Pulmonary Rehabilitation

Ries, Andrew L.; Bauldoff, Gerene; Carlin, Brian; Casaburi, Richard; Emery, Charles F.; Mahler, Donald A.; Make, Barry J.; Rochester, Carolyn L.; ZuWallack, Richard; Herrerias, Carla T.

doi:10.1378/chest.06-2418

Cited by 1,078 publications

(343 citation statements)

References 175 publications

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“…In accordance with international guidelines [19, 20], the multidisciplinary pulmonary rehabilitation consisted of 20 h of exercise training, 11 h of patient education, 5 h of nutrition counseling, 10 h of breathing therapy, 5 h of relaxation therapy, 3 h of psychosocial support and 5 h of smoking cessation support. The endurance training included exercise on a stationary cycle ergometer, on a treadmill and with an arm cycle ergometer, as well as strength training of the upper and lower extremities and of the trunk muscles.…”

Section: Methodsmentioning

confidence: 99%

Home-Based Exercise Training as Maintenance after Outpatient Pulmonary Rehabilitation

Moulin

Taube²,

Wegscheider³

et al. 2008

Respiration

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Background: Pulmonary rehabilitation is successful in improving exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD). However, training effects diminish over time. Objectives:We evaluated the effects of simple, daily, structured, self-monitored, home-based exercise training for patients with moderate COPD after a 3-week outpatient rehabilitation. Methods: We conducted a randomized, controlled, observer-blind trial. Twenty patients were recruited. Ten patients performed home-based exercise training (mean age 67 years, 95% confidence interval [CI] 63–72; FEV₁ 58.6%, 95% CI 53.8–63.4), and 10 patients served as controls (mean age 72 years, 95% CI 69–77; FEV₁ 62.5%, 95% CI 57.7–67.3). At baseline, and after 3 and 6 months, we assessed exercise capacity (6-min walk test, 6MWT, primary endpoint), health-related quality of life (Chronic Respiratory Questionnaire, CRQ) and lung function. An intention-to-treat analysis was performed using two-way ANOVA models for comparison of time trends between random groups. Results: The training group had better results than the control group in 6MWT (p = 0.033), in CRQ total (p = 0.027), CRQ dyspnea (p = 0.014) and CRQ fatigue (p = 0.016). Improvement in FEV₁ was also better in the intervention group than in the control group (p = 0.007). Conclusions: We demonstrated that training effects obtained from an outpatient rehabilitation program can be maintained by home-based exercise training in patients with moderate COPD.

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Section: Methodsmentioning

confidence: 99%

Home-Based Exercise Training as Maintenance after Outpatient Pulmonary Rehabilitation

Moulin

Taube²,

Wegscheider³

et al. 2008

Respiration

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“…Consequently, pulmonary rehabilitation is recommended as an integral part of the management of COPD patients 74) . In general, physical exercise training can increase the antioxidant and oxidative capacity in skeletal muscle of healthy subjects 21,41,75,76) .…”

Section: Acute Exercise and Exercise Training In Copdmentioning

confidence: 99%

Skeletal muscle dysfunction and oxidative stress in patients with chronic obstructive lung disease

Oh‐ishi

Nemoto

Saito

2015

JPFSM

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Chronic obstructive pulmonary disease (COPD) is an increasingly important global health problem, including Japan. COPD is associated with an enhanced inflammatory response to irritants in the airways and lungs, in particular cigarette smoke. Cigarette smoke contains gaseous and particulate oxidants, and is considered to be the major etiological factor in the development of COPD. The oxidants in cigarette smoke induce inflammation, and chronic inflammation causes narrowing of the small airways and destruction of the lung parenchyma. Inflammation and oxidative stress are intricately related and seem to play a critical role in the development and/or progression of COPD. There is growing evidence that systemic inflammation exists in patients with stable COPD, leading to extra-pulmonary manifestations including skeletal muscle dysfunction and other comorbidities. Oxidative stress is also observed in skeletal muscle of COPD patients. Therefore, both systemic inflammation and oxidative stress may be associated with skeletal muscle dysfunction in COPD patients, resulting in reduced limb muscle strength and exercise endurance and poor health status and quality of life. Pulmonary rehabilitation is important to improve exercise capacity and health-related quality of life for COPD patients. However, physical exercise, the main component of pulmonary rehabilitation, may increase oxidative stress in the skeletal muscle of such patients. Therefore, rehabilitation programs that not only improve exercise capacity and quality of life, but also reduce exerciseinduced oxidative stress should be established in the future.

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“…As a consequence, the improvement of muscle function after specific training is a milestone of application of pulmonary rehabilitation (PR) programs [2,3,4]. The individual assessment of exercise performance in these conditions then presents an important patient-centered outcome that should be embedded in the rehabilitation process and assessed with adequate instruments and valid exercise clinical tests.…”

Section: Introductionmentioning

confidence: 99%

Exercise Capacity as a Pulmonary Rehabilitation Outcome

Clini

Crisafulli

2009

Respiration

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Disabled patients with chronic respiratory disease and peripheral skeletal muscle disorders have limitations in their exercise capacity, which may be improved after specific training in a pulmonary rehabilitation (PR) program. Individual assessment of exercise capacity by clinically available exercise tests represents an important patient-centered outcome that should be embedded in the rehabilitation process. These measurements include laboratory (treadmill and/or cycle ergometer) and field (walking) tests. The cardiopulmonary exercise test, both performed with incremental (incremental-load test) or predetermined (constant-load or endurance test) loading, is an excellent means to describe the profile of an individual’s maximal exercise capacity and to record its change after PR. Among the variety of field-based tests, 6-min walking and shuttle walking are 2 simple tests widely used during PR. These tests are inexpensive and provide information on an individual’s functional abilities: the 6-min walking test has been shown to provide level of disability and functional status, whereas the shuttle walking test has been shown to be more suitable to detect change of physical performance following PR. Overall, several available physiologically targeted tests are useful to measure the patient’s tolerance to exercise, and many are even sensitive to change once intervention has taken place. In particular, endurance modality tests seem to provide better measurement of changes after PR than incremental exercise tests.

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Pulmonary Rehabilitation

Cited by 1,078 publications

References 175 publications

Home-Based Exercise Training as Maintenance after Outpatient Pulmonary Rehabilitation

Home-Based Exercise Training as Maintenance after Outpatient Pulmonary Rehabilitation

Skeletal muscle dysfunction and oxidative stress in patients with chronic obstructive lung disease

Exercise Capacity as a Pulmonary Rehabilitation Outcome

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