Practical recommendations for exercise training in patients with COPD

Gloeckl, Rainer; Marinov, Blagoi; Pitta, Fábio

doi:10.1183/09059180.00000513

Cited by 226 publications

(163 citation statements)

References 75 publications

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“…Although supervised exercise training is considered the cornerstone of effective pulmonary rehabilitation [108], there are many other approaches that may help to manage the impairments and symptom burden, as well as the psychosocial and lifestyle changes imposed by COPD. Consideration should be given to incorporating these approaches within the framework of a comprehensive pulmonary rehabilitation programme, with the goal of promoting effective life-long CDSM.…”

Section: Discussionmentioning

confidence: 99%

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

Hill¹,

Vogiatzis²,

Burtin³

2013

Eur Respir Rev

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Comprehensive pulmonary rehabilitation is an important component in the clinical management of people with chronic obstructive pulmonary disease (COPD). Although supervised exercise training is considered the cornerstone of effective pulmonary rehabilitation, there are many other components that should be considered to manage the impairments and symptom burden, as well as the psychosocial and lifestyle changes imposed by COPD. These include approaches designed to: 1) facilitate smoking cessation; 2) optimise pharmacotherapy; 3) assist with early identification and treatment of acute exacerbations; 4) manage acute dyspnoea; 5) increase physical activity; 6) improve body composition; 7) promote mental health; 8) facilitate advance care planning; and 9) establish social support networks. This article will describe these approaches, which may be incorporated within pulmonary rehabilitation, to optimise effective chronic disease self-management. @ERSpublications This paper describes several components of comprehensive pulmonary rehabilitation, other than simply exercise training http://ow.ly/mMNRp Pulmonary rehabilitation for chronic obstructive pulmonary diseaseChronic obstructive pulmonary disease (COPD) is characterised by persistent airflow limitation due to chronic inflammation within the airways and lung in response to noxious particles or gases [1]. People with this condition are limited by dyspnoea and have impaired exercise capacity and health-related quality of life [1]. The prevalence of COPD amongst adults aged o40 years is ,10% [2], and increases to 21% in those with a significant smoking history who are visiting their family physician for any reason [3]. The natural course of COPD is punctuated with episodes of acute worsening, known as exacerbations, which contribute

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Section: Discussionmentioning

confidence: 99%

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

Hill¹,

Vogiatzis²,

Burtin³

2013

Eur Respir Rev

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“…In the WBV group additional training was performed in a supervised manner 3×2 min/day on the vibrating platform. The patient stood with bended knees on the platform according to published recommendations [17]. The side-alternating movements of the device cause muscle contractions on the entire flexor and extensor chain of muscles in the legs and the trunk [6].…”

Section: Methodsmentioning

confidence: 99%

Benefits of whole body vibration training in patients hospitalised for COPD exacerbations – a randomized clinical trial

Koczulla¹,

Greulich²,

Nell³

et al. 2014

Pneumologie

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Background: Patients with stable COPD show improvements in exercise capacity and muscular function after the application of whole body vibration. We aimed to evaluate whether this modality added to conventional physiotherapy in exacerbated hospitalised COPD patients would be safe and would improve exercise capacity and quality of life. Methods: 49 hospitalised exacerbated COPD patients were randomized (1:1) to undergo physiotherapy alone or physiotherapy with the addition of whole body vibration. The primary endpoint was the between-group difference of the 6-minute walking test (day of discharge -day of admission). Secondary assessments included chair rising test, quality of life, and serum marker analysis.

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“…18 . Exercise training as part of pulmonary rehabilitation programs has been shown to be effective in all patients despite the degree of air-flow limitation [18][19] . The exercise includes endurance training aiming to increase exercise capacity, and muscle strength training both for the upper and lower limbs and the respiratory muscles 18 .…”

Section: Background Chronic Obstructive Pulmonary Diseasementioning

confidence: 99%

The relationship between physical function and experience of fatigue in patients with chronic obstructive pulmonary disease

Tödt¹

2014

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Background Chronic Obstructive Pulmonary Disease (COPD) is increasing throughout the world and most rapidly among women. COPD is characterized by a progressive loss of physical functions. The reason for this is multi-factorial and include not only lung related deficiencies but also several systemic consequences and symptoms of which several are potential restrictors of physical function. The relationship between physical function and symptoms are not clear, especially not among women with COPD. Aim The overall aim of this thesis was to illuminate the relationship between two dimensions of physical function (physical activity and physical capacity) and experience of fatigue. The specific aims were to explore factors associated with low physical activity and to examine experience of fatigue and its relationship to physical capacity and disease severity in men and women with COPD. Methods A cross-sectional study was conducted including 121 patients (67 women) with stable COPD and mean age of 67 (+/-7) years. Physical activity was measured with the International Physical Activity Questionnaire short form. Physical capacity included assessment of lung function (dynamic spirometry), exercise capacity (the 6-minute walk distance [perceived dyspnoea and leg fatigue in connection to the test]) and muscle strength (the Timed Stands Test and grip strength). Fatigue was assessed with structured questions covering the frequency, duration and severity of fatigue the previous month and patients were categorized as those with no fatigue, moderate fatigue or severe fatigue. Data about other symptoms (dyspnoea, anxiety and depression), symptom burden (Memorial Symptom Assessment Scale), fat and fat free mass (bio-impedance analysis) and smoking history was collected. Results Forty-two percent of the patients reported a low physical activity level. A majority of the patients reported experience of fatigue the previous month, 52% moderate fatigue and 25% severe fatigue. Low physical activity was associated with severe fatigue, worse exercise capacity and a higher amount of smoking. There were no differences in experience of fatigue between men and women. Men with fatigue had worse physical capacity and disease severity compared to men without fatigue. Women with fatigue had comparable physical capacity and disease severity to women without fatigue except for a higher perceived leg fatigue after the exercise capacity test. Multiple logistic regression analysis showed that exercise capacity and disease severity were associated with fatigue in both men and women but in women, leg fatigue was also strongly associated with the presence of fatigue. Conclusions Severe fatigue, worse exercise capacity and a higher amount of smoking were independently associated with low PA. This result suggests that patients with severe fatigue might need specific strategies to become more physically active. Presence of fatigue was associated with exercise capacity and disease severity in both men and women. In addition, in women leg fatigue was strongly a...

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Practical recommendations for exercise training in patients with COPD

Cited by 226 publications

References 75 publications

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

Benefits of whole body vibration training in patients hospitalised for COPD exacerbations – a randomized clinical trial

The relationship between physical function and experience of fatigue in patients with chronic obstructive pulmonary disease

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