Effectiveness of Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease With Different Degrees of Static Lung Hyperinflation

Houben-Wilke

et al. 2018

JCM

The degree of lung function is frequently used as referral criterion for pulmonary rehabilitation. The efficacy of pulmonary rehabilitation was assessed in 518 chronic obstructive pulmonary disease (COPD) patients, after clustering based on a comprehensive pre-rehabilitation lung function assessment. Mean improvements in dyspnea, exercise performance, health status, mood status and problematic activities of daily life after pulmonary rehabilitation were mostly comparable between the seven clusters, despite significant differences in the degree of lung function. The current study demonstrates no significant relationship between the seven lung-function-based clusters and response to pulmonary rehabilitation. Therefore, baseline lung function cannot be used to identify those who will respond well to pulmonary rehabilitation, and moreover, cannot be used as a criterion for referral to pulmonary rehabilitation in patients with COPD.

“…Thus, the degree of airflow limitation is a poor selection criterion for pulmonary rehabilitation. The same is true for the degree of static lung hyperinflation [10].…”

Section: Introductionmentioning

confidence: 96%

Comprehensive Lung Function Assessment Does not Allow to Infer Response to Pulmonary Rehabilitation in Patients with COPD

Augustin

Houben-Wilke

et al. 2018

JCM

“…As hyperinflation increased, patients were more prone to cachexia, were of younger age and had worse exercise capacity. All patients, irrespective of the severity of hyperinflation, showed improvement on exercise capacity and quality of life [118].…”

Section: Lung Volume Reduction and Pulmonary Rehabilitationmentioning

confidence: 86%

“…Vanfleteren et al [118] evaluated retrospectively the effect of PR in patients with different degrees of hyperinflation. As hyperinflation increased, patients were more prone to cachexia, were of younger age and had worse exercise capacity.…”

Section: Lung Volume Reduction and Pulmonary Rehabilitationmentioning

confidence: 99%

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

Expert Review of Respiratory Medicine

Posthuma

Koopman

et al. 2020

Self Cite

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.

“…Indeed, dyspnoea, fatigue, dynamic hyperinflation, a reduced physical capacity, an impaired disease‐specific health status and social deprivation already occur in patients with a mild degree of airflow limitation . Moreover, the degree of lung function impairment at entry to the pulmonary rehabilitation cannot forecast the efficacy of the programme …”

Section: Settings For Pulmonary Rehabilitationmentioning

confidence: 99%

Organizational aspects of pulmonary rehabilitation in chronic respiratory diseases

Spruit

2019

Respirology

Self Cite

Adult patients with chronic respiratory diseases may suffer from multiple physical (pulmonary and extrapulmonary), emotional and social features which necessitate a comprehensive, interdisciplinary rehabilitation programme. To date, pulmonary rehabilitation programmes show a lot of variation in setting, content, frequency and duration. Future projects should strive for a standard set of assessment measures to identify patients eligible for pulmonary rehabilitation, taking disease complexity into consideration, which should result in referral to an appropriate rehabilitation setting. Local circumstances may complicate this crucial endeavour.