Abstract
Respiratory rehabilitation in patients with chronic obstructive pulmonary disease (COPD) is recognized as a cornerstone for the therapeutic path. Physiotherapy involves physical activity with aerobic and anaerobic exercises, which can improve the patient's symptomatic picture, such as motor function, emotional status (depression and anxiety), and improve the pain perception. The training of proprioception is not included in the structure of the exercises proposed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The training of proprioception is a very useful strategy for stimulating the cerebellum, a neurological suffering area in patients with COPD. The cerebellum sorts information about pain and emotions, as well as motor stimuli. The article discusses the need to introduce proprioception in respiratory rehabilitation protocols, highlighting the neurological relationships with the management of comorbidities.
Highlights
Chronic obstructive pulmonary disease (COPD) is the expression of multiple local and systemic disorders that culminate in chronic respiratory diseases and chronic airflow limitation; chronic cough, dyspnea, phlegm production and recurrent infections or inflammations of the bronchial tree [1,2]
chronic obstructive pulmonary disease (COPD) is the third cause of mortality in the world and an estimated 400 million people are affected by this chronic disease; about one in five patients, once discharged from the hospital, is still hospitalized within 30 days [3,4]
Respiratory rehabilitation through exercise is a cornerstone for the patient's path, as highlighted by the 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report [15,16]
Summary
Chronic obstructive pulmonary disease (COPD) is the expression of multiple local and systemic disorders that culminate in chronic respiratory diseases and chronic airflow limitation; chronic cough, dyspnea, phlegm production and recurrent infections or inflammations of the bronchial tree [1,2]. Cognitive impairment may adversely affect postural control Another element that negatively affects the functionality of the movement and the emotional status is the presence of chronic pain in these patients [23]. The presence of chronic respiratory airway obstruction, in smokers, is linked to the decrease in the cerebral gray matter; in patients with lower FEV1/FVC there is a volumetric decrease in white matter [42] These adaptations are not necessarily linked to advancing age; these alterations reflect higher depression and anxiety values. The pursuit of physical activity in the rehabilitation process improves motor coordination (and proprioception), with improved emotional and pain threshold status [36,39,41].
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