Long-term Efficacy of Pulmonary Rehabilitation

Ochmann, Uta; Jörres, Rudolf A.; Nowak, Dennis

doi:10.1097/hcr.0b013e3182467194

Cited by 26 publications

(19 citation statements)

References 51 publications

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“…Repeating pulmonary rehabilitation can be offered to patients as exercise benefits from a PRP diminish after 1–2 years,5 but the ideal interval between repetition of a PRP remains unclear 1. Based on a study in patients with moderate COPD, there is likely little benefit to intervals less than 2 years;7 however, patients with severe COPD may benefit from a shorter interval 9.…”

Section: Discussionmentioning

confidence: 99%

“…Short-term benefits include enhanced health-related quality of life (HRQoL) and self-efficacy, improved exercise performance and mood, reduced breathlessness, and reduced health care utilization 1,2. However, long-term benefits are less well preserved, and most measures of improvement return to baseline by 12–24 months 5. Many attempts to prolong this effect have been trialed through a variety of maintenance and repeat programs with varied success.…”

Section: Introductionmentioning

confidence: 99%

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Magnitude of exercise capacity and quality of life improvement following repeat pulmonary rehabilitation in patients with COPD

Sandoz

Roberts

Cho

et al. 2017

COPD

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BackgroundMaintenance and repeated pulmonary rehabilitation programs (PRPs) for patients with COPD have attempted to prolong PRP benefits beyond 12–24 months. However, there is limited evidence as to the magnitude of benefit or the ideal interval between repeating the program under “real-world” conditions in which patients are referred based on clinical necessity. Therefore, we reviewed the effects of repeating PRP in a physician-referred cohort of patients with COPD.MethodsA total of 141 individuals with COPD completed PRP twice and 35 completed PRP three times over a 12-year period. We used linear mixed-effects models to quantify the magnitude and change in 6-minute walk distance (6MWD), St George’s Respiratory Questionnaire (SGRQ), and Hospital Anxiety and Depression Scale (HADS) for each PRP. One-way analysis of variance with Tukey’s post hoc analysis compared the effects of different time intervals on 6MWD, SGRQ, and HADS between PRPs.ResultsDespite 39 mL/year average decrease in forced expiratory volume in 1 second, overall 6MWD improved following each PRP (PRP1=58 m, P<0.0001; PRP2=42 m, P<0.0001; PRP3=32 m, P<0.003). Mean SGRQ decreased after PRP1 (−7.0 units; P<0.001) and PRP2 (−4.9 units; P<0.0001) but not after PRP3 (−3.2 units; P=0.10). HADS decreased after PRP1 (−1.9 units; P<0.0001) and PRP2 (−1.7 units; P=0.0001) but not after PRP3 (−0.4 units; P=0.63).ConclusionIn physician-referred patients who underwent repeat PRP as clinically required, there were clear benefits in functional exercise capacity following each repeat PRP, which was not affected by the time interval between PRPs. Health-related quality of life and mood improved after the first two PRPs, but not after a third.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Magnitude of exercise capacity and quality of life improvement following repeat pulmonary rehabilitation in patients with COPD

Sandoz

Roberts

Cho

et al. 2017

COPD

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“…Sabe-se que o aumento do número de exacerbações está diretamente relacionado com a gravidade da DPOC e com diminuição da função pulmonar; dessa forma, a exacerbação deve ser reconhecida e tratada rapidamente de forma que o paciente tenha a menor perda funcional possível 11 . Para o tratamento ideal da DPOC é necessária persistência nas mudanças de hábitos e estilo de vida, e a participação em PRP promove melhorias na qualidade de vida do paciente a curto e longo prazo 12 .…”

Section: Frequência De Exacerbação Em Pacientes Portadores De Dpoc Suunclassified

Frequência De Exacerbação Em Pacientes Portadores De Dpoc Submetidos a Um Programa De Reabilitação Pulmonar

Freitas

Brixner²,

Garske³

et al. 2017

Saúde (Sta. Maria)

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O objetivo deste estudo foi avaliar a frequência de exacerbação em pacientes diagnosticados com Doença Pulmonar Obstrutiva Crônica (DPOC) submetidos em Programa de Reabilitação Pulmonar (PRP) em hospital de ensino no interior do Rio Grande do Sul. Estudo transversal com 32 pacientes. A coleta de dados ocorreu em outubro de 2015, através do sistema computadorizado do hospital e banco de dados do PRP. A amostra foi estratificada em grupos, conforme o tempo de permanência no PRP: menos de dois meses (G1), de dois a 12 meses (G2) e mais de 12 meses (G3).Verificou-se que 59,4% eram do sexo masculino com idade média de 63,5 anos (± 6,9). No G1, 50% dos pacientes exacerbaram, no G2, 65% e no G3, 37,5%. Os resultados demonstraram que portadores de DPOC que frequentaram o PRP por tempo superior a 12 meses apresentaram menor frequência e menor intensidade de exacerbação da doença.Descritores: Reabilitação; Doença Pulmonar Obstrutiva Crônica; Exacerbação dos Sintomas.

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“…• Ensure proper use of inhalers and when to refill; consider changing MDI to nebulizer therapy; • Promote oral hygiene and periodontal health to avoid bacterial infections; • Prevent complications of immobility by increasing exercise (Ochmann et al, 2012); • Address nutritional needs to decrease risk of infection; monitor weight weekly; monitor body mass index; • Assure adequate oxygenation and secretion clearance and avoid cough suppressants; • Teach patients to avoid other persons with respiratory infections; • Use measures to avoid gastroesophageal reflux disease (GERD) (Kim et al, 2013); • Trial methods of smoking cessation if patient still smokes and avoid second-hand smoke; • Avoid the outdoors during increased levels of environmental pollutants (Mackay & Hurst, 2012); • Teach patients to recognize an exacerbation early and when to contact their healthcare provider; • Yearly influenza vaccination, ideally by October (CDC, 2013a); and • Pneumonia vaccine at least once with a single booster 5 years later if the person was younger than 65 years old when the initial vaccine was given (CDC, 2013a).…”

Section: Pneumonia and Influenzamentioning

confidence: 99%

Avoiding Emergency Department Visits for COPD, Pneumonia, and Heart Failure

Fritz

McKenzie²

2014

Home Healthcare Nurse

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Patients with pneumonia, chronic obstructive pulmonary disease (COPD), and heart failure make frequent visits to the emergency department. Heart failure alone is the reason for more than 1 million emergency department visits annually in the United States. This article describes strategies home care clinicians can use to prevent unnecessary emergency department visits for patients with pneumonia, COPD and heart failure.

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Long-term Efficacy of Pulmonary Rehabilitation

Cited by 26 publications

References 51 publications

Magnitude of exercise capacity and quality of life improvement following repeat pulmonary rehabilitation in patients with COPD

Magnitude of exercise capacity and quality of life improvement following repeat pulmonary rehabilitation in patients with COPD

Frequência De Exacerbação Em Pacientes Portadores De Dpoc Submetidos a Um Programa De Reabilitação Pulmonar

Avoiding Emergency Department Visits for COPD, Pneumonia, and Heart Failure

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