Prescribing exercise training in pulmonary rehabilitation: A clinical experience

Abstract

Built around exercise training, pulmonary rehabilitation (PR) is a multidisciplinary, evidence-based, comprehensive approach to working with the patient as a whole and not just the pulmonary component of the disease. Integrated into the individualized treatment, this intervention aims to reduce symptoms, optimize functional status, increase participation in daily life, and reduce health care costs through stabilizing or reversing systemic manifestations of the disease. Although there are many other components that should be considered to manage the impairment and symptom burden, supervised exercise training is considered the cornerstone of effective pulmonary rehabilitation. This paper addresses our clinical experience at Institut universitaire de cardiologie et de pneumologie de Québec to assess and manage exercise training in line with the current recommendations and guidelines surrounding PR. © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L. All rights reserved. PALAVRAS CHAVEReabilitação pulmonar; Exercício físico; Experiência clínica Prescrição de exercício físico na reabilitação pulmonar: uma experiência clínicaResumo Construída com base no exercício físico, a reabilitação pulmonar (RP) é uma abordagem multidisciplinar, fundamentada e abrangente para trabalhar com o doente como um todo, e não apenas com a componente pulmonar da doença. Integrado no tratamento individual, esta intervenção visa reduzir os sintomas, optimizar o estado funcional, aumentar a participação na vida diária e reduzir os custos do tratamento de saúde, através da estabilização ou inversão das manifestações sistémicas da doença. Embora existam muitos outros componentes que devem ser tidos em consideração para gerir o peso da incapacidade e dos sintomas, o exercí-cio físico supervisionado é considerado o fundamento da reabilitação pulmonar eficiente. Este documento trata da nossa experiência clínica no Institut universitaire de cardiologie et de pneumologie de Québec para avaliar e gerir o exercício físico em linha com as recomendações e orientações actuais envolvendo a RP.

Left Ventricular Function Before and After Aerobic Exercise Training in Women With Pulmonary Arterial Hypertension

“…23 This study found no evidence of significant decrease in left ventricular function at rest in the patients with PAH and left ventricular function at peak exercise was maintained similar to healthy controls before and after AET. The AET regimen used in this study was substantially more intense and prolonged compared to other studies in patients with severe chronic illnesses, [24][25][26] including PAH, [27][28][29][30][31][32] or individuals who are sedentary but otherwise healthy. 33 While significant benefits of participating in AET for people with PAH have been reported previously, 16,17 the current findings suggest that participation in AET appears to be safe and without adverse consequences on left ventricular function.…”

Método Pilates na reabilitação pulmonar e condicionamento fí­sico em pacientes com doença pulmonar obstrutiva crônica

“…A reabilitação pulmonar é uma das intervenções mais eficazes no manejo da DPOC [24]. Trata-se de uma terapia não farmacológica, definida como programa de intervenção multidisciplinar que envolve abordagens terapêuticas, suporte emocional, educação e recondicionamento físico, com o objetivo de melhorar e controlar os sintomas, diminuir as complicações da doença [25].…”

Revisiting pulmonary rehabilitation during COVID-19 pandemic: a narrative review

“…Patients with COPD and Asthma also show greater exercise intolerance, frequent bouts of dyspnea, more significant participation restrictions, and lower quality of life [36]. Aerobic exercises combined with bronchodilators can remove the struggle with most of the patients initiating the exercise program.…”

“…Aerobic exercises combined with bronchodilators can remove the struggle with most of the patients initiating the exercise program. The current guidelines for PR are programmed to two to five times a week for 6-12 weeks [23,36]. It's advisable to incorporate a short-acting b2-agonist before 15 min of starting the exercise to prevent exercise-induced airway hyper-responsiveness [23].…”