An update on pulmonary rehabilitation techniques for patients with chronic obstructive pulmonary disease

Abstract

Introduction: Pulmonary rehabilitation (PR) is one of the core components in the management of patients with chronic obstructive pulmonary disease (COPD). In order to achieve the maximal level of independence, autonomy, and functioning of the patient, targeted therapies and interventions based on the identification of physical, emotional and social traits need to be provided by a dedicated, interdisciplinary PR team. Areas covered: The review discusses cardiopulmonary exercise testing in the selection of different modes of training modalities. Neuromuscular electrical stimulation as well as gait assessment and training are discussed as well as add-on therapies as oxygen, noninvasive ventilator support or endoscopic lung volume reduction in selected patients. The potentials of pulsed inhaled nitric oxide in patients with underlying pulmonary hypertension is explored as well as nutritional support. The impact of sleep quality on outcomes of PR is reviewed. Expert opinion: Individualized, comprehensive intervention based on thorough assessment of physical, emotional, and social traits in COPD patients forms a continuous challenge for health-care professionals and PR organizations in order to dynamically implement and adapt these strategies based on dynamic, more optimal understanding of underlying pathophysiological mechanisms.

The narrative review of chronic obstructive pulmonary disease management in Turkey: medical treatment, pulmonary rehabilitation and endobronchial volume reduction

“…E x e r c i s e t r a i n i n g i s m a i n c o m p o n e n t s o f P R . International recommendations about exercise training are similar to Turkey (48,(62)(63)(64)(65)(66)(67) in order to increase exercise capacity, muscle strength, and endurance, which was found to be related with 8-year mortality in patients with COPD in a study from Turkey (68). Like lower limb exercise training, upper limb exercise training is also important.…”

Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease: Highly Effective but Often Overlooked

“…Inspiratory and expiratory muscle training combined with PR are reported to improve inspiratory muscle strength and exercise limitation although the practical benefits of such a strategy are far from clear [ 84 - 86 ]. Other areas such as nutritional support, sleep quality assurance, and neuromuscular electrical stimulation [ 87 ] show promise as useful adjuncts to PR. There is a small, but growing amount of literature exploring less conventional approaches such as acupuncture [ 88 ], meditation [ 89 ], and Tai Chi [ 90 ], though there is insufficient evidence at this time to make firm recommendations.…”

Malnutrition According to GLIM Criteria Is Associated with Mortality and Hospitalizations in Rehabilitation Patients with Stable Chronic Obstructive Pulmonary Disease

“…Chronic obstructive pulmonary disease (COPD), a heterogeneous disease with pulmonary and extrapulmonary manifestations, is the third-highest cause of mortality worldwide, claiming 3 million lives in 2016 [1]. It is also highly associated with morbidity and disability [2] and frequently associated with concomitant diseases, including nutritional disorders [3]. Malnutrition is associated with adverse medical consequences contributing to frailty, morbidity, and mortality [4][5][6][7][8].…”