**4. Essential components of pulmonary rehabilitation A**

Patient selection and assessment, psychological support, self-management education, nutritional support, and exercise training (including inspiratory muscle training (IMT) are all important components of PR (**Figure 2**) [5]. One of the actual PR program is a multidisciplinary home-based program. In this program, breathing retraining consists of pursed-lip breathing and diaphragmatic breathing performed in the supine or sitting positions. Exercise training includes upper- and lower-extremity exercise, respiratory muscle stretching calisthenics, level walking, and IMT. Patients with COPD participate in educational activities such as lectures on respiratory conditions, dyspnea control, medication, equipment use, diet, stress management, relaxation techniques, at-home exercise, and the idea and advantages of PR [3, 6]. Each patient receives periodic home visits from a registered nurse practitioner who informs them about the function of PR. This PR program is different from recent home-based

**Figure 2.** *Basic construction of pulmonary rehabilitation [5].*

PR programs in the point of low-intensity exercise program including such as respiratory muscle stretching calisthenics and low-intensity IMT [5–7].
