American Thoracic Society/European Respiratory Society Statement on Pulmonary Rehabilitation (original) (raw)

2006, American Journal of Respiratory and Critical Care Medicine

This document has been developed by an international committee and has been endorsed by both the ATS and the ERS. It places pulmonary rehabilitation within the concept of integrated care. The World Health Organization has defined integrated care as "a concept bringing together inputs, delivery, management and organization of services related to diagnosis, treatment, care, rehabilitation and health promotion" (1). Integration of services improves access, quality, user satisfaction, and efficiency of medical care. As such, pulmonary rehabilitation provides an opportunity to coordinate care and focus on the entire clinical course of an individual's disease. Building on previous statements (2, 3), this document presents recent scientific advances in our understanding of the multisystemic effects of chronic respiratory disease and how pulmonary rehabilitation addresses the resultant functional limitations. It was created as a comprehensive statement, using both a firm evidence-based approach and the clinical expertise of the writing committee. As such, it is complementary to two current documents on pulmonary rehabilitation: the American College of Chest Physicians and American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) evidence-based guidelines (4), which formally grade the level of scientific evidence, and the AACVPR Guidelines for Pulmonary Rehabilitation Programs (5), which give practical recommendations. SECTION 2: EXERCISE PERFORMANCE: LIMITATIONS AND INTERVENTIONS Practice guideline: Pulmonary rehabilitation programs should address body composition abnormalities, which are frequently present and underrecognized in chronic lung disease. Intervention may be in the form of caloric, physiologic, pharmacologic, or combination therapy.