Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a complex pathological condition associated with an important reduction in physical activity and psychological problems that contribute to the patient's disability and poor health-related quality of life. Pulmonary rehabilitation is aimed to eliminate or at least attenuate these difficulties, mainly by promoting muscular reconditioning. The scope of this paper has been the analysis of the literature on pulmonary rehabilitation in COPD patients has appeared in the last five years, focusing on the principal outcomes obtained. The results demonstrate that pulmonary rehabilitation has a beneficial effect on dyspnoea relief, improving muscle strength and endurance. Moreover, pulmonary rehabilitation appears to be a highly effective and safe treatment for reducing hospital admissions mortality and improving health-related quality of life in COPD patients. It represents, therefore, a very important therapeutic option that, along with standard pharmachological therapy, can be used to obtain the best patient management. The favourable results obtained with pulmonary rehabilitation programs should stimulate researchers to improve our understanding of the mechanisms that form the basis of the beneficial effects of this therapeutic intervention. This would in turn increase the effectiveness of pulmonary rehabilitation in COPD patients.
Highlights
Pulmonary rehabilitation is de ned by the American oracic Society and the European Respiratory Society as an “evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and o en have decreased daily life activities.” As such it is an integral part of the clinical management and health maintenance of those patients with chronic respiratory disease who remain symptomatic or continue to have decreased lung function despite standard medical treatment
Two of them have evaluated the improvement of the quality of life a er the Saint George Respiratory Questionnaire (SGRQ) score as the primary outcome [20, 21], whereas the third one has used the Chronic Respiratory Disease Questionnaire (CRQ) [22]
Twelve studies have analysed the six-minute walking test distance (6 MWTD) as a functional parameter; all of them concluded that pulmonary rehabilitation of chronic obstructive pulmonary disease (COPD) patients leads to an increase of the covered distance
Summary
Pulmonary rehabilitation is de ned by the American oracic Society and the European Respiratory Society as an “evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and o en have decreased daily life activities.” As such it is an integral part of the clinical management and health maintenance of those patients with chronic respiratory disease who remain symptomatic or continue to have decreased lung function despite standard medical treatment. Integrated into the individualised treatment of the patient, pulmonary rehabilitation is designed to reduce symptoms, optimise functional status, increase participation, and reduce health care costs by stabilising or reversing systemic manifestations of the disease [1] All together these considerations underline the general implications and the importance of this respiratory treatment, which should be considered fundamental during the management of chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation programs should address body composition abnormalities, which are frequently present but underrecognised in chronic lung diseases Interventions relating to these aspects may be in the form of caloric supplementation, physiological interventions, pharmacological strategies, or combination therapy in order to induce weight gain without an overall fat mass increase. We have analysed the literature on pulmonary rehabilitation in COPD patients that has appeared in the last ve years, focusing on the main outcomes used and their evaluation
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