Pulmonary rehabilitation in Crete, Vietnam and Kyrgyzstan

Population and methods

The study population consisted of patients with a diagnosis of clinically stable chronic lung disease, including COPD, post-TB lung disease, chronic asthma, interstitial lung disease, bronchiectasis, and pulmonary hypertension. Suitable patients received symptom screening, a range of tests, and a baseline assessment to determine eligibility. PR consisted of a programme of exercises and health education based on existing materials from the UK and Uganda, adapted to local circumstances. Each programme comprised six weeks of biweekly sessions.


All three countries have shown overall clinically important improvements in the Incremental Shuttle Walking Test (ISWT) and reduced totals in the Clinical COPD Questionnaire (CCQ). Qualitative data, such as interviews with patients, have shown significant symptom reduction, improved disease management, the opportunity for socialising which enhanced participation, and no major barriers to accessing the programme.


Evidence-based and low-cost PR programmes may constitute a feasible, acceptable and effective approach against CRDs in primary care in resource-limited countries. Local adaptations of the programme required changing some outcome measures, providing additional information leaflets to patients, and a change in recruitment strategy. 

After the H2020 FRESH AIR project finishes, all three countries plan to scale-up PR to other sites and regions as a routine health care service. Several papers are planned. 

Outputs from the project include:

  • The 5 Steps booklet available in English, Greek, Russian and Vietnamese which is a simple guide to managing your own chronic lung disease.
  • A film of implementing PR in Kyrgyzstan by professional filmmaker Gemma Selley.
  • An exhibition of photos by professional photographer Carey Marks.

Pulmonary rehabilitation in Crete, Vietnam and Kyrgyzstan
Pulmonary rehabilitation in Crete, Vietnam and Kyrgyzstan
Pulmonary rehabilitation in Crete, Vietnam and Kyrgyzstan

Pulmonary rehabilitation in Kyrgyzstan

See how experts from the University of Plymouth are helping to combat the increasing epidemic of lung disease caused by polluted air, tobacco use and indoor and outdoor pollution in Kyrgyzstan, under the FRESH AIR project.

Across the world, Chronic Obstructive Pulmonary Disease (COPD), drug-resistant tuberculosis and pneumonia are major causes of permanent lung damage, which is leading to a high mortality rate in many poor countries.

Through pulmonary rehabilitation, which includes exercise programmes, music, dance and collaborative projects, people are beginning to better understand and overcome their lung-related health issues.

Akimovich Sagymbaev: Director of the Krygyz Research Institute of Balneology
and Recovery Treatment. Image: Carey Marks