Pulmonary rehabilitation and COPD: providing patients a good environment for optimizing therapy

Jean-Louis Corhay, Delphine Nguyen Dang, Hélène Van Cauwenberge, Renaud Louis, Jean-Louis Corhay, Delphine Nguyen Dang, Hélène Van Cauwenberge, Renaud Louis

Abstract

Chronic obstructive pulmonary disease (COPD) is an obstructive and progressive airway disease associated with an important reduction in daily physical activity and psychological problems that contribute to the patient's disability and poor health-related quality of life (HRQoL). Nowadays, pulmonary rehabilitation (PR) plays an essential role in the management of symptomatic patients with COPD, by breaking the vicious circle of dyspnea-decreased activity-deconditioning-isolation. Indeed the main benefits of comprehensive PR programs for patients with COPD include a decrease in symptoms (dyspnea and fatigue), improvements in exercise tolerance and HRQoL, reduction of health care utilization (particularly bed-days), as well as an increase in physical activity. Several randomized studies and meta-analyses greatly established the benefits of PR, which additionally, is recommended in a number of influential guidelines. This review aimed to highlight the impact of PR on COPD patients, focusing on the clinical usefulness of PR, which provides patients a good support for change.

Keywords: chronic obstructive pulmonary disease; exercise training; physical activity; quality of life.

Figures

Figure 1
Figure 1
COPD’s “vicious” circle. Abbreviation: COPD, chronic obstructive pulmonary disease.
Figure 2
Figure 2
Multidisciplinary team involved in comprehensive pulmonary rehabilitation centered on the COPD patients. Abbreviation: COPD, chronic obstructive pulmonary disease.
Figure 3
Figure 3
Summary of the steps and benefits of pulmonary rehabilitation. Abbreviation: COPD, chronic obstructive pulmonary disease.
Figure 4
Figure 4
Use of a multisensory accelerometer. Notes: (A) An accelerometer worn on the arm. (B) Data recorded by the accelerometer from a severely disabled GOLD IV COPD patient. Abbreviations: MET, metabolic equivalent; COPD, chronic obstructive pulmonary disease; GOLD, Global initiative for Obstructive Lung Disease; min/day, minutes per day.

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