plan based on your needs.
Pulmonary rehabilitation has few risks. Rarely, physical activity during the program can cause problems, such as injuries to your muscles and bones. If serious problems occur during the supervised sessions, your pulmonary rehabilitation team will stop the physical activity right away, give you the appropriate treatment, and contact your doctor.
Source: National Heart, Lung, and Blood Institute (NIH)
Additional Materials (4)
Pulmonary Rehabilitation
Video by American Thoracic Society/YouTube
Learn About Pulmonary Rehabilitation
Video by NHLBI/YouTube
Understanding COPD
Video by Animated COPD Patient/YouTube
Normal Lungs and Lungs With COPD
Figure A shows the location of the lungs and airways in the body. The inset image shows a detailed cross-section of the bronchioles and alveoli. Figure B shows lungs damaged by COPD. The inset image shows a detailed cross-section of the damaged bronchioles and alveolar walls.
Image by National Heart Lung and Blood Institute
1:25
Pulmonary Rehabilitation
American Thoracic Society/YouTube
1:36
Learn About Pulmonary Rehabilitation
NHLBI/YouTube
4:36
Understanding COPD
Animated COPD Patient/YouTube
Normal Lungs and Lungs With COPD
National Heart Lung and Blood Institute
Who Needs
Cystic Fibrosis Gene (CFTR): Cystic Fibrosis Gene Test
Image by TheVisualMD
Cystic Fibrosis Gene (CFTR): Cystic Fibrosis Gene Test
Cystic fibrosis is a life-threatening disease that is passed on genetically. It causes a thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body and is one of the most common chronic lung diseases in children and young adults. A cystic fibrosis gene test allows a couple to find out if one of both of them are carriers of the cystic fibrosis gene.
Image by TheVisualMD
Who Needs Pulmonary Rehabilitation?
Your doctor may recommend pulmonary rehabilitation to help you breathe easier and improve your quality of life for certain lung conditions such as COPD, asthma, pulmonary hypertension, and cystic fibrosis. It can also improve daily life for people who have scoliosis or other health problems that affect how well the lungs work.
Your doctor may also recommend pulmonary rehabilitation before and after surgery for a lung transplant or lung cancer.
Source: National Heart, Lung, and Blood Institute (NIH)
Additional Materials (17)
How chronic obstructive pulmonary disease (COPD) develops
Video by Bupa Health UK/YouTube
Animation #1: What is cystic fibrosis?
Video by CFFightersUtah/YouTube
CYSTIC FIBROSIS, Causes, Signs and Symptoms, Diagnosis and Treatment.
Video by Medical Centric/YouTube
Hank The Heart Presents: What is Pulmonary Hypertension? | Cincinnati Children's
Video by Cincinnati Children's/YouTube
Lung Transplant Process
Video by Perioperative Interactive Education/YouTube
Breathing Better with a COPD Diagnosis
United States. The disease kills more than 120,000
Americans each year—that’s 1 death every 4
minutes—and causes serious, long-term disability.
The number of people with COPD is increasing.
More than 12 million people are diagnosed with
COPD and an additional 12 million likely have
the disease and don’t even know it.
Document by Centers for Disease Control and Prevention (CDC)
Male Thorax with Visible Trachea and Lung
3D visualization of an anterior oblique view of the trachea and the lungs, reconstructed from scanned human data. The bifurcation of the trachea and the extensive branching of the right and left bronchi are revealed. The respiratory system consists of branching tubes that work to bring oxygen from the air to the organs and tissues of the body, and to expel carbon dioxide wastes from the body to the air. The bronchial tree is a system of airways in which the \"trunk\" is the windpipe and the \"branches\" are the subdividing passages that permeate the lungs. While the rest of the system works as a kind of accordion pump, the structures of the bronchial network split and split again until they are so numerous and so thin at their membranous tips that gas molecules can cross over to the blood through a network of capillaries that, laid end to end, would measure more than 1,000 miles.
Image by TheVisualMD
Alveolus and Surrounding Capillary of Lung
3D visualization reconstructed from scanned human data of the heart and airways of the lungs. De-oxygenated red blood cells are sent by the right side of the heart through the pulmonary artery into the vessels of the lungs to be refilled with oxygen for their next circuit through the body. The blood is carried through the lung tissues, where it exchanges its carbon dioxide for oxygen in the alveoli. It is then returned through the pulmonary veins to the left side of the heart and sent out to the rest of the body. The pulmonary artery and veins are the only vessels that break the rules about arteries carrying oxygenated blood and veins carrying deoxygenated blood. Technically arteries carry blood away from the heart, and veins carry it back. Everywhere else in the body, blood flowing away from the heart is oxygenated, and blood flowing back to the heart is deoxygenated, but not in the lungs. The pulmonary artery carries away the deoxygenated blood, which returns fully oxygenated through the pulmonary vein.
Image by TheVisualMD
Thorax with visible Lung and Heart
3D visualization of a posterior view of the lungs and heart reconstructed from scanned human data. De-oxygenated red blood cells are sent by the right side of the heart through the pulmonary artery into the vessels of the lungs to be refilled with oxygen for their next circuit through the body. The blood is carried through the lung tissues, where it exchanges its carbon dioxide for oxygen in the alveoli. It is then returned through the pulmonary veins to the left side of the heart and sent out to the rest of the body. The pulmonary artery carries away the deoxygenated blood, which returns fully oxygenated through the pulmonary vein.
Image by TheVisualMD
Thorax with Visible Lung and Bronchial Tree
3D visualization of an anterioinferior view of the thorax reconstructed from scanned human data. When air is inhaled into the lungs, it flows through large tubes called bronchi, branches into smaller tubes known as bronchioles, and ends up in the thousands of small pouches that are the alveoli. This is where the oxygen is transferred from the air into the bloodstream. Each alveolar sac, or air sac, is surrounded by a bed of capillaries, and the walls between the lung and the capillary are extremely thin. The walls are so delicate, in fact, that the inhaled oxygen can seep from the air sacs to bind to the hemoglobin in the blood, while the carbon dioxide and other waste gasses leave the blood and diffuse into the lungs where they can be exhaled.
Image by TheVisualMD
A Quick Guide On COPD
This guide provides an overview of chronic obstructive pulmonary disease (COPD), its symptoms, how it affects breathing, and how it's diagnosed and treated. It can be used by health care professionals to have a dialogue with patients or as a general handout to raise awareness about COPD.
Document by NHLBI
Bronchi and Bronchiole of Lung
3D visualization of an inferior view of a transverse section of the thorax, highlighting the lungs, reconstructed from scanned human data. The trachea, cardiac impression, and transverse sections of the thoracic aorta and esophagus are clearly illustrated. The bronchial tree is also visible. When air is inhaled into the lungs, it flows through large tubes called bronchi, branches into smaller tubes known as bronchioles, and ends up in the thousands of small pouches that are the alveoli. This is where the oxygen is transferred from the air into the bloodstream. Each alveolar sac, or air sac, is surrounded by a bed of capillaries, and the walls between the lung and the capillary are extremely thin. The walls are so delicate, in fact, that the inhaled oxygen can seep from the air sacs to bind to the hemoglobin in the blood, while the carbon dioxide and other waste gasses leave the blood and diffuse into the lungs where they can be exhaled.
Image by TheVisualMD
Bronchus Leading into Alveolar Sac and Surrounding Capillary
The main airways of the lungs (bronchi) branch off into smaller passageways called bronchioles. At the end of the bronchioles are tiny air sacs called alveoli, which are the \"leaves\" of the respiratory tree and the site of gas exchange. The membranes between alveoli and the capillaries that surround them are extremely thin. Oxygen diffuses through these membranes into the capillaries and carbon dioxide follows the reverse course. Red blood cells deliver oxygen to tissues throughout the body and then carry carbon dioxide from those cells back to the lungs.
Image by TheVisualMD
Lung with Visible Bronchi and Bronchiole
The pulmonary circulation and systemic circulation are tied together - in that they work in synchrony to provide the body with oxygen and to get rid of the body's carbon dioxide. Enzymes digest, or break down, the carbohydrates from the foods you eat into sugars, which the cells of your body use to produce energy. Oxygen is needed for energy production and carbon dioxide is one of the waste products. These gases are transported by your cardiovascular system through the blood. Your blood has cells called red blood cells, or erythrocytes. These cells have molecules (hemoglobin), which can bind to or release oxygen as needed. When you breathe, oxygenated air flows through your lungs and ends up in thousands of small air sacs in the lungs called alveoli. The right side of your heart sends deoxygenated blood to the capillaries surrounding these alveoli. The walls between the alveoli and the capillaries are extremely thin, so that the inhaled oxygen can seep from the air sacs to bind to the hemoglobin molecules in the erythrocytes. Carbon dioxide and other waste gases leave the blood and diffuse into the air sacs, where they are exhaled through the lungs. This gas exchange is passive: oxygen goes from the higher concentration in the lungs to the lower concentration in the blood. Similarly, carbon dioxide goes from the blood to the lungs.
Image by TheVisualMD
Fluid Filled Alveoli
This image shows a fluid-filled alveoli within the lungs. The alveolus (singular) is the smallest unit of the lungs. It is the site of gas exchange with the capillaries. Oxygen and carbon dioxide move between the alveoli to the surrounding capillaries.
Image by TheVisualMD
COPD Symptoms
COPD Symptoms
Image by TheVisualMD
Normal Lungs and Lungs With COPD
Figure A shows the location of the lungs and airways in the body. The inset image shows a detailed cross-section of the bronchioles and alveoli. Figure B shows lungs damaged by COPD. The inset image shows a detailed cross-section of the damaged bronchioles and alveolar walls.
Image by National Heart, Lung, and Blood Institute
2:21
How chronic obstructive pulmonary disease (COPD) develops
Bupa Health UK/YouTube
4:59
Animation #1: What is cystic fibrosis?
CFFightersUtah/YouTube
6:26
CYSTIC FIBROSIS, Causes, Signs and Symptoms, Diagnosis and Treatment.
Medical Centric/YouTube
2:50
Hank The Heart Presents: What is Pulmonary Hypertension? | Cincinnati Children's
Cincinnati Children's/YouTube
11:34
Lung Transplant Process
Perioperative Interactive Education/YouTube
Breathing Better with a COPD Diagnosis
Centers for Disease Control and Prevention (CDC)
Male Thorax with Visible Trachea and Lung
TheVisualMD
Alveolus and Surrounding Capillary of Lung
TheVisualMD
Thorax with visible Lung and Heart
TheVisualMD
Thorax with Visible Lung and Bronchial Tree
TheVisualMD
A Quick Guide On COPD
NHLBI
Bronchi and Bronchiole of Lung
TheVisualMD
Bronchus Leading into Alveolar Sac and Surrounding Capillary
TheVisualMD
Lung with Visible Bronchi and Bronchiole
TheVisualMD
Fluid Filled Alveoli
TheVisualMD
COPD Symptoms
TheVisualMD
Normal Lungs and Lungs With COPD
National Heart, Lung, and Blood Institute
Expect Before
Types of Lung Function Tests
Image by Finchbook01 (talk)
Types of Lung Function Tests
A man undergoing whole body plethysmography
Image by Finchbook01 (talk)
What To Expect Before Pulmonary Rehabilitation
To help design your pulmonary rehabilitation plan, your healthcare team may do one of the following tests:
Exercise stress test to measure your oxygen level, blood pressure, and heart rate while you exercise
Breathing tests to check how well your lungs are working
Six-minute walk test to measure how far you can walk in six minutes
You may have pulmonary rehabilitation in the hospital or a clinic, or you may learn physical therapy or breathing exercises to do at home. You may also use activity monitors or smartphone-based lessons or monitoring.
Source: National Heart, Lung, and Blood Institute (NIH)
Additional Materials (9)
COPD - Are You at Risk?
COPD is a serious lung disease
that over time makes it hard
to breathe. Its official name is
Chronic Obstructive Pulmonary
Disease, but COPD has other
names, like emphysema or
chronic bronchitis.
Document by National Heart, Lung, and Blood Institute (NHLBI)
Pulmonary Rehab for COPD
Video by LMH Health/YouTube
What is a Stress Test?
Video by Henry Ford Allegiance Health/YouTube
An Introduction to Pulmonary Rehabilitation
Video by NNUH FT/YouTube
Peak Flow and Spirometry - Lung Function Tests
Video by Oxford Medical Education/YouTube
Lung Function - Lung Volumes and Capacities
Video by Armando Hasudungan/YouTube
Mayo Clinic Minute: What is a cardiac stress test?
Video by Mayo Clinic/YouTube
The Importance of Pulmonary Rehabilitation
Video by West Park Healthcare Centre/YouTube
Lung Function Testing Machine
Former machinist mr. Wilbur Shuff uses a lung function testing machine to measure his breathing capacity. Having developed emphysema, he suffers severely from air pollution.
Also called: Cardiac Stress Test, Cardiac Diagnostic Test
Stress tests shows how well your heart works when it's pumping hard. They can find problems with blood flow to your heart muscle and other heart conditions. Reduced blood flow can be a sign of a serious heart disease.
Stress Tests
Also called: Cardiac Stress Test, Cardiac Diagnostic Test
Stress tests shows how well your heart works when it's pumping hard. They can find problems with blood flow to your heart muscle and other heart conditions. Reduced blood flow can be a sign of a serious heart disease.
Stress tests show how well your heart works when it's pumping hard. Some heart diseases are easier to find when your heart is working its hardest to pump blood through your body. So stress tests check your heart while you exercise on a treadmill or stationary bicycle. If you're not able to exercise, medicine can be used to make your heart work harder , as if you were exercising.
There are different types of stress tests. They all check:
Blood flow in your heart
Your blood pressure
The rate and rhythm of your heartbeat
The strength of the electrical signals that control your heartbeat
Some stress tests also take pictures of your heart at rest and when it's working hard. The pictures provide more detail about how your heart is working.
Stress tests are most often used to find the cause of symptoms that may be from a heart problem.
The tests can help diagnose certain heart conditions, including:
Coronary artery disease (CAD)
Angina
Arrhythmia
Heart failure
Heart valve diseases
Cardiomyopathy
Stress testing is also used:
To find out how serious a known heart condition is, including the chance that you'll have a heart attack in the future.
To help make treatment decisions for a heart condition.
You may need a stress test if you have symptoms that could be from a heart condition. Symptoms may include:
Chest pain or discomfort without a known cause
Shortness of breath
Irregular or rapid heartbeat that may feel like a fluttering in your chest
Feeling dizzy or lightheaded
You may also need a stress test to check your heart health if you:
Have a heart condition with new or worsening symptoms.
Are going to have surgery. Your health care provider may want to see if your heart is strong enough for the operation.
Are being treated for heart disease. The test can show how much treatment is helping, including heart surgery.
Have a high risk for heart disease. Your risk may be higher than normal if you have a family history of heart disease and/or certain conditions, such as diabetes, that are linked to heart disease.
Plan to start an exercise program. If you have a heart condition or a high risk for a heart condition, a stress test can show what level of exercise is safe for you. (Always talk with your provider before starting any strenuous, new exercise.)
Stress tests may be done with or without imaging (pictures of your heart). The most common type of test is an exercise stress test. It doesn't include pictures. But the main steps of an exercise stress test are part of all stress tests:
You'll have a blood pressure cuff on your arm to check your blood pressure.
Electrodes will be placed on your body for an electrocardiogram test (also called EKG or ECG). Electrodes are small sensors that stick to your skin. Wires connect the electrodes to a computer or an EKG machine that records the electrical activity in your heart during the stress test.
If you're unable to exercise: An intravenous (IV) line will be inserted into a vein in your arm. You'll get medicine through the IV. The medicine will make your heart work harder for 10 to 20 minutes while an EKG records your heart's electrical activity. Medicine can be used instead of exercise for all types of stress tests.
If you can exercise: You'll walk on a treadmill or ride a stationary bicycle. On a treadmill, the speed will slowly increase. The treadmill may also tilt so you feel like you're walking uphill. On a bicycle, the resistance will slowly increase, so it's harder to pedal.
You'll exercise for about 10 to 15 minutes until you reach a target heart rate based on your age and fitness level. But you may stop the test sooner if:
You develop chest pain, shortness of breath, dizziness, fatigue or other symptoms
The EKG shows a problem with your heart
After all types of stress tests, you'll be monitored for 10-15 minutes or until your heart rate returns to normal.
Stress tests with pictures include stress echocardiograms, nuclear stress tests, and cardiac (heart) MRI stress tests. These tests have extra steps:
A stress echocardiogram or "echo" takes moving pictures of your heart using doppler ultrasound. The pictures show the size and shape of your heart and blood flow through your heart. Pictures will be taken before and after your heart has worked its hardest. You'll lie on your left side on a table as a provider moves an ultrasound device on your chest. If you exercise on a bicycle, the second set of pictures may be taken while you're pedaling.
A nuclear stress test takes pictures of your heart using a small amount of a radioactive substance called a "tracer" and a special camera that scans your heart. A provider injects the tracer into your bloodstream through an IV line that's placed in a vein. Your heart and blood vessels absorb the tracer, which makes them show up more clearly in the pictures.
Pictures are taken while you lie on a table before and after your heart has worked its hardest. After the test, the tracer naturally leaves your body in your urine (pee). Drinking lots of water will help remove it faster.
A cardiac MRI stress test takes the most detailed pictures of your heart using radio waves, magnets, and a computer. It is a newer test that's mostly used for very serious heart problems. For an MRI stress test:
A provider may inject dye into your bloodstream through an IV line placed in your arm. Some cardiac MRIs, but not all, use dye to help show very small details on the pictures.
Pictures of your heart may be taken before and after your heart has worked hard. To take the pictures, you'll lie on a table that slides into a large, tunnel-like MRI machine. You'll hear loud sounds as the machine takes pictures. If you're exercising for the test, you may use a treadmill near the MRI, or you may exercise while lying in the MRI machine using special devices to move your arms or legs.
Wear comfortable shoes and clothing for exercise. Your provider will tell you what else to do before a stress test. You'll usually need to fast (not eat or drink) and stop smoking for at least a few hours before the test. You may need to avoid drinks with caffeine, such as coffee, tea, and colas, for a longer period of time.
If you take medicines or supplements, ask your provider if you should take them as usual. Don't stop taking any medicine unless your provider tells you to. If your test uses MRI, tell your provider about any metal you have in your body. An MRI can heat certain metal and cause burns.
Stress tests are usually safe. You will be closely watched during the test. If a problem develops, you'll be treated quickly. Medicines that make your heart work harder sometimes cause symptoms such as chest pain, dizziness, or nausea. An IV may bruise your arm.
The tracers and dyes used in nuclear and MRI stress tests may cause an allergic reaction, but this is rare. If you are or could become pregnant or are breastfeeding, talk with your provider before you have these tests.
A normal test result means no blood flow problems were found. Your heart is working well.
If your test result was not normal, it may mean you have heart disease. Ask your provider to explain what condition you may have. You may need more tests to find out how serious your condition is.
Stress Tests: MedlinePlus Medical Test [accessed on Mar 09, 2023]
Exercise Tolerance Test
Exercise Tolerance Test
Also called: Treadmill Stress Testing, Exercise Stress Test, Cardiopulmonary Exercise Test, CPX Test
Exercise tolerance testing is a form of cardiac stress testing that uses treadmill exercise with electrocardiogram (EKG) and blood pressure monitoring. The test is used to determine a patient’s functional capacity, assess the probability and extent of coronary artery disease (CAD) as well as assess risks, prognosis and effects of therapy.
Exercise Tolerance Test
Also called: Treadmill Stress Testing, Exercise Stress Test, Cardiopulmonary Exercise Test, CPX Test
Exercise tolerance testing is a form of cardiac stress testing that uses treadmill exercise with electrocardiogram (EKG) and blood pressure monitoring. The test is used to determine a patient’s functional capacity, assess the probability and extent of coronary artery disease (CAD) as well as assess risks, prognosis and effects of therapy.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A normal test is when the blood pressure and heart rate increase appropriately to graded exercise. Some normal physiologic and EKG changes may occur during exercise.
Related conditions
Fatigue, dyspnea, diaphoresis, flushing
Incremental increase in blood pressure and heart rate
Minor EKG changes
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Use the slider below to see how your results affect your
health.
-11
5
Your result is Low risk.
Low risk (score > 5) indicates a 5-year survival of 97%. No need for further investigation with coronary angiography.
Related conditions
This test allows your doctor to learn how your heart reacts to exercise. As you walk on the treadmill, an EKG (electrocardiogram) will check your heart’s electrical activity. The EKG may show if your heart lacks blood flow or has abnormal heartbeats during exercise. The stress test also helps your doctor decide if you need further tests to evaluate your heart.
Before the test begins, your nurse or doctor will explain it to you. Feel free to ask questions and voice concerns at this time. When you understand what will happen, you will be asked to sign a consent for the test to be performed.
To monitor your heart during exercise, adhesive patches, called electrodes, will be put on your chest. Your chest will be cleansed with alcohol and shaved in some areas (if necessary) before these electrodes are placed.
You will be asked about symptoms you have had with exercise in the past. Describe, as completely as you can, any chest discomfort, breathing problems, lightheadedness or dizziness, fluttering in the chest, weakness, fatigue, or anything else you think may be relevant. Also, mention anything you feel while you are being prepared for the test.
A nurse or doctor will be with you throughout the test. Your heart rate and rhythm and your blood pressure will be checked during the test.
Generally, the treadmill’s pace and incline will increase every 3 minutes. It is important that you describe anything you feel as you exercise. If you become short of breath, the nurse may ask you to rate it as “mild,” “moderate,” or “severe.” If you have chest discomfort, you will be asked to describe it as best you can and rate it on a scale of 1 to 10 (1 is very mild; 10 is very severe). There is no right or wrong number. This helps your doctor know how you are doing and gives us a better way to compare how you feel before and after the test.
Keep walking until you are told to stop or until you cannot walk any longer. Let the nurse know when you need to slow down. Keep walk-ing as the treadmill slows. Do not jump off.
While you rest, your heart will continue to be monitored.
Inform the doctor or nurse about any temporary or permanent condition that could affect your ability to move, walk, bear weight, or keep your balance. If possible, discuss this when you are first scheduled for the test. It is also important that the doctor and/or nurse conducting the test have this information.
Carefully follow your doctor’s instructions about medications. Some medications should be stopped for 48 hours before the test; others should not be stopped. If you do not have clear instructions about all your medications (including those for your heart, blood pressure, or other medications), contact your doctor or nurse a few days before the test.
Avoid caffeine, alcohol, and nicotine 8 hours before the test. Do not eat 2 hours before the test, and do not drink liquids 1 hour before the test. If your exercise test is combined with heart imaging (such as a thallium scan), follow the specific instructions for that test.
Try to be as well rested as possible. You may need to reschedule the test if you feel unwell (for example, if you have a cold). If you do not feel you can give your maximum exercise effort, contact your nurse or doctor before the test.
Wear loose, comfortable clothing with a separate top and bottom. Women should wear bras. Wear comfortable, flat shoes that will not slip off while you are walking.
After the procedure:
You can eat and drink as usual.
Depending on how you feel, you may go about your normal routine or take it easy if the test tired you.
Do not take a hot shower for at least an hour after the test. Your blood vessels expand with exercise and need time to return to normal. A hot shower may expand them more, causing low blood pressure and dizziness.
Procedures/Diagnostic Tests. Exercise tolerance test. National Institutes of Health Clinical Center. [accessed on Dec 11, 2018]
Vilcant V, Zeltser R. Treadmill Stress Testing. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. [accessed on Dec 11, 2018]
Am Fam Physician. 2017 Sep 1;96(5):293-299. Exercise Stress Testing: Indications and Common Questions. Garner KK, Pomeroy W, Arnold JJ. [accessed on Dec 11, 2018]
Am Fam Physician. 1999 Jan 15;59(2):401-10. Ordering and understanding the exercise stress test. Darrow MD. [accessed on Dec 11, 2018]
Harvard Men's Health. Cardiac exercise stress testing: What it can and cannot tell you. [accessed on Dec 11, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Stress Echocardiography
Stress Echocardiography
Also called: Echocardiography Stress Test, Stress Echo
Stress echocardiography, or echo, is a test that uses sound waves to create moving pictures of your heart. A stress echo is done as part of a stress test. Some heart problems, such as coronary heart disease, are easier to diagnose when the heart is working hard and beating fast.
Stress Echocardiography
Also called: Echocardiography Stress Test, Stress Echo
Stress echocardiography, or echo, is a test that uses sound waves to create moving pictures of your heart. A stress echo is done as part of a stress test. Some heart problems, such as coronary heart disease, are easier to diagnose when the heart is working hard and beating fast.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that blood flow through the coronary arteries is probably normal.
Related conditions
https://medlineplus.gov/ency/article/007150.htm [accessed on Feb 23, 2022]
https://medlineplus.gov/lab-tests/stress-tests/ [accessed on Feb 23, 2022]
https://www.nhlbi.nih.gov/health-topics/echocardiography [accessed on Feb 23, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Lung Function Tests
Lung Function Tests
Also called: Pulmonary Function Tests, PFTs, Respiratory Function Tests
Lung function tests are a group of tests that check to see if your lungs are working right. For most tests, you will breathe into a mouthpiece while a machine measures how well your lungs are working.
Lung Function Tests
Also called: Pulmonary Function Tests, PFTs, Respiratory Function Tests
Lung function tests are a group of tests that check to see if your lungs are working right. For most tests, you will breathe into a mouthpiece while a machine measures how well your lungs are working.
Lung function tests are a group of tests that check how well your lungs are working. These tests are also called pulmonary function tests, or PFTs. They may be used with other tests and information to help diagnose and monitor certain lung diseases.
There are many types of lung function tests. Most of them involve breathing through a mouthpiece. The mouthpiece is connected to a device that makes different types of measurements, such as:
How much air your lungs can hold
How well you move air in and out of your lungs when you breathe
How well your lungs absorb oxygen from the air you breathe and move it into your blood
Lung function tests also help check the health of your airways. Your airways are the parts of your body that carry air to your lungs, including your nose, throat, trachea (windpipe), and bronchial tubes that connect your windpipe to each lung.
Common lung function tests include:
Spirometry. This lung function test is used the most. A spirometry test measures how much air you breathe out and how fast you can blow air out of your lungs.
Lung volume test, also called as body plethysmography. This test is the most accurate way to measure the amount of air your lungs can hold. It also measures the amount of air that remains in your lungs after you exhale as much as you can.
Lung diffusion capacity test. This test measures how well your lungs deliver oxygen to your blood from the air you breathe.
Exercise tests. There are different types of tests that measure how well your lungs work when you are active, including:
Six minute walk test
Cardiopulmonary (heart and lung) exercise test (CPET)
Your health care provider may order one or more lung function tests, depending on the reason you need to be tested.
Other names: pulmonary function tests, PFTs
Lung function tests are often used to:
Help diagnose and monitor lung diseases, including:
Asthma
COPD (chronic obstructive pulmonary disease)
Emphysema
Pulmonary fibrosis
Pulmonary hypertension
Guide decisions about treating certain lung diseases with medicine
Help diagnose and monitor certain diseases that can affect the lungs, such as scleroderma or sarcoidosis
Check lung function before surgery
Check for lung damage from exposure to chemicals or other substances at home or work
Lung function tests are done for many different reasons. You may need testing if you:
Have signs and/or symptoms of a breathing problem such as:
Shortness of breath
Wheezing
Coughing
A tight feeling in your chest or trouble breathing deeply
An abnormal chest x-ray
Have a lung condition or another type of condition that could damage your lungs
Have been exposed to substances that can cause lung damage, such as asbestos, radiation, or certain medicines
Are going to have surgery
Your provider may also order a lung function test as part of your routine exam.
There are different ways to do each type of lung function test. But the basic steps are about the same.
For a spirometry test:
You'll sit on a chair with a soft clip on your nose. The clip makes sure you breathe only through your mouth.
You'll place your lips tightly around a mouthpiece that's connected to a device called a spirometer.
You'll be told to take a deep breath in and then blow it out into the mouthpiece as hard as you can. The spirometer will measure how much air you breathe out and how fast you blow it out.
You may be given medicine to inhale (breath in) that opens your airways. Then you'll blow into the tube again to see if the medicine helps you blow out more air faster.
For a lung volume (body plethysmography) test:
You'll sit in a small, airtight room with clear walls. It looks like a telephone booth.
You'll wear a soft clip on your nose to make sure you breathe only through your mouth.
You'll place your lips tightly around a mouthpiece.
You'll be told how to breathe in and out through the mouthpiece.
Air pressure changes inside the room will show how much air your lungs can hold and how much air stays in your lungs after you breath out.
A lung volume test may be done by breathing a special mixture of gases for a few minutes while wearing a clip on your nose. For this test, you do not need to sit in an airtight room.
For a gas diffusion test:
You'll sit on a chair with a soft clip on your nose. The clip makes sure you breathe only through your mouth.
You'll place your lips tightly around a mouthpiece that's connected to a spirometer.
You will be asked to breathe in a very small, safe amount of carbon monoxide gas. Then you'll hold your breath for about 10 seconds.
Next, you'll breathe out through the mouthpiece. The spirometer will measure the amount of carbon dioxide you exhale. This shows how much of the gas your lungs were able to absorb and move into your blood.
For exercise tests:
Six minute walk test:
Your blood pressure will be measured, and you'll be asked to rate any shortness of breath and fatigue that you feel.
You'll walk as far as possible in six minutes, usually in a hallway.
Your heart rate and the amount of oxygen in your blood will be checked as you walk.
After six minutes, your blood pressure will be measured again, and you'll rate your shortness of breath and fatigue.
If you normally use portable oxygen for a lung condition, you'll be able to use it during this test.
Cardiopulmonary exercise test (CPET):
You'll be attached to monitors and machines that will measure your breathing, heart rate, blood pressure, and blood oxygen levels while you exercise.
You'll breathe through a face mask or mouthpiece connected to a monitor. It measures how much oxygen you breath in and how much carbon dioxide you breath out.
You'll exercise on a stationary bicycle or treadmill for a total of 10 to 20 minutes:
You'll begin exercising with the bike or treadmill set to the easiest level.
You'll slowly increase your effort until you feel you can't continue. On a bicycle, the resistance will increase, so it's harder to pedal. On a treadmill, the speed will increase, and the platform may tilt so you feel like you're walking uphill.
As you exercise, you'll be asked to rate how you're feeling. If you have serious symptoms, the test will stop.
The bike or treadmill will return to the easiest level while you keep pedaling or walking to cool down.
Your provider will let you know how to prepare for your lung function test. To make sure your test results are accurate, follow the instructions you're give. In general:
Wear loose, comfortable clothing.
Don't eat a large meal within at least two hours of the test.
You may need to avoid certain activities or foods and beverages before your test. Your provider will tell you for how long. These include:
Heavy exercise
Smoking
Drinking alcohol
Drinking or eating products with caffeine, such as coffee, colas, and chocolate
If you use inhaler medicines (bronchodilators), you may need to stop for a period of time before testing. Your provider will tell you when to stop. But never stop taking any medicine without talking with your provider first.
If you wear dentures, wear them for the test. They'll help you close your lips tightly around the mouthpiece.
There is very little risk to having a lung function test. Some people may feel lightheaded, dizzy, or tired from breathing hard. It's also common to cough. Some people may feel nervous being in a small space for a lung volume test. If you have concerns about your test, talk with your provider.
A normal lung function test result for you depends on the size of your lungs. Your lung size is based on your height, sex, and age. So, your provider will compare your test results to results from healthy people who are the same height, age, and sex as you.
If your results aren't normal, it may mean you have a lung condition. Lung function tests can't diagnose which specific lung disease you have. But your test results can tell which of the two main types you have:
Obstructive lung conditions cause your airways to become narrow, making it hard for air to flow out of your lungs. Examples of obstructive lung diseases include asthma, bronchitis, and emphysema.
Restrictive lung conditions decrease the amount of air your lungs can hold. This may happen if your lungs or your chest muscles can't expand fully when you breath in. Examples of restrictive lung conditions include scleroderma, sarcoidosis, pulmonary fibrosis, and interstitial lung diseases.
If you have questions about your results, talk with your provider.
If you need one or more lung function tests, your provider may also order a blood oxygen level test called an arterial blood gas (ABG) test. This blood test measures the amount of oxygen and carbon dioxide in your blood.
https://medlineplus.gov/lab-tests/lung-function-tests/ [accessed on May 31, 2019]
https://medlineplus.gov/ency/article/003853.htm [accessed on May 31, 2019]
https://www.nhlbi.nih.gov/health-topics/pulmonary-function-tests [accessed on May 31, 2019]
Spirometry Test
Spirometry Test
Also called: Breathing Test, Lung Capacity, Pulmonary Function Testing
Spirometry is a pulmonary function test that is used to help diagnose and monitor chronic lung conditions such as asthma or COPD. During this test, you will make maximum breathing efforts several times, and a special machine called spirometer will be used to calculate and graph your results.
Spirometry Test
Also called: Breathing Test, Lung Capacity, Pulmonary Function Testing
Spirometry is a pulmonary function test that is used to help diagnose and monitor chronic lung conditions such as asthma or COPD. During this test, you will make maximum breathing efforts several times, and a special machine called spirometer will be used to calculate and graph your results.
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35
50
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Your result is Normal.
This indicates the absence of airway obstruction.
Related conditions
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Your result is Normal.
Restrictive lung disease can cause a normal or increased FEV1/FVC ratio. But, in the absence of lung disease, a normal value indicates healthy lungs.
Related conditions
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Use the slider below to see how your results affect your
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%
80
Your result is Normal.
Normal results vary from person to person depending on their gender, age, height, and race.
Related conditions
Spirometry is a pulmonary function test that is used to estimate the size of the lungs and measure the rate of air flow into and out of them. This helps determine how well your lungs are functioning.
Your doctor may want to order this test to help diagnose and monitor chronic lung conditions, such as:
Asthma
Chronic obstructive pulmonary disease (COPD)
Restrictive lung disease, such as pulmonary fibrosis
Cystic fibrosis
Other disorders affecting lung function
Spirometry let doctors diagnose lung diseases at early stages when treatment is most effective. Then, routine spirometry tests can help monitor treatment effectiveness by assessing changes in lung functions.
A spirometry test can be performed in your doctor’s office.
During the test, your healthcare provider will place a clip on your nose to keep your nostrils closed. Then, you will be asked to sit, take a deep breath in, hold your breath for one or two seconds, and then exhale as hard as you can into a small machine called a spirometer until your lungs feel entirely empty.
You will be asked to repeat this procedure at least three times to ensure consistent results.
If at this point, your results show evidence of a breathing disorder, your doctor might give you an inhaled drug known as a bronchodilator to open up your airways; then, you will be asked to wait for approximately 15 minutes to perform another round of sets. Both sets of tests will be compared at the end of the exam to see whether the bronchodilator helped increase your airflow.
A computer that is attached to the spirometer calculates and graphs your results.
You will be asked to refrain from taking alcohol on the day of the test, and avoid smoking, eating, or exercising for at least a few hours before the test is done. Don’t wear tight clothing that could restrict your breathing.
Inform your healthcare practitioner if you are taking any over-the-counter or prescription medications since you might be asked to temporarily stop taking certain drugs that may affect your test results, especially puffer medications.
Complications are rare during or after a spirometry test. You may feel dizziness or experience shortness of breath immediately after performing the test. In very rare cases, severe breathing problems may be triggered.
Spirometry is not recommended for people who recently had eye surgery, heart surgery, or have other heart problems.
Spirometry results indicate whether your lungs are functioning normally. It does this through several breathing measurements:
Forced vital capacity (FVC): this is the total air volume that you can force out of your lungs after you take your biggest breath in.
Forced expiratory volume in one second (FEV1): this is the amount of air that you can blow out of your lungs within the first second. It indicates whether or not there is airway obstruction.
FEV1/FVC ratio: this is the percentage of the FVC exhaled in the first second.
Normal results vary from person to person depending on their gender, age, height, and race.
Abnormal spirometry results could be due to either restrictive lung disease (such as pulmonary fibrosis or sarcoidosis), obstructive lung disease (such as asthma or COPD), or a combination of both restrictive and obstructive lung disease.
Your doctor will take into consideration all spirometry measurements, along with the results of other tests, and your clinical findings to determine which type of lung disease is present.
Spirometry is often performed once a year or once every two years to monitor people with well-controlled breathing disorders. People who have uncontrolled or more severe breathing problems may need to have this test more frequently.
Pulmonary Function Tests | National Heart, Lung, and Blood Institute (NHLBI) [accessed on Dec 09, 2018]
https://www.cdc.gov/nchs/data/nhanes/nhanes_11_12/spirometry_procedures_manual.pdf [accessed on Dec 09, 2018]
Spirometry and Bronchodilator Test [accessed on Dec 09, 2018]
Spirometry | the lung association [accessed on Dec 09, 2018]
Spirometry Testing | Breathing Test | Lung Capacity [accessed on Dec 09, 2018]
Spirometry: Procedure, Normal Values, and Test Results [accessed on Dec 09, 2018]
https://www.racgp.org.au/download/documents/AFP/2011/April/201104paraskeva.pdf [accessed on Dec 09, 2018]
https://cnx.org/contents/bbaedbf4-4d78-4b7c-bc94-2a742f0f2f8c [accessed on Dec 09, 2018]
https://covid19.nih.gov/news-and-stories/monitoring-lung-function [accessed on Sep 03, 2021]
Additional Materials (14)
An illustration depicting an incentive spirometer.
An illustration depicting an incentive spirometer.
Image by BruceBlaus
A medical illustration depicting spirometry
A medical illustration depicting spirometry
Image by BruceBlaus
Testing and Diagnosis
Your doctor will first take your medical history and ask you about your symptoms. He or she will probably listen to your lungs using a stethoscope, although there may be no abnormal chest sounds between asthma attacks. Your doctor may ask about any patterns relating to your symptoms: are they worse during allergy seasons, at work or at home, during exercise? Do you have a family history of asthma?
Image by TheVisualMD
Testing and Diagnosis
Your doctor will first take your medical history and ask you about your symptoms. He or she will probably listen to your lungs using a stethoscope, although there may be no abnormal chest sounds between asthma attacks. Your doctor may ask about any patterns relating to your symptoms: are they worse during allergy seasons, at work or at home, during exercise? Do you have a family history of asthma?
Image by TheVisualMD
Testing and Diagnosis of Asthma
Testing and Diagnosis of Asthma
Image by TheVisualMD
Airway during asthma symptoms
Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms.
Image by National Heart, Lung, Blood Institute
How Is the Cause of Cough Diagnosed?
The image shows how spirometry is done. The patient takes a deep breath and blows as hard as possible into a tube connected to a spirometer. The spirometer measures the amount of air breathed out. It also measures how fast the air was blown out.
Image by National Heart Lung and Blood Institute (NIH)
Asthma before-after
During an asthma episode, inflamed airways react to environmental triggers such as smoke, dust, or pollen. The airways narrow and produce excess mucus, making it difficult to breathe.
Image by FDA/Renée Gordon; vectors by Mysid
How Is COPD Diagnosed?
Doing a spirometry
Image by Jmarchn
Asthma in Children
A child using a peak expiratory flow meter in a pediatric clinic.
Image by National Heart, Lung and Blood Institute, a division of the National Institute of Health
Types of Lung Function Tests
A man undergoing whole body plethysmography
Image by Finchbook01 (talk)
Asthma Attacks
Constriction of the bronchioles and excess mucous production during an asthma attack.
Image by 7mike5000
Gas Exchange across Respiratory Surfaces
The partial pressures of oxygen and carbon dioxide change as blood moves through the body.
Image by CNX Openstax
Spirometry: how to take a lung function test
Video by The European Lung Foundation/YouTube
An illustration depicting an incentive spirometer.
BruceBlaus
A medical illustration depicting spirometry
BruceBlaus
Testing and Diagnosis
TheVisualMD
Testing and Diagnosis
TheVisualMD
Testing and Diagnosis of Asthma
TheVisualMD
Airway during asthma symptoms
National Heart, Lung, Blood Institute
How Is the Cause of Cough Diagnosed?
National Heart Lung and Blood Institute (NIH)
Asthma before-after
FDA/Renée Gordon; vectors by Mysid
How Is COPD Diagnosed?
Jmarchn
Asthma in Children
National Heart, Lung and Blood Institute, a division of the National Institute of Health
Types of Lung Function Tests
Finchbook01 (talk)
Asthma Attacks
7mike5000
Gas Exchange across Respiratory Surfaces
CNX Openstax
4:00
Spirometry: how to take a lung function test
The European Lung Foundation/YouTube
Lung Diffusion Testing
Lung Diffusion Testing
Also called: Gas Diffusion Study, Diffusing Capacity of the Lung for Carbon Monoxide, DLCO
A lung diffusion test is a painless and risk-free procedure in which you will be required to inhale a small amount of carbon monoxide that will be compared with the amount of the same carbon monoxide you exhale. This is useful to assess how well your lungs are functioning.
Lung Diffusion Testing
Also called: Gas Diffusion Study, Diffusing Capacity of the Lung for Carbon Monoxide, DLCO
A lung diffusion test is a painless and risk-free procedure in which you will be required to inhale a small amount of carbon monoxide that will be compared with the amount of the same carbon monoxide you exhale. This is useful to assess how well your lungs are functioning.
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Your result is Normal.
A normal result means that your lung function is normal because the carbon monoxide was successfully absorbed into your bloodstream.
Related conditions
A lung diffusion test is used to assess how well the lungs are able to allow the “diffusion” or exchange of oxygen and carbon dioxide in and out the blood.
This test helps determine how well your lungs are functioning.
Your doctor may want to order this test to help diagnose and monitor chronic lung conditions, such as:
Asthma
Chronic obstructive pulmonary disease (COPD)
Restrictive lung disease, such as pulmonary fibrosis
Cystic fibrosis
Other disorders affecting lung function
Your healthcare practitioner will put clips on your nose and will place a mouthpiece tightly around your mouth so you can breathe through it.
Then, you will inhale air that contains a very small, and safe, amount of carbon monoxide or another gas that can be used as a tracer, such as helium or methane. At this point, you will be required to hold your breath for 10 seconds and then quickly exhale it out of your lungs.
The exhaled air is then analyzed to determine how much of the tracer gas was absorbed in your lungs.
You will be asked to eat a light meal on the day of the test, and avoid smoking for at least a 6 hours before the test is done.
Inform your healthcare practitioner if you are taking any over-the-counter or prescription medications since you might be asked to temporarily stop taking certain drugs that may affect your test results, especially puffer medications.
There are no known risks associated with this test.
Normal results vary depending on the person’s age, sex, height, ethnicity, and health status.
Normal
If there’s significantly less exhaled carbon monoxide in your breath when compared with the amount of carbon monoxide that you inhaled, then this means that your lung function is normal because the gas was successfully absorbed into your bloodstream.
Abnormal
If the amount of inhaled and exhaled carbon monoxide in your breath is similar, it means that there is a problem in your lungs that is preventing the gas from being absorbed adequately. This can happen due to:
Asthma
Emphysema
Cystic fibrosis
Pulmonary fibrosis
Sarcoidosis (a chronic disease characterized by the development of small tumors throughout the body)
Airway blockage by a foreign body
Pulmonary hypertension (high blood pressure in the lungs)
Lung tissue loss
Pulmonary embolism
https://medlineplus.gov/ency/article/003854.htm [accessed on Feb 03, 2019]
https://my.clevelandclinic.org/health/diagnostics/15445-gas-diffusion-study [accessed on Feb 03, 2019]
https://www.healthline.com/health/lung-diffusion-testing [accessed on Mar 20, 2019]
https://www.verywellhealth.com/lung-diffusion-tests-914897 [accessed on Mar 20, 2019]
https://www.nationaljewish.org/treatment-programs/tests-procedures/pulmonary-physiology/pulmonary-function/lung-diffusion-capacity [accessed on Mar 20, 2019]
https://www.uclahealth.org/lungcancer/lung-diffusion [accessed on Mar 20, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Plethysmography
Plethysmography
Also called: Pulmonary plethysmography, Body plethysmography, Lung Volume Measurement
Lung plethysmography, also called pulmonary plethysmography, is a test used to calculate how much air you can hold in your lungs. This helps determine whether you have problems with your lung capacity.
Plethysmography
Also called: Pulmonary plethysmography, Body plethysmography, Lung Volume Measurement
Lung plethysmography, also called pulmonary plethysmography, is a test used to calculate how much air you can hold in your lungs. This helps determine whether you have problems with your lung capacity.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
Normal results vary depending on the person’s age, sex, fitness level, and body size.
Related conditions
Plethysmography is a test that uses a special machine called plethysmograph to measure volume changes in different areas of your body.
A lung plethysmography is used to calculate how much air you can hold in your lungs. Measurements include:
Functional residual volume (FRV): this is the amount of air left in your lungs after you force out as much air as you can.
Functional residual capacity (FRC): this is the amount of air that is left in your lungs after you breathe out normally.
Total lung capacity (TLC): this is the total amount of air in your lungs after you take your biggest breath in.
Your doctor may want to order this test in the following situations:
If you have signs and symptoms of upper respiratory problems, such as pain or shortness of breath.
To measure lung function in people with chronic pulmonary diseases, such as chronic obstructive pulmonary disease (COPD), asthma, or cystic fibrosis.
To differentiate obstructive lung disease (such as asthma or COPD) from restrictive lung disease (such as pulmonary fibrosis or sarcoidosis), especially when other pulmonary function tests have failed to do so.
To monitor your response to treatment.
To assess whether your lungs would tolerate lung cancer surgery.
You will be asked to sit in a small, airtight room, that looks very much like a telephone booth. Your healthcare practitioner will then place clips on your nose and will give you a mouthpiece so you can breathe through it.
Then, you will be guided through various breathing patterns, alternating normal breathing, panting, and deep breaths.
If you are receiving oxygen, it will be temporarily suspended during the duration of this test, which usually lasts around 15 minutes.
You will be asked to stop smoking for at least 8 hours and avoid doing exercise for a couple hours before the test. You should also eat a light meal on the day of the test.
Make sure to wear loose and comfortable clothing.
Most people don’t experience any discomfort during this test. However, in some cases, some symptoms like lightheadedness, dizziness, shortness of breath, or anxiety from being in a tight space can occur.
Normal
Normal results vary depending on the person’s age, sex, fitness level, and body size.
Abnormal
An abnormal plethysmography test result indicates a problem with your lung capacity, but it doesn’t provide a specific diagnosis. Further testing is usually required.
An abnormal result may be due to:
Emphysema
Cystic fibrosis
Pulmonary fibrosis
Sarcoidosis (a chronic disease characterized by the development of small tumors throughout the body)
Obesity
Scoliosis (abnormally curved spine)
This test is not the same as impedance plethysmography which is a test for blood clots in the legs.
Another test called spirometry is the standard way to measure lung function; however, lung plethysmography is more accurate.
This test cannot be done in people who require continuous oxygen therapy or in people with claustrophobia (a severe fear of being in small and enclosed places).
https://my.clevelandclinic.org/health/diagnostics/15467-body-plethysmography-pulmonary-function-test [accessed on Feb 03, 2019]
https://www.healthline.com/health/lung-plethysmography [accessed on Feb 03, 2019]
https://www.healthline.com/health/plethysmography#results [accessed on Mar 14, 2019]
https://medlineplus.gov/ency/article/003771.htm [accessed on Mar 14, 2019]
https://www.verywellhealth.com/what-is-plethysmography-2249161 [accessed on Mar 14, 2019]
https://lunginstitute.com/blog/lung-plethysmography/ [accessed on Mar 14, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (12)
Body Plethysmography Chamber
Chamber used for Body Plethysmography and other related medical tests. Photographed at Swedish Hospital Ballard Campus, Seattle, Washington.
Image by Joe Mabel/Wikimedia
Lung Volumes Measurement by Body Plethysmography
Lung Volumes Measurement by Body Plethysmography technology from COSMED (http://www.cosmed.com/en/products/pulmonary-function/q-box-body-plethysmography)
Image by Cosmed/Wikimedia
Respiratory System
The respiratory system consists of the airways, the lungs, and the respiratory muscles that mediate the movement of air into and out of the body.
Image by LadyofHats
Lung Function - Lung Volumes and Capacities
Video by Armando Hasudungan/YouTube
Types of Lung Function Tests
A man undergoing whole body plethysmography
Image by Finchbook01 (talk)
Blood circulation: Red = oxygenated (arteries), Blue = deoxygenated (veins)
Oximetry - Blood circulation: Red = oxygenated (arteries), Blue = deoxygenated (veins)
Image by User:Sansculotte
Lung Function test for COPD
A modern USB spirometer
Image by AME
Lung Volume Testing by Plethysmography
Video by Launceston Lung Centre/YouTube
Pulmonary Function Tests (PFT): Lesson 3 - Lung Volumes
Video by Strong Medicine/YouTube
5 facts about DVT (Deep Vein Thrombosis)
Video by Comprehensive Bleeding Disorders Center/YouTube
About Thrombosis: Symptoms and risk factors for deep vein thrombosis (DVT)
Video by Thrombosis Adviser/YouTube
How A Pulmonary FunctionTest Works
Video by LivingHealthyChicago/YouTube
Body Plethysmography Chamber
Joe Mabel/Wikimedia
Lung Volumes Measurement by Body Plethysmography
Cosmed/Wikimedia
Respiratory System
LadyofHats
8:31
Lung Function - Lung Volumes and Capacities
Armando Hasudungan/YouTube
Types of Lung Function Tests
Finchbook01 (talk)
Blood circulation: Red = oxygenated (arteries), Blue = deoxygenated (veins)
User:Sansculotte
Lung Function test for COPD
AME
3:03
Lung Volume Testing by Plethysmography
Launceston Lung Centre/YouTube
12:11
Pulmonary Function Tests (PFT): Lesson 3 - Lung Volumes
Strong Medicine/YouTube
2:28
5 facts about DVT (Deep Vein Thrombosis)
Comprehensive Bleeding Disorders Center/YouTube
1:27
About Thrombosis: Symptoms and risk factors for deep vein thrombosis (DVT)
Thrombosis Adviser/YouTube
3:11
How A Pulmonary FunctionTest Works
LivingHealthyChicago/YouTube
Expect During
Breathing Lesson
Image by TheVisualMD
Breathing Lesson
How our branching bronchial pathway, lungs, and blood vessels keep us breathing in and out
Image by TheVisualMD
What To Expect During Pulmonary Rehabilitation
Your pulmonary rehabilitation plan may include the following training and education:
Breathing techniques
You may learn specific techniques such as pursed lip breathing, yoga breathing, or breathing with computer-aided feedback. With these techniques, you can better control your breathing and avoid feeling out of breath, especially when you are physically active or under stress. You may also learn ways to help clear mucus from your lungs.
Education
In group or individual sessions, your providers can answer questions about your lung disease and offer guidance for how to manage it.
You may learn to recognize the signs of a flare-up early and develop a plan to avoid or manage one.
If you smoke, your team may be able to help you quit.
You may learn how to conserve your energy and avoid feeling short of breath by finding easier ways to do daily tasks. This may include ways to avoid reaching, lifting, and bending, or ways to avoid or relieve stress.
Psychological counseling
People who have a chronic (long-term) lung disease may also experience depression, anxiety, and other emotional problems. Individual or group support can offer training in stress management.
Exercise training
Exercise training aims to strengthen your back, arms, and legs, as well as the muscles you use to breathe. Training can also help you build stamina and flexibility, making it easier to do everyday tasks and the things you enjoy.
Your healthcare team may recommend using medicine to open your airways, or they may recommend adjusting your regular oxygen therapy during physical activity.
Nutritional counseling
You will learn what foods to eat and how to prepare meals to manage your condition and feel your best. Nutritional counseling can help ensure that you are getting the right nutrients in the proper amounts. A dietitian may also recommend a weight-loss plan or nutritional supplements or medicines to help you build muscle.
Source: National Heart, Lung, and Blood Institute (NIH)
Additional Materials (9)
Pulmonary rehabilitation for COPD after an exacerbation
Video by Royal Brompton and Harefield hospitals/YouTube
COPD Treatments & Rehab: Pursed Lip Breathing
Video by Burke Rehabilitation/YouTube
Pursed Lip Breathing
Video by American Lung Association/YouTube
Pulmonary rehabilitation | NHS
Video by NHS/YouTube
Breathing control for breathlessness - Cancer Research UK
Video by Cancer Research UK/YouTube
COPD Treatments & Rehab: Upper Body Exercises
Video by Burke Rehabilitation/YouTube
Respiratory System of Male and Female
Medical visualization of the respiratory systems of a female and male. The translucent skin of both the male and female reveals the nasal cavity, trachea and the lungs.
Image by TheVisualMD
Lung and Bronchi of a Human Adult
Computer generated image reconstructed from scanned human data. This image presents a frontal view of the lungs of an adult. The average weight of left lung = 565 g, right lung = 625 g. The lungs are the primary organs in the respiratory system and are protected inside the rib cage. The bronchus and branch-like structures, bronchioles, highlighted in light blue, are depicted. Each bronchiole contains hundreds of alveoli, which are the sites of gas exchange. The red-brown, tube-like structure above the lungs is the trachea.
Image by TheVisualMD
Trachea and Lung
Visualization of the human respiratory tract and heart, based on segmented human data. The thyroid cartilage resides above the trachea. The trachea branches above the heart into the two lungs. Several branching bronchi and bronchioles are shown penetrating throughout the lungs. The bronchiole tree conducts air, allowing oxygen to pass into the lungs and carbon monoxide to exit.
Image by TheVisualMD
4:54
Pulmonary rehabilitation for COPD after an exacerbation
Royal Brompton and Harefield hospitals/YouTube
1:37
COPD Treatments & Rehab: Pursed Lip Breathing
Burke Rehabilitation/YouTube
2:27
Pursed Lip Breathing
American Lung Association/YouTube
2:59
Pulmonary rehabilitation | NHS
NHS/YouTube
3:15
Breathing control for breathlessness - Cancer Research UK
Cancer Research UK/YouTube
27:52
COPD Treatments & Rehab: Upper Body Exercises
Burke Rehabilitation/YouTube
Respiratory System of Male and Female
TheVisualMD
Lung and Bronchi of a Human Adult
TheVisualMD
Trachea and Lung
TheVisualMD
How Long
Lungs, Bronchi and Bronchioles / Bronchioles and Arteries in Lungs within Male Chest / Bronchi and Bronchioles in Lungs within Male Chest
Lungs, Bronchi and Bronchioles
Interactive by TheVisualMD
Lungs, Bronchi and Bronchioles / Bronchioles and Arteries in Lungs within Male Chest / Bronchi and Bronchioles in Lungs within Male Chest
Lungs, Bronchi and Bronchioles
1) Lungs, Bronchi and Bronchioles
2) Bronchioles and Arteries
3) Bronchi and Bronchioles
When you inhale, air passes down the back of your throat, past your vocal cords, and into your windpipe, or trachea. Your trachea divides into twin air pipes (one for each lung) called the bronchi. Much the way in which a tree branches, the bronchi continue to divide into smaller air passages called bronchioles. Collectively, these air passages are known as the airways. The bronchioles continue to branch until they become extremely narrow-the small airways are less than 2 micrometers in diameter! They end in microscopic air sacs called alveoli. Your lungs contain about 500 million alveoli.
Interactive by TheVisualMD
How Long Is a Pulmonary Rehabilitation Program?
Usually, pulmonary rehabilitation is a series of 2 or 3 weekly sessions lasting several weeks or months.
At the end of your program, your healthcare team will give you tests to check your lung function again to see if your breathing has improved. Some of these tests, such as exercise tests, will be the same ones you had at the start of your program.
Source: National Heart, Lung, and Blood Institute (NIH)
Additional Materials (5)
COPD Treatment Option: Pulmonary Rehab
Video by LivingHealthyChicago/YouTube
AnnaMarie's COPD and Pulmonary Rehabilitation Story
Video by Beaumont Health/YouTube
COPD Treatments & Rehab: Nutrition
Video by Burke Rehabilitation/YouTube
COPD Treatments & Rehab: Recovery Positions
Video by Burke Rehabilitation/YouTube
Male Chest with Bronchioles and Lungs lateral view
In asthma, the airways of your lungs are always inflamed. Allergies or other triggers can make your airways produce too much mucus. The muscle tissue around them tightens up. You may experience coughing, wheezing, shortness of breath, or a feeling of tightness. Asthma is one of the most common diseases in the world. In the US, about 7% of adults and 9% of children have asthma. And the percentage of children with asthma is climbing.
Image by TheVisualMD
4:20
COPD Treatment Option: Pulmonary Rehab
LivingHealthyChicago/YouTube
2:59
AnnaMarie's COPD and Pulmonary Rehabilitation Story
Beaumont Health/YouTube
12:23
COPD Treatments & Rehab: Nutrition
Burke Rehabilitation/YouTube
2:59
COPD Treatments & Rehab: Recovery Positions
Burke Rehabilitation/YouTube
Male Chest with Bronchioles and Lungs lateral view
TheVisualMD
Benefits & Risks
Pulmonary Rehabilitation improving Quality of Life
Image by TheVisualMD
Pulmonary Rehabilitation improving Quality of Life
Pulmonary Rehabilitation improving Quality of Life
Image by TheVisualMD
Benefits and Risks of Pulmonary Rehabilitation
Benefits
Pulmonary rehabilitation (PR) can't cure your lung disease or completely relieve your breathing problems. However, PR does have many benefits. For example, it may:
Improve your quality of life
Help you function better in your daily life
Increase your ability to exercise
Decrease the symptoms of your disease or condition
Help you manage anxiety and depression
You also may have fewer breathing problems as a result of PR. Although PR doesn't improve your lung function, it allows you to make the most of the limited lung function you have.
Risks
PR usually is safe. The only risks are related to the exercise part of the program. For example, physical activity may cause injuries to your muscles or bones. If you have another disorder, such as heart disease, physical activity may increase your risk of having a heart attack or arrhythmia (ah-RITH-me-ah). An arrhythmia is a problem with the rate or rhythm of your heartbeat.
The health data that your PR team collects at the start of your program and during the program can help prevent these problems.
Source: National Heart, Lung, and Blood Institute (NIH)
Additional Materials (7)
The Benefits of Pulmonary Rehab
Video by Dartmouth-Hitchcock/YouTube
Outpatient Pulmonary Rehab Program
Video by Gaylord Specialty Healthcare / Gaylord Hospital/YouTube
The Importance of Pulmonary Rehabilitation
Video by West Park Healthcare Centre/YouTube
Pulmonary Rehabilitation: A Path to Breathing Better
People diagnosed with chronic obstructive pulmonary disease (COPD) know that it is a serious and debilitating condition requiring ongoing medical attention. But many do not realize that pulmonary rehabilitation (PR) may help them live and breathe better. This infographic introduces what a person with COPD can expect from pulmonary rehabilitation and how it can benefit them.
Document by National Heart, Lung, and Blood Institute (NIH)
CMC Pulmonary Rehab - Overview & Benefits of Exercise
Video by CMChealthsystem/YouTube
Beat Stress with Mindful Awareness
Meditation, yoga, group therapy—find the area of focus that helps you overcome stress. What is mindful awareness? It is, at heart, a catch-all term for many activities that emphasize focus on your physical, mental and emotional being. Yoga, various forms of meditation, tai chi, positive visualization, and different kinds of therapy all have in common the goal of quieting the mind, paying attention to the body, and restoring the spirit. That may sound unscientific, or even antiscientific, when in fact the scientific evidence for the benefits of mindful awareness practices are growing by the day. Group Therapy: One of the most stressed out populations in the modern world, military combat veterans with post-traumatic stress disorder, were found to benefit from a group therapy structure that required them to share their experiences with other vets. Groups of 9 to 11 troops spent a total of 60 or more hours together over 18 weeks, discussing their wartime memories and other aspects of their lives. Each gave two 2 ½-hour talks about their experience, and listened to recordings of their presentations 10 times. An impressive 81 percent of participants showed “clinically significant improvement” in stress symptoms after the group experience, an effect that remained steady six months after the group adjourned. For some, just hearing that others had frozen under fire or felt helpless alleviated the guilt or shame they had felt about doing the same. The power of group counseling is often in discovering that others who have faced the same kind of stress you face have found ways to cope, and are working to improve, just as you are. Meditation: In a study, 133 healthy adults volunteered to learn meditation techniques to reduce stress. They took a variety of mood and psychological assessments. Then they learned a simple meditation technique involving focusing on a single, meaningful word, called a mantra. The students met four times for one hour each meeting in small groups, and were instructed to practice the meditation for 15-20 minutes twice a day. After the instruction period, student scores on the mood and psychological assessments improved. Their perceived stress, mood states, anxiety inventory and brief symptom inventory scores all improved. Those who had practiced most frequently had the greatest improvement. Yoga: Emotionally distressed women volunteered to participate in a 3-month yoga program to relieve stress. The subjects took multiple assessment tools to measure their perceived stress, anxiety, mood, relative depression, well-being, physical status and more. Their levels of salivary cortisol, the stress hormone, were also measured. They met twice a week for a 90-minute Iyengar yoga class. Compared with volunteers who had been put on a waiting list for the class, the yoga students showed pronounced improvements in all of the assessment areas measured. Their cortisol levels dropped after participation in a class, and those who had suffered from headache or back pain reported significant pain relief. Choosing a Practice: Mindful awareness is about your individual mind, stressors and lifestyle. Find an approach that appeals to you, and see if you can sit in on a class or group meeting before committing to an intervention. The medical establishment has not always accepted the notion that some of these practices could improve your health and longevity. But all of that is changing in the face of compelling research about the connections between the mind and body.
Image by TheVisualMD
An Inflammatory Situation
Asthma, also called bronchial asthma, can have different triggers and may create anything from mild to severe symptoms. But there is one thing all cases of asthma have in common: chronic (long-term) inflammation. When you have asthma, your airways—specifically, your bronchioles—are always inflamed.
Pulmonary Rehabilitation: A Path to Breathing Better
National Heart, Lung, and Blood Institute (NIH)
12:03
CMC Pulmonary Rehab - Overview & Benefits of Exercise
CMChealthsystem/YouTube
Beat Stress with Mindful Awareness
TheVisualMD
An Inflammatory Situation
TheVisualMD
What You Need to Know
Lung vasculature
Lung vasculature
1
2
Transparent Normal Lungs
Interactive by TheVisualMD
Lung vasculature
Lung vasculature
1
2
Transparent Normal Lungs
Interactive by TheVisualMD
Pulmonary Rehabilitation
What is pulmonary rehabilitation?
Pulmonary rehabilitation, also known as pulmonary rehab or PR, is a program for people who have chronic (ongoing) breathing problems. It can help improve your ability to function and quality of life. PR does not replace your medical treatment. Instead, you use them together.
PR is often an outpatient program that you do in a hospital or clinic. Some people have PR in their homes. You work with a team of health care providers to find ways to lessen your symptoms, increase your ability to exercise, and make it easier to do your daily activities.
Who needs pulmonary rehabilitation?
Your health care provider may recommend pulmonary rehabilitation (PR) if you have a chronic lung disease or another condition that makes it hard for you to breathe and limits your activities. For example, PR may help you if you:
Have COPD (chronic obstructive pulmonary disease). The two main types are emphysema and chronic bronchitis. In COPD, your airways (tubes that carry air in and out of your lungs) are partially blocked. This makes it hard to get air in and out.
Have an interstitial lung disease such as sarcoidosis and pulmonary fibrosis. These diseases cause scarring of the lungs over time. This makes it hard to get enough oxygen.
Have cystic fibrosis (CF). CF is an inherited disease that causes thick, sticky mucus to collect in the lungs and block the airways.
Need lung surgery. You may have PR before and after lung surgery to help you prepare for and recover from the surgery.
Have a muscle-wasting disorder that affects the muscles used for breathing. An example is muscular dystrophy.
PR works best if you start it before your disease is severe. However, even people who have advanced lung disease can benefit from PR.
What does pulmonary rehabilitation include?
When you first start pulmonary rehabilitation (PR), your team of health care providers will want to learn more about your health. You will have lung function, exercise, and possibly blood tests. Your team will go over your medical history and current treatments. They may check on your mental health and ask about your diet. Then they will work together to create a plan that is right for you. It may include:
Exercise training. Your team will come up with an exercise plan to improve your endurance and muscle strength. You will likely have exercises for both your arms and legs. You might use a treadmill, stationary bike, or weights. You may need to start slowly and increase your exercise as you get stronger.
Nutritional counseling. Being either overweight or underweight can affect your breathing. A nutritious eating plan can help you work towards a healthy weight.
Education about your disease and how to manage it. This includes learning how to avoid situations that make your symptoms worse, how to avoid infections, and how/when to take your medicines.
Techniques you can use to save your energy. Your team may teach you easier ways to do daily tasks. For example, you may learn ways to avoid reaching, lifting, or bending. Those movements make it harder to breathe, since they use up energy and make you tighten your abdominal muscles. You may also learn how to better deal with stress, since stress can also take up energy and affect your breathing.
Breathing strategies. You will learn techniques to improve your breathing. These techniques may increase your oxygen levels, decrease how often you take breaths, and keep your airways open longer.
Psychological counseling and/or group support. It can feel scary to have trouble breathing. If you have a chronic lung disease, you are more likely to have depression, anxiety, or other emotional problems. Many PR programs include counseling and/or support groups. If not, your PR team may be able to refer you to an organization that offers them.
Source: NIH: National Heart, Lung, and Blood Institute
Additional Materials (10)
Pulmonary rehabilitation | NHS
Video by NHS/YouTube
COPD Treatment Option: Pulmonary Rehab
Video by LivingHealthyChicago/YouTube
An Introduction to Pulmonary Rehabilitation
Video by NNUH FT/YouTube
Pulmonary Rehabilitation for Chronic Lung Conditions
Video by NHS Forth Valley/YouTube
What is Pulmonary Rehabilitation?
Video by Ascension Via Christi/YouTube
Learn About Pulmonary Rehabilitation
Video by NHLBI/YouTube
Pulmonary Rehabilitation 101
Video by Pulmonary Fibrosis Foundation/YouTube
The Importance of Pulmonary Rehabilitation
Video by West Park Healthcare Centre/YouTube
Why you MUST know your oxygen saturations / levels!
Video by PulmonaryRehab/YouTube
Pulmonary Rehabilitation improving Quality of Life
Pulmonary Rehabilitation improving Quality of Life
Image by TheVisualMD
2:59
Pulmonary rehabilitation | NHS
NHS/YouTube
4:20
COPD Treatment Option: Pulmonary Rehab
LivingHealthyChicago/YouTube
9:36
An Introduction to Pulmonary Rehabilitation
NNUH FT/YouTube
19:28
Pulmonary Rehabilitation for Chronic Lung Conditions
NHS Forth Valley/YouTube
2:50
What is Pulmonary Rehabilitation?
Ascension Via Christi/YouTube
1:36
Learn About Pulmonary Rehabilitation
NHLBI/YouTube
33:54
Pulmonary Rehabilitation 101
Pulmonary Fibrosis Foundation/YouTube
5:13
The Importance of Pulmonary Rehabilitation
West Park Healthcare Centre/YouTube
4:12
Why you MUST know your oxygen saturations / levels!
PulmonaryRehab/YouTube
Pulmonary Rehabilitation improving Quality of Life
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Pulmonary Rehabilitation
Pulmonary rehabilitation is a supervised program that includes exercise training, health education, and breathing techniques for people who have certain lung conditions or lung problems due to other conditions. Discover more about the power of pulmonary rehabilitation.