Optimizing Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease – Practical Issues: A Canadian Thoracic Society Clinical Practice Guideline

Marciniuk, Darcy; Brooks, Dina; Butcher, Scotty; Debigaré, Richard; Dechman, Gail; Ford, Gordon; Pepin, Véronique; Reid, Darlene; Sheel, A. William; Stickland, Micheal K; Todd, D.; Walker, Shannon L.; Aaron, Shawn D.; Balter, Meyer; Bourbeau, Jean; Hernández, Paul; Maltais, François; O’Donnell, Denis E.; Bleakney, Donna; Carlin, Brian; Goldstein, Roger; Muthuri, Stella

doi:10.1155/2010/425975

Cited by 118 publications

(82 citation statements)

References 76 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Endurance training is recommended by various guidelines as the cornerstone of successful pulmonary rehabilitation. [38][39][40] Although increases in muscle strength after resistance training were demonstrated in subjects with COPD, 41 the effect of resistance training and combined resistance and endurance training on clinically relevant outcomes in patients with COPD remains controversial. This meta-analysis incorporated 18 RCTs and included data from 750 subjects with advanced COPD.…”

Section: Discussionmentioning

confidence: 99%

Impact of Resistance Training in Subjects With COPD: A Systematic Review and Meta-Analysis

Liao¹,

Chen²,

Chen

et al. 2015

Respir Care

101

View full text Add to dashboard Cite

BACKGROUND: The goal of this study was to evaluate the effects of resistance training on subjects with COPD. METHODS: We performed a systematic search in MEDLINE, PubMed, Embase, CINAHL, Elsevier ScienceDirect, EBM Reviews, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov and also of leading respiratory journals for randomized controlled trials on COPD treatment for > 4 weeks with resistance training compared with non-exercise control or with combined resistance and endurance training compared with endurance training alone. Data from these studies were pooled to calculate odds ratio and weighted mean differences (WMDs) with 95% CI. RESULTS: Eighteen trials with 750 subjects with advanced COPD met the inclusion criteria. There were 2 primary and 5 secondary outcomes. Compared with non-exercise control, resistance training led to significant improvements in the dyspnea domain of the Chronic Respiratory Disease Questionnaire (WMD of 0.59, 95% CI 0.26 -0.93, I2 ‫؍‬ 0%, P < .001), skeletal muscle strength, and percent-of-predicted FEV 1 (WMD of 6.88%, 95% CI 0.41-13.35%, I2 ‫؍‬ 0%, P ‫؍‬ .04). The combination of resistance and endurance training significantly improved the St George Respiratory Questionnaire total score (WMD of ؊7.44, 95% CI ؊12.62 to ؊2.25, I2 ‫؍‬ 0%, P ‫؍‬ .005), each domain score, and skeletal muscle strength. There were no significant differences in 6-min walk distance, 6-min pegboard and ring test, maximum exercise work load, and maximum oxygen consumption between the 2 groups. There were no reports of adverse events related to resistancetraining intervention. CONCLUSIONS: Resistance training can be successfully performed alone or in conjunction with endurance training without increased adverse events during pulmonary rehabilitation in COPD.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of Resistance Training in Subjects With COPD: A Systematic Review and Meta-Analysis

Liao¹,

Chen²,

Chen

et al. 2015

Respir Care

101

View full text Add to dashboard Cite

show abstract

“…6 Pulmonary rehabilitation (PR) is the standard of care for individuals diagnosed with COPD who remain symptomatic despite bronchodilator therapies. 7 An important goal of PR is to improve exercise capacity over the course of multiple weeks of exercise training and to reduce the symptoms of COPD, including dyspnea and lack of energy. 8 Despite the importance of exercise training to COPD, participation in PR and program completion rates among those who attend PR are low.…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Exploration of Exercise Among Pulmonary Rehabilitation Participants: Insight From Multiple Sources of Social Influence

Witcher

McGannon

Hernández³

et al. 2015

Respir Care

View full text Add to dashboard Cite

BACKGROUND: Exercise training within the pulmonary rehabilitation (PR) context is considered the most effective strategy to reduce COPD symptoms. However, participation in PR and continued exercise training following program completion are low. Previous research examined factors related to attendance and adherence, but the knowledge base to date has been limited to quantitative findings that focus solely on participants diagnosed with COPD. In addition to quantitative research, exploring multiple perspectives (eg, PR participants, significant others, staff, and stakeholders) using qualitative research methods opens a window of additional understanding. The goal of this study was to obtain multiple perspectives on PR to gain insight into factors that affect exercise participation among individuals diagnosed with COPD. METHODS: A total of 26 participants were interviewed via telephone, including 8 individuals diagnosed with COPD (4 men and 4 women, mean age of 67 [range of 58 -77] y), 4 family members, 11 PR staff, and 3 community stakeholders. RESULTS: Analysis revealed 3 themes: task self-efficacy for exercise, provision of support and encouragement, and perceptions of gender differences. Despite initial concerns, individuals diagnosed with COPD reported becoming more confident during PR and emphasized the importance of being supported by staff. PR staff perceived that men tended to approach exercise in a more eager and aggressive manner compared with women, who were more cautious and hesitant. CONCLUSIONS: In addition to enhancing task self-efficacy, findings suggest that exercise participation and adherence within the PR environment may be improved by adopting a gender-tailored approach.

show abstract

“…The median (inter-quartile range) attendance was 13 (7,16) from a maximum 18 sessions with 56% of patients completing 12 or more sessions.…”

Section: Methodsmentioning

confidence: 99%

“…), intensity and type of exercises, educational, psychological and behavioural components, oxygen supplementation, what outcomes to measure and total duration [3][4][5][6][7] . However, there still remain unanswered questions including what are the best sites for delivery of a PRP, whether nutritional supplementation should be offered during PRP, what are optimal target populations and what post-rehabilitation maintenance strategies reduce the declines seen in nearly all settings [7][8][9] . Other important concerns relate to variable attendance and high drop-out rates in PRPs 10,11 .…”

Section: Introductionmentioning

confidence: 99%

Twice versus three-times weekly pulmonary rehabilitation in a real-life clinical setting

et al. 2014

View full text Add to dashboard Cite

Our aim was to compare a less intensive but longer pulmonary Aim rehabilitation programme (PRP) against a more intensive but shorter PRP.: We carried out an observational, cohort study in a real-life clinical Methods setting in patients primarily with chronic obstructive pulmonary disease (COPD). We compared standard outcomes in patients who were receiving 18 sessions of PRP delivered twice weekly over 9 weeks (Group 1) against similar patients receiving an identical PRP delivered three times weekly over 6 weeks (Group 2). Outcome measures were the St. George's Respiratory Questionnaire (SGRQ), the Incremental Shuttle Walk Test (ISWT) and the number of hospital bed-days pre-and post-PRP.: Both groups showed statistically significant and clinically important Results improvements post-PRP. The largest effects were seen immediately post-PRP and waned over the following 12 months. Group 1 showed a larger improvement in ISWT immediately post-PRP (Group 1, +92 m Group 2 versus +64 m ( =0.001), but there were no differences between groups at 6 ( =0.67) p p or 12 months (p=0.96). There were no differences in SGRQ between groups immediately post-PRP ( =0.09) or at 12 months ( =0.78). There were no p p differences between groups in the number of hospital days 12 months prior to PRP versus 12 months post-PRP ( =0.18). p : Twice weekly outpatient, multidisciplinary PRP over 9 weeks is as Conclusion effective as three times weekly PRP over 6 weeks.

show abstract

Optimizing Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease – Practical Issues: A Canadian Thoracic Society Clinical Practice Guideline

Cited by 118 publications

References 76 publications

Impact of Resistance Training in Subjects With COPD: A Systematic Review and Meta-Analysis

Impact of Resistance Training in Subjects With COPD: A Systematic Review and Meta-Analysis

A Qualitative Exploration of Exercise Among Pulmonary Rehabilitation Participants: Insight From Multiple Sources of Social Influence

Twice versus three-times weekly pulmonary rehabilitation in a real-life clinical setting

Contact Info

Product

Resources

About