The PRAXIS Nexus The PRAXIS Nexus

Virtual Pulmonary Rehabilitation: A Helpful Tool For a New Era

Posted on March 16, 2023   |   

This post was written by Kristen Szymonik, BS, RRT, AE-C.

When we think of pulmonary rehabilitation, we usually think of a clinic-based, in-person program. But the COVID-19 pandemic has changed the landscape of medicine and has paved the way for comprehensive virtual medical programs. These include telehealth visits, online support groups, and even virtual pulmonary rehab.

In the past few years, traditional pulmonary rehab programs across the United States have been forced to reduce their capacity or consolidate locations. Some have permanently closed their doors. These changes in service negatively impact patients, particularly those in rural areas. Patients who once showed progress in their COPD management with the help of in-person pulmonary rehab were suddenly left without those services. Many lost the progress they had made and found themselves with worsening symptoms and reduced quality of life.

While COVID-19 may have increased the need for virtual pulmonary rehab, the interest in these programs has always been present. Virtual pulmonary rehab has been a helpful resource for patients who either didn’t have access to a pulmonary rehab program in their community or were unable to travel to a local in-person program due to severe COPD symptoms or transportation and logistical factors. One study showed that just under 3% of eligible patients actually accessed a pulmonary rehab program within a year of their discharge from the hospital.1 In this study, distance was a major indicator of program utilization.1 Virtual pulmonary rehab addresses these barriers to participation, offering patients an important service that is not dependent upon transportation to a clinic or similar facility.

Pulmonary rehab is one of the most effective treatments for managing COPD symptoms. While many patients benefit from the camaraderie and interaction with other patients that in-person pulmonary rehab provides, they can still participate in and benefit from the other components of pulmonary rehab that are still present in a virtual program. In fact, recent studies indicate that virtual pulmonary rehab is not inferior to in-person programs.2 Instead, it was determined to be a safe and beneficial alternative to traditional pulmonary rehab programs.2The benefits of pulmonary rehab can extend for several months beyond the completion of a program. These improvements in symptoms, stamina, and overall health can be long-lasting.

Unfortunately, despite the value pulmonary rehab brings to the COPD community and the demonstrated benefit of virtual pulmonary rehab, these programs are threatened with the potential loss of Medicare coverage on May 11, 2023. On this date, the federal extension of Medicare coverage for pulmonary rehab is set to expire, potentially leaving many patients without this vital service.

The COPD Foundation is very concerned about this issue. Foundation staff members recently participated alongside patients, caregivers, and other advocates in IMPACT Lung Health 2023, an advocacy event that raises awareness for COPD-related issues. One of the main initiatives this year was calling upon legislators to expand and make permanent Medicare coverage for virtual pulmonary rehab. But we still need your help! You can contact your local elected officials and ask them to support virtual pulmonary rehab. Our Advocacy Action Center is a great place to get started. Here, you can find other ways to lend your voice to COPD issues. Even if you have never participated in advocacy before, there is no time like the present! Join us in our efforts to ensure COPD patients have the services and treatments they need. We can’t do it without you!

1. Spitzer KA, Stefan MS, Priya A, et al. Participation in Pulmonary Rehabilitation after Hospitalization for Chronic Obstructive Pulmonary Disease among Medicare Beneficiaries. Ann Am Thorac Soc. 2019;16(1):99-106. Accessed March 2023 from:

2. Cox NS, Dal Corso S, Hansen H, et al. Telerehabilitation for chronic respiratory disease. Cochrane Database Syst Rev. 2021;1(1):CD013040. Published 2021 Jan 29. Accessed March 2023 from:


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  • Kristen, thanks for bringing this important topic to light. I've been active in the VPR space for 10 years. For a world that has embraced gaming, telehealth and zoom, it is time to bring these tools together to benefit millions of people with COPD.
  • This has been an ongoing topic of discussion here at our hospital and our out-patient services. These very topics need to be conveyed routinely to our state legislatures which I have been doing. It's vital everyone across the country continue to do the same.

    Kristen Szymonik, this is a great article you provided and this should be shared to many levels. Thank you.

    James Lippi RRT, LPSGT
    Out-patient Pulmonary Transitions Coordinator
    St. Charles Health System
    • Thank you, James. I agree completely. It is very concerning that in a few short months, these services may no longer be covered by Medicare. I hope we can raise awareness of this issue and change that!
    • Thanks, James! This was also one of our focused asks during this week's IMPACT lobbying events. I would encourage people to reach out to their Congressional delegations to get them to extend access to these programs for people who need them. As you know, barriers to pulmonary rehab existed before COVID, and they aren't going away just because the public health emergency is.
  • Kristen,

    Thank you for this informative post. And thank you for the call to action with regard to reaching out to our Congressional delegations. Living in, and working with patients in a rural area I understand the immense need for virtual options. I will surely be making some phone calls next week!