Conventional programs: Settings, cost, staffing, and maintenance

Pulmonary rehabilitation (PR) can be implemented and delivered successfully in a variety of settings [1, 2]. Inpatient, outpatient, and home-based programs exist. In these settings, PR can be delivered to medically stable individuals with chronic respiratory diseases, as well as to those with COPD early following COPD exacerbation. The location and composition of PR programs varies widely within and across countries [3-5]. Program settings, components, and staff depend principally on individual countries' health systems, as well as on locally available program funding and resources. To be considered PR, however, the core components including patient assessments [at least including exercise capacity, symptoms and health status/quality of life (QOL)], supervised multimodality exercise training of the upper and lower extremities, education geared towards health-enhancing behavior change, and outcomes measures must be included [1, 6, 7]. The severity of the patient's respiratory disease, complexity of comorbidities, patient preference, and availability of transportation also influence the optimal setting for PR. Maintenance of benefits achieved in PR is an important goal. While resources for maintenance PR programs are not universally available, several models of such programs have been investigated. The settings, staffing, and cost for conventional PR programs will be considered further below.