Cough Assessment and Management in Pulmonary Rehabilitation– A Canadian Survey

Figures & data

Table 1. PR program characteristics.

Locations in Canada, n (%)
Unreported*	9 (29.0)
ON	7 (22.5)
BC	5 (16.1)
SK	4 (12.9)
AB	3 (9.7)
Eastern Provinces (PEI, NB)	2 (6.5)
MB	1 (3.2)
Healthcare professionals, n (%)
Respiratory Therapist	13 (42.9)
Physiotherapist	8 (25.8)
Nurse	6 (19.4)
Other*	6 (18.1)
Years of experience, mean (SD)	8.6 ± 6.0
Type of program offered, n (%)
Out-patient	27 (93.1)
Maintenance	12 (42.9)
Home Program	9 (31.0)
In-patient	1 (3.6)
Virtual Out-patient	1 (3.6)
Number of patients with chronic cough median (Q1-Q3)	50 (28.75 − 80.0)

Legend: AB, Alberta; BC, British Columbia; IQR, interquartile range; MB, Manitoba; NB, New Brunswick; ON, Ontario; PEI, Prince Edward Island; SD, standard deviation; SK, Saskatchewan.

* Unreported: Refers to healthcare providers not reporting the geographical location of the PR program.

** “Other” includes kinesiologists (n = 2; 6.5%), an exercise physiologist, (n = 1; 3.2%), a respirologist (n = 1; 3.2%), an exercise therapist (n = 1; 3.2%), and a personal trainer (n = 1; 3.2%).

Figure 1. Program characteristics based on type of pulmonary rehabilitation program offered.

*"Other” type of PR offered included virtual PR. To note, many maintenance programs run indefinitely and on rolling admission.

Figure 2. Distribution of respiratory diseases managed in pulmonary rehabilitation programs.

*“Other Respiratory Diseases”: respiratory diseases managed in PR include bronchiectasis, pulmonary hypertension, embolism, empyema, bullae, pneumothorax, atelectasis, obesity hypoventilation syndrome, post-covid symptoms. ** “Other Program Type”: Out-patient virtual program

Figure 3. Healthcare providers (A) Assessing and (B) managing cough.

Table 2. Assessment of chronic cough in PR programs.

Healthcare professional assessing cough, n (%)
Physiotherapist	7 (50.0)
Respiratory Therapist	6 (42.9)
Nurse	4 (28.6)
Exercise Physiologist	1 (7.1)
Kinesiologist	1 (7.1)
Assessment point, n (%)
Beginning of Program	14 (100)
End of Program	7 (50.0)
Monthly	3 (21.4)
Each Session	2 (14.3)
As Needed	2 (14.3)
Weekly	1 (7.1)
Outcome measures, n (%)
Patient History	13 (92.9)
Questionnaire/Scale	8 (57.1)
Physical Examination	4 (28.6)
Objective Assessment	3 (21.4)
Other: As-needed basis	1 (7.1)
Aspects of cough assessed, n (%)
Frequency of Cough	13 (92.9)
Type of Cough	12 (85.7)
Cough Triggers	12 (85.7)
Risk Factors for Cough	12 (85.7)
Duration of Cough	9 (64.3)
Relieving Factors	8 (57.1)
Impacts of Cough	7 (50.0)
Other: (Continence and sputum)	1 (7.1)

Table 3. Management of chronic cough in PR programs.

Techniques used, n (%)
Non-productive Chronic Cough
Breathing Exercises	13 (81.3)
Education	12 (75.0)
Medication	11 (68.8)
Smoking Cessation	10 (62.5)
Airway Clearance Techniques	8 (50.0)
Behaviour Change Techniques	5 (31.3)
Cough Suppression Techniques	4 (25.0)
Productive Chronic Cough
Airway Clearance Techniques	15 (93.8)
Medication	12 (75.0)
Breathing Exercises	11 (68.8)
Smoking Cessation	9 (56.3)
Behaviour Change Techniques	6 (37.5)
Education	5 (31.3)
Cough Suppression Techniques	1 (6.3)