Advances in rehabilitation for chronic diseases: improving health outcomes and function

Abstract

Much of the burden on healthcare systems is related to the management of chronic conditions such as cardiovascular disease and chronic obstructive pulmonary disease. Although conventional outpatient cardiopulmonary rehabilitation programs significantly decrease morbidity and mortality and improve function and health related quality of life for people with chronic diseases, rehabilitation programs are underused. Barriers to enrollment are multifactorial and include failure to recommend and refer patients to these services; poor communication with patients about potential benefits; and patient factors including logistical and financial barriers, comorbidities, and competing demands that make participation in facility based programs difficult. Recent advances in rehabilitation programs that involve remotely delivered technology could help deliver services to more people who might benefit. Problems with intensity, adherence, and safety of home based programs have been investigated in recent clinical trials, and larger dissemination and implementation trials are under way. This review summarizes the evidence for benefit of in-person cardiac and pulmonary rehabilitation programs. It also reviews the literature on newer developments, such as home based remotely mediated exercise programs developed to decrease cost and improve accessibility, high intensity interval training in cardiac rehabilitation, and alternative therapies such as tai chi and yoga for people with chronic obstructive pulmonary disease.

Management of breathlessness in patients with cancer: ESMO Clinical Practice Guidelines

“…45 Both pulmonary and cardiac rehabilitation have a strong evidence of effectiveness in improving breathlessness, functional exercise capacity and health-related QoL. 46 Though most evidence for pulmonary rehabilitation relates to COPD, consistent effects are found across other respiratory diseases, including lung cancer. 47 However, the efficacy of pulmonary rehabilitation in patients with advanced cancer is unclear, especially when these patients may be too weak to participate in exercise sessions.…”

Tai Chi exercise for psychological well-being among adults with cardiovascular disease: A systematic review and meta-analysis

“…9 Tai Chi exercise is a promising, relatively low cost, and easily accessible option for holistic CVD management. [10][11][12] Originating in China, Tai Chi (also called taiji or tai chi chuan) is a mind-body exercise combining a series of meditative, synergistic dance-like movements that promote energetic (Qi) balance, relaxation, and diaphragmatic breathing. 13 Tai Chi is generally considered a safe, lowimpact, moderate-intensity exercise, making it a feasible option for individuals with CVD, including those with low exercise tolerance.…”

The Beneficial Role of Exercise Training for Myocardial Infarction Treatment in Elderly

“…Exercise-based cardiac rehabilitation (CR) is a multidisciplinary program for individuals after MI to reduce cardiorespiratory fitness (CRF), morbidity and mortality as well as improve QoL and exercise capacity (Franklin et al, 2013;Korzeniowska-Kubacka et al, 2015;Tessitore et al, 2017). It covers 10 domains of cardiac risk factor regulation, including weight management, exercise training, patient assessment, and so on (Costantino et al, 2016;Richardson et al, 2019). The main benefits associated with CR are produced by exercise training (Oldridge, 2012;Lewinter et al, 2015;Anderson et al, 2016).…”