Peculiarities of pulmonary rehabilitation in patients with chronic respiratory diseases in palliative and hospice care (review)

Abstract

Pulmonary rehabilitation is an interdisciplinary program of care for patients with chronic respiratory disorders, created individually and aimed at physical and social indicators and autonomy optimizing. Physical therapists in an interdisciplinary palliative care team are key to the success of pulmonary rehabilitation for palliative patients, focusing on the physical functioning.Objective — to review the data from literature references regarding the characteristics and usage frequency of pulmonary rehabilitation for patients with respiratory diseases who require palliative and hospice care, and to specify respiratory diseases in palliative care patients for which pulmonary rehabilitation is currently used. As a result of the literature review, it was established that pulmonary rehabilitation in patients with chronic respiratory diseases who require palliative and hospice care is aimed at improving pulmonary symptoms (shortness of breaths) and functional status, reducing the intensity of accompanying symptoms, even in the late stages of the disease, which ultimately contributes improving the quality of life and survival of patients, reducing the burden on those who care for them. But access to physical (pulmonary) rehabilitation for patients with chronic respiratory diseases who need palliative and hospice care, is currently not routine in practice and not used enough around the world, unfortunately. It was found that today pulmonary rehabilitation in palliative patients is used only for chronic obstructive pulmonary diseases, interstitial lung diseases, cystic fibrosis, sarcoidosis, idiopathic pulmonary fibrosis and bronchiectasis. At the same time, the literature does not describe the use of physical therapy methods, including pulmonary rehabilitation, in patients with bronchial asthma who require palliative treatment. Pulmonary rehabilitation in patients with chronic respiratory diseases who require palliative and hospice care is a relevant and effective method of treatment, but needs wider implementation in the modern health care system.