Pulmonary rehabilitation: an integral part of the long-term management of COPD (original) (raw)
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THE BENEFITS OF PULMONARY REHABILITATION IN COPD PATIENTS
BACKGROUND: Pulmonary rehabilitation (PR) has become a standard of care in patients affected by chronic pulmonary diseases. This article addresses the currently available literature on respiratory rehabilitation in patients with chronic obstructive pulmonary disease (COPD). OBJECTIVES: To investigate the impact of PR on quality of life and on the physical and psychological conditions of the patient. METHODS: In June 2016 the Pubmed and Google Scholar databases were searched to retrieve the articles dealing with the efficacy of PR. RESULTS: It has been demonstrated that positive outcomes from PR programs include increased exercise tolerance, reduced dyspnea and overall improvement in health-related quality of life (QoL), regardless of the patient's age. The BODE index (a multidimensional scoring system) was used to test patients diagnosed with COPD and to predict long-term outcomes for them. CONCLUSIONS: PR has proved to be clinically beneficial and considered the right therapeutic approach in the follow-up and management of patients suffering from respiratory diseases.
Pulmonary Rehabilitation Among Copd Patients
2020
Respiratory diseases are defined as impaired lungs functions and ventilation. Respiratory disorders are common around the world. Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation leading to declined ventilation capacity and is associated with shortness of breath. In the world, approximately 210 million people are affected from COPD. At global level, COPD was the 4th leading cause of death (5.1%) in 2004 and is projected to occupy the 3ed position (8.6%) in 2030. Pulmonary Rehabilitation (PR) is a multi-disciplinary program design for the patients with chronic respiratory diseases. It is an evidence-based, multidisciplinary, and comprehensive intervention for respiratory disease patients who have poor daily life activities; and is individually tailored and designed to optimize physical and social performance and autonomy. The program is effective for almost all respiratory diseases. The main components of exercise training programs for COPD are toler...
International journal of chronic obstructive pulmonary disease, 2009
Pulmonary rehabilitation (PR) is recognized as an evidence-based treatment in improving dyspnea and quality of life in patients with COPD. We evaluated the number needed to treat (NNT) to achieve an increase in physical capacity, as defined by a significant improvement in the six-minute walk test (6MWT) in patients with COPD undergoing PR. The study enrolled 284 patients aged 41 to 86 years (mean age 69.4 years) divided into two groups: a study group (222 patients) undergoing a PR program, and a control group (62 patients) treated only with drugs. The study group included patients with COPD divided in four subgroups according to GOLD stages. In the study group, 142 out of 222 patients (64%) had an increase of at least 54 m in the 6MWT following PR versus 8 out of 62 patients (13%) in the control group after the same time interval. The NNT in the overall study group was 2; the same NNT was obtained in GOLD stages 2, 3, and 4, but was 8 in stage 1. PR is highly effective in improving ...
Different outcomes of pulmonary rehabilitation in patients with COPD with or without exacerbations
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo, 2005
Pulmonary rehabilitation is recognised as an effective treatment in reducing disability and improving the quality of life in patients with COPD. We evaluated the effects of a course of pulmonary rehabilitation in improving the physical performance and lung function in patients with or without COPD exacerbations. 74 patients with COPD were enrolled, 37 (24 males and 13 females, mean age 74.6 years) without exacerbations (group A), and 37 (23 males, 14 females, mean age 73.9 years) with exacerbations (group B). The latter must have had the latest exacerbation at least one month before the inclusion. All patients underwent to a rehabilitation programme of 8 visits in 4 weeks in a day-hospital setting, with exercise training, respiratory muscle training and education on COPD. The changes in physical performance and lung function in respect to baseline were measured by a 6-minute walking test, using phethysmography, and by an analogic manometer measuring maximal inspiratory and expirator...
Effectiveness of Pulmonary Rehabilitation in Patients with COPD
The International Journal of Frontier Sciences, 2020
Background: Pulmonary rehabilitation (PR) is beneficial for patients with COPD, with improvement in exercise capacity and health-related quality of life. Despite these overall benefits, the responses to PR vary significantly among different individuals. It is not clear if PR is beneficial for patients with COPD and normal exercise capacity. Although it is believed that longer pulmonary rehabilitation programs can provide better results, most of the evidence comes from short-term programs. Objective: The objective of this analysis was to determine the effectiveness of respiratory services provided in the hospital or community by respiratory therapists (RTs) in reducing health care utilization and improving patient outcomes. The aim was to evaluate the outcomes of a comprehensive pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease. Methodology: All 65 Pakistani patients who met the inclusion criteria with ages between 40 to 65 years, including both male and female, ...
Impact of pulmonary rehabilitation programs in improving health status in COPD patients
Balneo Research Journal, 2019
Pulmonary rehabilitation programme (PRP) have a positive impact on multiple outcomes of COPD, such as decreasing symptoms, increasing exercise tolerance and improving general health status. The aim of this study is to evaluate exercise tolerance impairment and to assess the impact of PRP in improving health status in patients diagnosed with COPD. It was conducted a prospective parallel group study in the Pulmonary Rehabilitation Department of the Clinical Hospital "V. Babes”, Timisoara, from 2007 to 2010. The subjects included in the study were patients diagnosed with COPD stages I-IV GOLD, initially evaluated and started a PRP, then re-evaluated after 3 weeks and 6 months. The study group included 168 patients, 158 men, mean age 61.73 years. The initial evaluation revealed higher values of dyspnea scores using mMRC scale in advanced COPD stages (3.69±0.77 in patients with COPD stage IV, vs 0.88±0.5 in patients with COPD stage, p<0.05), decreased Forced expiratory volume in ...
Respiratory rehabilitation techniques used for the treatment of COPD patients
Balneo Research Journal, 2020
Introduction. Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality throughout the world. At present, the pharmacological therapy is not enough for a patient with COPD in regard to heath status and exercise tolerance. It requires additional therapies aimed to improve the quality of life, delay the lung function decline, increase exercise capacity, and reduce the respiratory symptoms and the number of exacerbations. Pulmonary rehabilitation program (PRP) has been shown to improve respiratory muscle, to optimize functional, psychosocial, behavioral and nutritional status. The aim of the present study was to asses the impact of PRP on COPD patients, focusing on the clinical benefits of PRP, which may further provide to the patients a good support for change. Material and method. Sixty-seven patients with clinically stable COPD were enrolled in this prospective study, consisting in a 6-weeks of PRP. There were recorded demographic data, smo...
Benefits of pulmonary rehabilitation in patients with COPD and normal exercise capacity
2013
BACKGROUND: Pulmonary rehabilitation (PR) is beneficial for patients with COPD, with improvement in exercise capacity and health-related quality of life. Despite these overall benefits, the responses to PR vary significantly among different individuals. It is not clear if PR is beneficial for patients with COPD and normal exercise capacity. We aimed to investigate the effects of PR in patients with normal exercise capacity on health-related quality of life and exercise capacity. METHODS: Twenty-six subjects with COPD and normal exercise capacity were studied. All subjects participated in 12-week, 2 sessions per week, hospital-based, outpatient PR. Baseline and post-PR status were evaluated by spirometry, the St George's Respiratory Questionnaire, cardiopulmonary exercise test, respiratory muscle strength, and dyspnea scores. RESULTS: The mean FEV 1 in the subjects was 1.29 ؎ 0.47 L/min, 64.8 ؎ 23.0% of predicted. After PR there was significant improvement in maximal oxygen uptake and work rate. Improvements in St George's Respiratory Questionnaire scores of total, symptoms, activity, and impact were accompanied by improvements of exercise capacity, respiratory muscle strength, maximum oxygen pulse, and exertional dyspnea scores (all P < .05). There were no significant changes in pulmonary function test results (FEV 1 , FVC, and FEV 1 /FVC), minute ventilation, breathing frequency, or tidal volume at rest or exercise after PR. CONCLUSIONS: Exercise training can result in significant improvement in health-related quality of life, exercise capacity, respiratory muscle strength, and exertional dyspnea in subjects with COPD and normal exercise capacity. Exercise training is still indicated for patients with normal exercise capacity.
Rehabilitation of COPD patients: which training modality
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo
Non pharmacological therapy has been gaining more interest and has been evolving rapidly over the last decade as an essential part of therapy for COPD patients. Pulmonary Rehabilitation (PR), the most important non pharmacological treatment in patients with COPD, has a primary goal: to achieve the highest possible level of individual exercise tolerance, thus reducing the primary and/or secondary health care utilisation. The aim of the present review is to focus the role of exercise training in these patients as well as to address the question on which training methods are the most beneficial. We have therefore undertaken a MEDLINE-based search including the terms: pulmonary rehabilitation, exercise, lung disease/obstructive. Several strategies based on endurance or strength training are nowadays implemented during PR programmes in order to maximise the benefits for each patient. The impaired function of ambulation muscles causing breathlessness as one of the more frequent symptoms i...
Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease
American Journal of Respiratory and Critical Care Medicine, 2005
Exercise training COPD Muscle Multidisciplinary a b s t r a c t Pulmonary rehabilitation has become part of the evidence-based care in patients with COPD who remain symptomatic and have reduced participation in everyday life, after optimal medical treatment. Pulmonary rehabilitation is-by definition-a multidisciplinary intervention. By consequence the assessment of patients before entering a rehabilitation program includes both physiological and psychosocial assessment. In addition nutritional status and physical activity participation needs to be assessed. Effects of pulmonary rehabilitation are clinically relevant and include effects on the above-mentioned dimensions. In general the effects of pulmonary rehabilitation are larger than the minimal clinically important difference and rehabilitation programs have shown to be highly costeffective. This review focuses on the exercise training intervention. Different training modalities (endurance, interval and resistance training) are discussed and different 'supplements' are highlighted (oxygen, non-invasive mechanical ventilation, testosterone and inspiratory muscle training) along with their suggested indications for use. Lastly other interventions which may also be part of the rehabilitation program are briefly discussed.