Expert consensus and operational guidelines on exercise rehabilitation of chronic obstructive pulmonary disease with integrating traditional Chinese medicine and Western medicine.

Abstract

Chronic obstructive pulmonary disease (COPD) has become a widespread global chronic respiratory disease. In view of the large patient population, high mortality and disability rate, and heavy medical burden, COPD has become a major challenge for public health worldwide. According to epidemiological studies and demographic data, the prevalence of COPD in China is 13.7% and the number of COPD patients has reached more than 100 million. Therefore, it is of considerable significance to make more efforts to prevent and treat COPD (1). COPD is a chronic respiratory disease with dyspnea as its main clinical manifestation, especially during physical activity. COPD is often associated with cardiovascular, motor, metabolic and other systemic diseases, and may lead to pathological changes in many other systems (2). Muscle dysfunction is the most common extrapulmonary change that may influence the skeleton and respiratory muscles. Muscle dysfunction can lead to amyotrophy, muscle weakness, and other symptoms, which influence the skeletal muscle most significantly and result in poor exercise tolerance in patients (3). The pathological changes in skeletal muscle and dyspnea reduce the participation of activities in COPD patients and cause secondary muscle atrophy. These factors can result in declining motor ability, which is the critical predictor of mortality in COPD patients (4). COPD can influence patients’ health and quality of life. Delaying disease progression, alleviating symptoms, improving psychological status, and enhancing quality of life are the main goals of medical interventions for COPD patients. Pulmonary rehabilitation, as an indispensable part of effective treatments, is a multidisciplinary management program targeted at COPD patients to control disease progression, improve quality of life, and reduce the hospitalization rate (5). Exercise treatment, as the core of rehabilitation programs, has a higher degree of evidence in pulmonary rehabilitation that can improve dyspnea symptoms, increase motor abilities, and be helpful for improving psychological disorders and enhancing quality of life (3,6,7). To better guide exercise rehabilitation treatment for COPD patients, and to provide a systematic and operational plan for community doctors, pulmonary doctors and other health care providers on rehabilitation treatment, evaluation, treatment and follow-up, an expert group on respiratory rehabilitation and a professional committee on respiratory rehabilitation of the China Medical Education Association formed a common understanding by searching domestic and foreign studies, consulting with experts, and discussion. This consensus is based on existing research to develop a declarative document, focusing on the feasibility of our current clinical reality. In clinical practice, we still need to consider each patient’s specific situation to design individualized exercise rehabilitation programs. We present the following article in accordance with the RIGHT reporting checklist (available at https://dx.doi.org/10.21037/jtd-21-431).