Selection of medical devices in pulmonary rehabilitation

Abstract

Introduction: Pulmonary rehabilitation is a multicomponent intervention; however, the judicious integration of medical devices may enhance symptom control, secretion management, cough effectiveness, and respiratory muscle strength in people with chronic respiratory disease.

Objective: To synthesise recent evidence and provide a practical guide to support the selection and safe implementation of devices within the context of pulmonary rehabilitation.

Methodology: Narrative review guided by a systematised search of biomedical databases (2019–2025) and consultation of international recommendations; the synthesis was structured according to clinical objectives and patient profiles.

Results: The most consistent evidence supports inspiratory muscle training to improve inspiratory strength and reduce dyspnoea, as well as the use of airway clearance techniques and devices in bronchiectasis and hypersecretory phenotypes. Evidence for chest wall oscillation and mechanical insufflation–exsufflation is more robust in selected populations (e.g., neuromuscular disease) and less consistent in others. Incentive spirometry is best understood as part of a bundle of measures in the postoperative setting rather than as a stand-alone intervention.

Conclusion: The value of medical devices emerges when they are integrated into assessment, training, education, monitoring, and follow-up. A clinical algorithm and practical recommendations are proposed to support shared decision-making and sustainable implementation.