Pulmonary Rehabilitation: Patient Assessment (video)



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Patients attending PR undergo a comprehensive assessment looking at:


  • Which respiratory condition or conditions has the patient been diagnosed with.
  • Forced Expiratory Volume in one second (FEV1) shows the amount of air a person can forcefully exhale in one second of their forced vital capacity (FVC). This can be helpful in diagnosis.


  • How often do patients have an exacerbation?
  • Most recent?
  • Able to identify exacerbation?
  • Early identification.


  • Respiratory medications and other medications including oxygen – dose / check inhaler technique.
  • Vaccinations – influenza and pneumonia.

Smoking history

  • Current smoker?
  • How long been smoking for, cigarettes/pipe/cigar/ e-cigarette? 
  • Ex-smoker, when stopped.
  • Calculate pack years.
  • Referral to smoking cessation services as required.

Social history 

  • The patient's home circumstances, housing, stairs, mobility and exercise, activity of daily living, occupation.

Exercise capacity

  • Field walking tests – ISWT or 6m walk test.

Outcome measures:

  • Incremental Shuttle Walk Test (ISWT)
  • 6 minute Walk Test (6mWT)
  • Endurance Shuttle Walk Test (ESWT)

Leg strength

  • 1RM, functional measures e.g. 5Tsts.

Outcome measures:

  • Usually quads, can be done with machinery or functionally.

Health status (usually a questionnaire)

  • CAT 
  • St Georges 

Outcome measures:

  • Using validated questionnaires related to specific respiratory condition, e.g. COPD Assessment Test (CAT), Kings Brief interstitial Lung Disease (KBILD).

Anxiety and depression

  • PHQ-4 
  • PHQ8: As PHQ9 with the 9th item removed. Eight items, each of which is scored 0 to 3, providing a 0 to 24 severity score.
  • GAD-7

Outcome measures:

  • Using validated questionnaires.

Goal setting 

  • Joint goal setting with patient, used to guide treatment plan.

Self management

  • How much does the patient know about their condition and what is important to them in their daily life when coping with long term respiratory disease?


  • The assessment should be thourough and based on a two way discussion about the patient's lifestyle and symptoms.
  • It is important to know what having a long term lung condition means to the patient from their perspective.
  • Do they understand their medication?
  • What are their goals?
  • What are they concerned about regarding their physical and mental health?
  • A good assessment results in the patient learning more about their condition and eager to attend rehabilitation classes.
Additional information
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Anxiety and depression

Patient Health Questionnaire Screeners:

  • PHQ4 [.pdf]
  • PHQ8: As PHQ9 with the 9th item removed. Eight items, each of which is scored 0 to 3, providing a 0 to 24 severity score.
  • GAD-7 [.pdf]

Health Status