Unravelling self-management for COPD

Wagg, Katy

doi:10.1177/1479972311435910

Cited by 54 publications

(63 citation statements)

References 12 publications

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“…The median (IQR) number of types of interventions within the pulmonary rehabilitation programmes was 11 (9)(10)(11)(12). The most common interventions were education (94.4%), stationary cycling (92.6%), breathing exercises including pursed lips breathing (91.6%) and nutritional support (84.4%) ( fig.…”

Section: Interventionsmentioning

confidence: 99%

“…Pulmonary rehabilitation has consistently shown that individuals with chronic respiratory disease experience: a decrease in daily symptoms of dyspnoea, fatigue, anxiety and depression; improvements in exercise performance, self-efficacy and health status; and a decrease in healthcare utilisation [2][3][4][5][6][7][8][9]. As pulmonary rehabilitation addresses the symptoms, activity limitations and reduced health-related quality of life associated with chronic respiratory disease, it is now considered a fundamental component of the integrated disease management of individuals with chronic respiratory disease [10].…”

Section: Introductionmentioning

confidence: 99%

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Differences in content and organisational aspects of pulmonary rehabilitation programmes

Spruit¹,

Pitta²,

et al. 2013

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The aim was to study the overall content and organisational aspects of pulmonary rehabilitation programmes from a global perspective in order to get an initial appraisal on the degree of heterogeneity worldwide.A 12-question survey on content and organisational aspects was completed by representatives of pulmonary rehabilitation programmes that had previously participated in the European Respiratory Society (ERS) COPD Audit. Moreover, all ERS members affiliated with the ERS Rehabilitation and Chronic Care and/or Physiotherapists Scientific Groups, all members of the American Association of Cardiovascular and Pulmonary Rehabilitation, and all American Thoracic Society Pulmonary Rehabilitation Assembly members were asked to complete the survey via multiple e-mailings.The survey has been completed by representatives of 430 centres from 40 countries. The findings demonstrate large differences among pulmonary rehabilitation programmes across continents for all aspects that were surveyed, including the setting, the case mix of individuals with a chronic respiratory disease, composition of the pulmonary rehabilitation team, completion rates, methods of referral and types of reimbursement.The current findings stress the importance of future development of processes and performance metrics to monitor pulmonary rehabilitation programmes, to be able to start international benchmarking, and to provide recommendations for international standards based on evidence and best practice. @ERSpublications Differences in aspects of pulmonary rehabilitation programmes suggest caution in generalisation of research findings

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Section: Interventionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Differences in content and organisational aspects of pulmonary rehabilitation programmes

Spruit¹,

Pitta²,

et al. 2013

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“…In the past 20 years, pulmonary rehabilitation has become an integrated part of the management of individuals with moderate to very severe COPD [12,13]. Pulmonary rehabilitation, defined as an evidence-based, multidisciplinary and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and often have decreased daily life activities, is designed to reduce symptoms, optimise functional status and increase participation in activities of daily living [14].…”

mentioning

confidence: 99%

“…Consequently exercise intolerance may render activities of daily life problematic, leading to a downward spiral in which there is a progressive reduction in physical activity [3][4][5][6][7][8]. Thus, individuals with COPD can end up in a vicious circle of physical deconditioning, including loss of lower limb muscle mass and strength, loss of balance and osteoporosis [8][9][10][11].In the past 20 years, pulmonary rehabilitation has become an integrated part of the management of individuals with moderate to very severe COPD [12,13]. Pulmonary rehabilitation, defined as an evidence-based, multidisciplinary and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and often have decreased daily life activities, is designed to reduce symptoms, optimise functional status and increase participation in activities of daily living [14].…”

mentioning

confidence: 99%

T’ai chi for individuals with COPD: an ancient wisdom for a 21st century disease?

Spruit

Polkey

2013

Eur Respir J

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Even when receiving optimal medical treatment, individuals with chronic obstructive pulmonary disease (COPD) commonly experience daily symptoms of dyspnoea and fatigue [1,2]. Consequently exercise intolerance may render activities of daily life problematic, leading to a downward spiral in which there is a progressive reduction in physical activity [3][4][5][6][7][8]. Thus, individuals with COPD can end up in a vicious circle of physical deconditioning, including loss of lower limb muscle mass and strength, loss of balance and osteoporosis [8][9][10][11].In the past 20 years, pulmonary rehabilitation has become an integrated part of the management of individuals with moderate to very severe COPD [12,13]. Pulmonary rehabilitation, defined as an evidence-based, multidisciplinary and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and often have decreased daily life activities, is designed to reduce symptoms, optimise functional status and increase participation in activities of daily living [14]. Pulmonary rehabilitation, which usually involves an initial assessment, exercise training, education and behaviour change, is safe and effective in individuals with COPD [14][15][16]. Indeed, improvements in health-related quality of life, functional mobility and lower limb muscle function have been reported [17]. Exercise training is the cornerstone of pulmonary rehabilitation and mostly consists of aerobic exercises (stationary cycling, treadmill walking and/or ground walking) in combination with muscle strengthening exercises (resistance training and/or transcutaneous neuromuscular electrical stimulation) [14,15,18,19].T'ai chi is a traditional Chinese form of conditioning exercise derived from martial arts. When practised correctly, t'ai chi is thought to strengthen the body's vital energy and enhance the passage of this energy throughout the body to confer its healthpromoting effects. T'ai chi has spread worldwide as improvements in physical and emotional functioning have frequently been reported in older adults [20] [25] present new insights into the effects of Sun-style t'ai chi in individuals with COPD. 42 individuals with COPD were randomly assigned to a usual care control group or a twice weekly supervised Sun-style t'ai chi training in combination with an unsupervised, home-based t'ai chi training programme (including a t'ai chi training booklet and DVD) on the remaining 5 days a week (30 min per day) for a total duration of 12 weeks. Improvements in lower limb muscle function, balance, functional exercise performance, health-related quality of life and mood status following Sun-style t'ai chi were significantly better compared to the usual care control group. Indeed, the mean differences between groups in changes in incremental shuttle walk distance, endurance shuttle walk time, and health-related quality of life questionnaire scores exceeded the minimal important difference of 47.5 m, 186 s or 0.5 points per question, respectively [26][27][28]. Interestingly, indiv...

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“…Self-efficacy has been acknowledged in the article as an important aspect of behavior change. 5,6 By identifying deficits in self-efficacy and manipulating it, behavior change might be more successful. 5,6 Rationale and Outcomes Recent evidence-based reviews have confirmed the effect of PR on COPD outcomes, including improved exercise capacity, reduced dyspnea and leg discomfort, improved quality of life (QoL), enhanced self-efficacy, improved activities of daily living (Table 1).…”

mentioning

confidence: 99%

Recent Advances in Pulmonary Rehabilitation for Patients with COPD

Shioya¹,

Iwakura²,

Kawagoshi³

et al. 2017

Pulm Res Respir Med Open J

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Pulmonary rehabilitation (PR) is a non-pharmacologic therapy that has emerged as a standard of care for patients with chronic obstructive pulmonary disease (COPD). It is a comprehensive, multidisciplinary, patient-centered intervention that includes patient assessment, exercise training, self-management education, and psychosocial support. PR is usually given in inpatient, outpatient, community-based or home-based setting lasting 8-12 weeks. Positive outcomes from PR include increased exercise tolerance, reduced dyspnea and anxiety, increased selfefficacy, and improvement in health-related quality of life (QoL). Hospital admissions after exacerbations of COPD are also reduced with this intervention. The positive outcomes associated with PR are realized without demonstrable improvements in lung function. This paradox is explained by the fact that PR identifies and treats the systemic effects of the disease. This intervention should be considered in patients who remain symptomatic or have decreased functional status despite optimal medical management. Physical activity in patients with COPD is dependent on many factors, including physiologic, behavioral, social, environmental, and cultural factors. A strong inverse association between daily physical activity and dynamic hyperinflation, which correlates strongly with exertional dyspnea in COPD. Changing physical activity behavior inpatients with COPD needs an interdisciplinary approach, bringing together respiratory medicine, rehabilitation sciences, social sciences, and behavioral sciences. There is a need for more education and learning opportunities for primary care physicians, nurse practitioners, and all allied health care professionals about the process and benefits of PR. There is also a need for the sustainability and the safety of PR in the future study.

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Unravelling self-management for COPD

Cited by 54 publications

References 12 publications

Differences in content and organisational aspects of pulmonary rehabilitation programmes

Differences in content and organisational aspects of pulmonary rehabilitation programmes

T’ai chi for individuals with COPD: an ancient wisdom for a 21st century disease?

Recent Advances in Pulmonary Rehabilitation for Patients with COPD

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