How to adapt the pulmonary rehabilitation programme to patients with chronic respiratory disease other than COPD

Anne E Holland, Karin Wadell, Martijn A Spruit, Anne E Holland, Karin Wadell, Martijn A Spruit

Abstract

Dyspnoea, fatigue, reduced exercise tolerance, peripheral muscle dysfunction and mood disorders are common features of many chronic respiratory disorders. Pulmonary rehabilitation successfully treats these manifestations in chronic obstructive pulmonary disease (COPD) and emerging evidence suggests that these benefits could be extended to other chronic respiratory conditions, although adaptations to the standard programme format may be required. Whilst the benefits of exercise training are well established in asthma, pulmonary rehabilitation can also provide evidence-based interventions including breathing techniques and self-management training. In interstitial lung disease, a small number of trials show improved exercise capacity, symptoms and quality of life following pulmonary rehabilitation, which is a positive development for patients who may have few treatment options. In pulmonary arterial hypertension, exercise training is safe and effective if patients are stable on medical therapy and close supervision is provided. Pulmonary rehabilitation for bronchiectasis, including exercise training and airway clearance techniques, improves exercise capacity and quality of life. In nonsmall cell lung cancer, a comprehensive interdisciplinary approach is required to ensure the success of pulmonary rehabilitation following surgery. Pulmonary rehabilitation programmes provide important and underutilised opportunities to improve the integrated care of people with chronic respiratory disorders other than COPD.

Conflict of interest statement

Conflict of interest: Disclosures can be found alongside the online version of this article at err.ersjournals.com

References

    1. Spruit MA, Singh SJ, Garvey C, et al. . An Official American Thoracic Society/European Respiratory Society Statement: key concepts and advances in pulmonary rehabilitation – an Executive Summary. Am J Respir Crit Care Med 2013. [in press].
    1. McNamara RJ, McKeough ZJ, McKenzie DK, et al. . Water-based exercise in COPD with physical comorbidities: a randomised controlled trial. Eur Respir J 2013; 41: 1284–1291.
    1. Leung RW, McKeough ZJ, Peters MJ, et al. . Short-form Sun-style t'ai chi as an exercise training modality in people with COPD. Eur Respir J 2013; 41: 1051–1057.
    1. Gouzi F, Prefaut C, Abdellaoui A, et al. . Blunted muscle angiogenic training-response in COPD patients versus sedentary controls. Eur Respir J 2013; 41: 806–814.
    1. Bronstad E, Rognmo O, Tjonna AE, et al. . High-intensity knee extensor training restores skeletal muscle function in COPD patients. Eur Respir J 2012; 40: 1130–1136.
    1. Burtin C, Saey D, Saglam M, et al. . Effectiveness of exercise training in patients with COPD: the role of muscle fatigue. Eur Respir J 2012; 40: 338–344.
    1. Huppmann P, Sczepanski B, Boensch M, et al. . Effects of inpatient pulmonary rehabilitation in patients with interstitial lung disease. Eur Respir J 2013; 42: 444–453.
    1. Rubin LJ. Exercise training for pulmonary hypertension: another prescription to write? Eur Respir J 2012; 40: 7–8.
    1. Grunig E, Lichtblau M, Ehlken N, et al. . Safety and efficacy of exercise training in various forms of pulmonary hypertension. Eur Respir J 2012; 40: 84–92.
    1. Wertz DA, Pollack M, Rodgers K, et al. . Impact of asthma control on sleep, attendance at work, normal activities, and disease burden. Ann Allergy Asthma Immunol 2010; 105: 118–123.
    1. Ryerson CJ, Arean PA, Berkeley J, et al. . Depression is a common and chronic comorbidity in patients with interstitial lung disease. Respirology 2012; 17: 525–532.
    1. Taichman DB, Shin J, Hud L, et al. . Health-related quality of life in patients with pulmonary arterial hypertension. Respir Res 2005; 6: 92.
    1. Spruit MA, Thomeer MJ, Gosselink R, et al. . Skeletal muscle weakness in patients with sarcoidosis and its relationship with exercise intolerance and reduced health status. Thorax 2005; 60: 32–38.
    1. Spruit MA, Thomeer MJ, Gosselink R, et al. . Hypogonadism in male outpatients with sarcoidosis. Respir Med 2007; 101: 2502–2510.
    1. Spruit MA, Janssen DJ, Franssen FM, et al. . Rehabilitation and palliative care in lung fibrosis. Respirology 2009; 14: 781–787.
    1. Decramer M, Lacquet LM, Fagard R, et al. . Corticosteroids contribute to muscle weakness in chronic airflow obstruction. Am J Respir Crit Care Med 1994; 150: 11–16.
    1. Nishiyama O, Taniguchi H, Kondoh Y, et al. . Quadriceps weakness is related to exercise capacity in idiopathic pulmonary fibrosis. Chest 2005; 127: 2028–2033.
    1. Mainguy V, Maltais F, Saey D, et al. . Peripheral muscle dysfunction in idiopathic pulmonary arterial hypertension. Thorax 2010; 65: 113–117.
    1. Yohannes AM, Connolly MJ. Pulmonary rehabilitation programmes in the UK: a national representative survey. Clin Rehabil 2004; 18: 444–449.
    1. Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. Bethesda, National Heart, Lung, and Blood Institute of Health, 2006.
    1. Clark CJ, Cochrane LM. Assessment of work performance in asthma for determination of cardiorespiratory fitness and training capacity. Thorax 1988; 43: 745–749.
    1. Adams RJ, Wilson DH, Taylor AW, et al. . Psychological factors and asthma quality of life: a population based study. Thorax 2004; 59: 930–935.
    1. Oga T, Tsukino M, Hajiro T, et al. . Multidimensional analyses of long-term clinical courses of asthma and chronic obstructive pulmonary disease. Allergol Int 2010; 59: 257–265.
    1. Chandratilleke MG, Carson KV, Picot J, et al. . Physical training for asthma. Cochrane Database Syst Rev 2012; 5: CD001116.
    1. Mendes FA, Goncalves RC, Nunes MP, et al. . Effects of aerobic training on psychosocial morbidity and symptoms in patients with asthma: a randomized clinical trial. Chest 2010; 138: 331–337.
    1. Turner S, Eastwood P, Cook A, et al. . Improvements in symptoms and quality of life following exercise training in older adults with moderate/severe persistent asthma. Respiration 2011; 81: 302–310.
    1. Global Strategy for Asthma Management and Prevention Global Initiative for Asthma (GINA). 2002. Date last updated: 2012. Date last accessed: August 1, 2013.
    1. Reiff DB, Choudry NB, Pride NB, et al. . The effect of prolonged submaximal warm-up exercise on exercise-induced asthma. Am Rev Respir Dis 1989; 139: 479–484.
    1. Crapo RO, Casaburi R, Coates AL, et al. . Guidelines for methacholine and exercise challenge testing – 1999. Am J Respir Crit Care Med 2000; 161: 309–329.
    1. Hill K, Vogiatzis I, Burtin C. The importance of components of pulmonary rehabilitation, other than exercise training, in COPD. Eur Respir Rev 2013; 22: 405–413.
    1. Burgess J, Ekanayake B, Lowe A, et al. . Systematic review of the effectiveness of breathing retraining in asthma management. Expert Rev Respir Med 2011; 5: 789–807.
    1. Holland AE, Hill CJ, Jones AY, et al. . Breathing exercises for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2012; 10: CD008250.
    1. Gibson PG, Powell H, Coughlan J, et al. . Limited (information only) patient education programs for adults with asthma. Cochrane Database Syst Rev;2002: CD001005.
    1. Nici L, Donner C, Wouters E, et al. . American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med 2006; 173: 1390–1413.
    1. Javaheri S, Sicilian L. Lung function, breathing pattern, and gas exchange in interstitial lung disease. Thorax 1992; 47: 93–97.
    1. Lama VN, Flaherty KR, Toews GB, et al. . Prognostic value of desaturation during a 6-minute walk test in idiopathic interstitial pneumonia. Am J Respir Crit Care Med 2003; 168: 1084–1090.
    1. Shorr AF, Wainright JL, Cors CS, et al. . Pulmonary hypertension in patients with pulmonary fibrosis awaiting lung transplant. Eur Respir J 2007; 30: 715–721.
    1. Glaser S, Noga O, Koch B, et al. . Impact of pulmonary hypertension on gas exchange and exercise capacity in patients with pulmonary fibrosis. Respir Med 2009; 103: 317–324.
    1. Raghu G, Collard HR, Egan JJ, et al. . An Official ATS/ERS/JRS/ALAT Statement. Idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 2011; 183: 788–824.
    1. Swigris JJ, Fairclough DL, Morrison M, et al. . Beneficial effects of pulmonary rehabilitation in idiopathic pulmonary fibrosis. Respir Care 2011; 56: 783–789.
    1. Swigris JJ, Gould MK, Wilson SR. Health-related quality of life among patients with idiopathic pulmonary fibrosis. Chest 2005; 127: 284–294.
    1. Ryerson CJ, Berkeley J, Carrieri-Kohlman VL, et al. . Depression and functional status are strongly associated with dyspnea in interstitial lung disease. Chest 2011; 139: 609–616.
    1. Chang JA, Curtis JR, Patrick DL, et al. . Assessment of health-related quality of life in patients with interstitial lung disease. Chest 1999; 116: 1175–1182.
    1. Holland AE, Hill CJ, Conron M, et al. . Short term improvement in exercise capacity and symptoms following exercise training in interstitial lung disease. Thorax 2008; 63: 549–554.
    1. Nishiyama O, Kondoh Y, Kimura T, et al. . Effects of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis. Respirology 2008; 13: 394–399.
    1. Holland A, Hill C. Physical training for interstitial lung disease. Cochrane Database Syst Rev 2008; 4: CD006322.
    1. Lacasse Y, Goldstein R, Lasserson TJ, et al. . Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2006; 4: CD003793.
    1. Holland AE, Hill CJ, Conron M, et al. . Small changes in six-minute walk distance are important in diffuse parenchymal lung disease. Respir Med 2009; 103: 1430–1435.
    1. Gloeckl R, Marinov B, Pitta F. Practical recommendations for exercise training in patients with COPD. Eur Respir Rev 2013; 22: 178–186.
    1. Sillen MJ, Speksnijder CM, Eterman RM, et al. . Effects of neuromuscular electrical stimulation of muscles of ambulation in patients with chronic heart failure or COPD: a systematic review of the English-language literature. Chest 2009; 136: 44–61.
    1. Holland AE, Hill CJ, Glaspole I, et al. . Predictors of benefit following pulmonary rehabilitation for interstitial lung disease. Respir Med 2012; 106: 429–435.
    1. Ferreira A, Garvey C, Connors GL, et al. . Pulmonary rehabilitation in interstitial lung disease: benefits and predictors of response. Chest 2009; 135: 442–447.
    1. Garin MC, Highland KB, Silver RM, et al. . Limitations to the 6-minute walk test in interstitial lung disease and pulmonary hypertension in scleroderma. J Rheumatol 2009; 36: 330–336.
    1. Schoenheit G, Becattelli I, Cohen AH. Living with idiopathic pulmonary fibrosis: an in-depth qualitative survey of European patients. Chron Respir Dise 2011; 8: 225–231.
    1. McLaughlin VV, Archer SL, Badesch DB, et al. . ACCF/AHA 2009 expert consensus document on pulmonary hypertension: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association: developed in collaboration with the American College of Chest Physicians, American Thoracic Society, Inc., and the Pulmonary Hypertension Association. Circulation 2009; 119: 2250–2294.
    1. Seferian A, Simonneau G. Therapies for pulmonary arterial hypertension: where are we today, where do we go tomorrow? Eur Respir Rev 2013; 22: 217–226.
    1. Deboeck G, Niset G, Lamotte M, et al. . Exercise testing in pulmonary arterial hypertension and in chronic heart failure. Eur Respir J 2004; 23: 747–751.
    1. Yasunobu Y, Oudiz RJ, Sun XG, et al. . End-tidal PCO2 abnormality and exercise limitation in patients with primary pulmonary hypertension. Chest 2005; 127: 1637–1646.
    1. Desai SA, Channick RN. Exercise in patients with pulmonary arterial hypertension. J Cardiopulm Rehabil Prev 2008; 28: 12–16.
    1. Mereles D, Ehlken N, Kreuscher S, et al. . Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension. Circulation 2006; 114: 1482–1489.
    1. de Man FS, Handoko ML, Groepenhoff H, et al. . Effects of exercise training in patients with idiopathic pulmonary arterial hypertension. Eur Respir J 2009; 34: 669–675.
    1. Mainguy V, Maltais F, Saey D, et al. . Effects of a rehabilitation program on skeletal muscle function in idiopathic pulmonary arterial hypertension. J Cardiopulm Rehabil Prev 2010; 30: 319–323.
    1. Fox BD, Kassirer M, Weiss I, et al. . Ambulatory rehabilitation improves exercise capacity in patients with pulmonary hypertension. J Card Fail 2011; 17: 196–200.
    1. Chan L, Chin LM, Kennedy M, et al. . Benefits of intensive treadmill exercise training on cardiorespiratory function and quality of life in patients with pulmonary hypertension. Chest 2013; 143: 333–343.
    1. Tsang KW, Bilton D. Clinical challenges in managing bronchiectasis. Respirology 2009; 14: 637–650.
    1. Martinez-Garcia MA, Perpina-Tordera M, Roman-Sanchez P, et al. . Quality-of-life determinants in patients with clinically stable bronchiectasis. Chest 2005; 128: 739–745.
    1. Koulouris NG, Retsou S, Kosmas E, et al. . Tidal expiratory flow limitation, dyspnoea and exercise capacity in patients with bilateral bronchiectasis. Eur Respir J 2003; 21: 743–748.
    1. Ozalp O, Inal-Ince D, Calik E, et al. . Extrapulmonary features of bronchiectasis: muscle function, exercise capacity, fatigue, and health status. Multidiscip Respir Med 2012; 7: 3.
    1. King PT, Holdsworth SR, Freezer NJ, et al. . Outcome in adult bronchiectasis. COPD 2005; 2: 27–34.
    1. Newall C, Stockley RA, Hill SL. Exercise training and inspiratory muscle training in patients with bronchiectasis. Thorax 2005; 60: 943–948.
    1. Mandal P, Sidhu MK, Kope L, et al. . A pilot study of pulmonary rehabilitation and chest physiotherapy versus chest physiotherapy alone in bronchiectasis. Respir Med 2012; 106: 1647–1654.
    1. Lee AL, Burge A, Holland AE. Airway clearance techniques for bronchiectasis. Cochrane Database Syst Rev 2013; 5: CD008351.
    1. Jemal A, Thun MJ, Ries LA, et al. . Annual report to the nation on the status of cancer, 1975–2005, featuring trends in lung cancer, tobacco use, and tobacco control. J Natl Cancer Inst 2008; 100: 1672–1694.
    1. Govindan R, Page N, Morgensztern D, et al. . Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database. J Clin Oncol 2006; 24: 4539–4544.
    1. Firat S, Bousamra M, Gore E, et al. . Comorbidity and KPS are independent prognostic factors in stage I non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2002; 52: 1047–1057.
    1. Pompili C, Salati M, Refai M, et al. . Preoperative quality of life predicts survival following pulmonary resection in stage I non-small-cell lung cancer. Eur J Cardiothorac Surg 2013; 43: 905–910.
    1. Brunelli A, Pompili C, Berardi R, et al. . Performance at preoperative stair-climbing test is associated with prognosis after pulmonary resection in stage I non-small cell lung cancer. Ann Thorac Surg 2012; 93: 1796–1800.
    1. Jemal A, Siegel R, Ward E, et al. . Cancer statistics, 2009. CA Cancer J Clin 2009; 59: 225–249.
    1. Wilcock A, Maddocks M, Lewis M, et al. . Symptoms limiting activity in cancer patients with breathlessness on exertion: ask about muscle fatigue. Thorax 2008; 63: 91–92.
    1. Jones LW, Eves ND, Mackey JR, et al. . Safety and feasibility of cardiopulmonary exercise testing in patients with advanced cancer. Lung Cancer 2007; 55: 225–232.
    1. Castelli L, Binaschi L, Caldera P, et al. . Depression in lung cancer patients: is the HADS an effective screening tool? Support Care Cancer 2009; 17: 1129–1132.
    1. Brunelli A, Socci L, Refai M, et al. . Quality of life before and after major lung resection for lung cancer: a prospective follow-up analysis. Ann Thorac Surg 2007; 84: 410–416.
    1. Nezu K, Kushibe K, Tojo T, et al. . Recovery and limitation of exercise capacity after lung resection for lung cancer. Chest 1998; 113: 1511–1516.
    1. Morice RC, Peters EJ, Ryan MB, et al. . Exercise testing in the evaluation of patients at high risk for complications from lung resection. Chest 1992; 101: 356–361.
    1. Op den Kamp CM, Langen RC, Snepvangers FJ, et al. . Nuclear transcription factor kappaB activation and protein turnover adaptations in skeletal muscle of patients with progressive stages of lung cancer cachexia. Am J Clin Nutr 2013; 98: 738–748.
    1. Nagamatsu Y, Maeshiro K, Kimura NY, et al. . Long-term recovery of exercise capacity and pulmonary function after lobectomy. J Thorac Cardiovasc Surg 2007; 134: 1273–1278.
    1. Handy JR, Jr, Asaph JW, Skokan L, et al. . What happens to patients undergoing lung cancer surgery? Outcomes and quality of life before and after surgery. Chest 2002; 122: 21–30.
    1. Schulte T, Schniewind B, Dohrmann P, et al. . The extent of lung parenchyma resection significantly impacts long-term quality of life in patients with non-small cell lung cancer. Chest 2009; 135: 322–329.
    1. Brunelli A, Monteverde M, Salati M, et al. . Stair-climbing test to evaluate maximum aerobic capacity early after lung resection. Ann Thorac Surg 2001; 72: 1705–1710.
    1. Coups EJ, Park BJ, Feinstein MB, et al. . Physical activity among lung cancer survivors: changes across the cancer trajectory and associations with quality of life. Cancer Epidemiol Biomarkers Prev 2009; 18: 664–672.
    1. Novoa N, Varela G, Jimenez MF, et al. . Influence of major pulmonary resection on postoperative daily ambulatory activity of the patients. Interact Cardiovasc Thorac Surg 2009; 9: 934–938.
    1. Bobbio A, Chetta A, Carbognani P, et al. . Changes in pulmonary function test and cardio-pulmonary exercise capacity in COPD patients after lobar pulmonary resection. Eur J Cardiothorac Surg 2005; 28: 754–758.
    1. Agostini P, Reeve J, Dromard S, et al. . A survey of physiotherapeutic provision for patients undergoing thoracic surgery in the UK. Physiotherapy 2013; 99: 56–62.
    1. Benzo R, Wigle D, Novotny P, et al. . Preoperative pulmonary rehabilitation before lung cancer resection: results from two randomized studies. Lung Cancer 2011; 74: 441–445.
    1. Morano MT, Araujo AS, Nascimento FB, et al. . Preoperative pulmonary rehabilitation versus chest physical therapy in patients undergoing lung cancer resection: a pilot randomized controlled trial. Arch Phys Med Rehabil 2013; 94: 53–58.
    1. Cavalheri V, Tahirah F, Nonoyama M, et al. . Exercise training undertaken by people within 12 months of lung resection for non-small cell lung cancer. Cochrane Database Syst Rev 2013; 7: CD009955.
    1. Cavalheri V, Jenkins S, Hill K. Physiotherapy practice patterns for patients undergoing surgery for lung cancer: a survey of hospitals in Australia and New Zealand. Intern Med J 2013; 43: 394–401.
    1. Cesario A, Ferri L, Galetta D, et al. . Post-operative respiratory rehabilitation after lung resection for non-small cell lung cancer. Lung Cancer 2007; 57: 175–180.
    1. Spruit MA, Janssen PP, Willemsen SC, et al. . Exercise capacity before and after an 8-week multidisciplinary inpatient rehabilitation program in lung cancer patients: a pilot study. Lung Cancer 2006; 52: 257–260.
    1. Jones LW, Eves ND, Peterson BL, et al. . Safety and feasibility of aerobic training on cardiopulmonary function and quality of life in postsurgical nonsmall cell lung cancer patients: a pilot study. Cancer 2008; 113: 3430–3439.
    1. Granger CL, Chao C, McDonald CF, et al. . Safety and feasibility of an exercise intervention for patients following lung resection: a pilot randomized controlled trial. Integr Cancer Ther 2013; 12: 213–224.
    1. Peddle-McIntyre CJ, Bell G, Fenton D, et al. . Feasibility and preliminary efficacy of progressive resistance exercise training in lung cancer survivors. Lung Cancer 2012; 75: 126–132.
    1. Hoffman AJ, Brintnall RA, Brown JK, et al. . Virtual reality bringing a new reality to postthoracotomy lung cancer patients via a home-based exercise intervention targeting fatigue while undergoing adjuvant treatment. Cancer Nurs 2013. [in press DOI: 10.1097/NCC.0b013e318278d52f].
    1. Spruit MA, Vanderhoven-Augustin I, Janssen PP, et al. . Integration of pulmonary rehabilitation in COPD. Lancet 2008; 371: 12–13.
    1. Vanfleteren LE, Spruit MA, Groenen M, et al. . Clusters of comorbidities based on validated objective measurements and systemic inflammation in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2013; 187: 728–735.
    1. Jones LW, Eves ND, Kraus WE, et al. . The lung cancer exercise training study: a randomized trial of aerobic training, resistance training, or both in postsurgical lung cancer patients: rationale and design. BMC Cancer 2010; 10: 155.
    1. Wang R, Liu J, Chen P, et al. . Regular tai chi exercise decreases the percentage of type 2 cytokine-producing cells in postsurgical non-small cell lung cancer survivors. Cancer Nurs 2013; 36: E27–E34.
    1. Maddocks M, Lewis M, Chauhan A, et al. . Randomized controlled pilot study of neuromuscular electrical stimulation of the quadriceps in patients with non-small cell lung cancer. J Pain Symptom Manage 2009; 38: 950–956.
    1. Dimeo FC, Thomas F, Raabe-Menssen C, et al. . Effect of aerobic exercise and relaxation training on fatigue and physical performance of cancer patients after surgery. A randomised controlled trial. Support Care Cancer 2004; 12: 774–779.
    1. Liu W, Pan YL, Gao CX, et al. . Breathing exercises improve post-operative pulmonary function and quality of life in patients with lung cancer: A meta-analysis. Exp Ther Med 2013; 5: 1194–1200.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel