Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease

Lacasse, Yves; Brosseau, Lucie; Milne, Stephen; Martin, Susan E.; Wong, Eric; Gh, Guyatt; Goldstein, RS

doi:10.1016/s0031-9406(05)60714-6

Cited by 307 publications

(344 citation statements)

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“…The results of over 30 randomised trials of pulmonary rehabilitation have shown that it is possible to beneficially impact on functional capacity, health-related quality of life, perception of dyspnoea, healthcare utilisation and on the BODE index with minimal, if any, impact on lung function, thus supporting the argument that it may be possible to modulate the course of COPD with therapies aimed at improving the nonpulmonary domains of COPD [177].…”

Section: Pulmonary Rehabilitationmentioning

confidence: 94%

“…Decreased exercise capacity measured as decreased peak oxygen uptake and decreased 6MWD predict mortality better than FEV1 [61,62]. Pulmonary rehabilitation with exercise training has been shown to increase exercise capacity and thus, it is possible to modify the functional capacity of patients [63,64]. Whether this will impact on outcome needs to be formally tested, although preliminary results from an uncontrolled trial suggest that pulmonary rehabilitation may improve survival.…”

Section: Copd and Impaired Functional Capacitymentioning

confidence: 99%

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Systemic manifestations and comorbidities of COPD

Barnes¹,

Celli²

2009

European Respiratory Journal

1,465

1,113

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Increasing evidence indicates that chronic obstructive pulmonary disease (COPD) is a complex disease involving more than airflow obstruction. Airflow obstruction has profound effects on cardiac function and gas exchange with systemic consequences. In addition, as COPD results from inflammation and/or alterations in repair mechanisms, the ''spill-over'' of inflammatory mediators into the circulation may result in important systemic manifestations of the disease, such as skeletal muscle wasting and cachexia. Systemic inflammation may also initiate or worsen comorbid diseases, such as ischaemic heart disease, heart failure, osteoporosis, normocytic anaemia, lung cancer, depression and diabetes. Comorbid diseases potentiate the morbidity of COPD, leading to increased hospitalisations, mortality and healthcare costs. Comorbidities complicate the management of COPD and need to be evaluated carefully. Current therapies for comorbid diseases, such as statins and peroxisome proliferator-activated receptor-agonists, may provide unexpected benefits for COPD patients. Treatment of COPD inflammation may concomitantly treat systemic inflammation and associated comorbidities. However, new broad-spectrum anti-inflammatory treatments, such as phosphodiesterase 4 inhibitors, have significant side-effects so it may be necessary to develop inhaled drugs in the future. Another approach is the reversal of corticosteroid resistance, for example with effective antioxidants. More research is needed on COPD comorbidities and their treatment.

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Section: Pulmonary Rehabilitationmentioning

confidence: 94%

Section: Copd and Impaired Functional Capacitymentioning

confidence: 99%

Systemic manifestations and comorbidities of COPD

Barnes¹,

Celli²

2009

European Respiratory Journal

1,465

1,113

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“…Pulmonary rehabilitation including exercise training has been shown to increase exercise capacity 134 but the effect of pulmonary rehabilitation on physical activity seems to be small 135 . A recent study showed that pulmonary rehabilitation improved different dimensions of fatigue 136 .…”

Section: Factors Associated With Low Physical Activitymentioning

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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“…Rehabilitation programmes, including physiotherapy (mobility training, breathing exercises and physical exercise), nutritional support, psychotherapy and education, are recommended in international treatment guidelines for COPD patients (Siafakas et al, 1995;Ries et al, 1997). Lacasse et al (2002) concluded in a Cochrane review that rehabilitation relieves dyspnea and fatigue, increases exercise capacity and improves quality of life. Physical exercise comprises activities aiming at maintaining and improving physical and psychological functions and restoring the physiologic balance in the skeletal muscles.…”

Section: Introductionmentioning

confidence: 99%

Energy expenditure in underweight chronic obstructive pulmonary disease patients before and during a physiotherapy programme

et al. 2006

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Objective: To investigate how total daily energy expenditure (TEE) changes when underweight patients with chronic obstructive pulmonary disease (COPD) enters a physiotherapy programme. Design: Prospective intervention study. Setting: Sahlgrenska University Hospital, Göteborg, Sweden. Subjects: Fifteen patients with severe COPD and BMIo21 kg/m 2 were recruited consecutively at the outpatient COPD unit at the Department of Respiratory Medicine. Fourteen patients completed the whole study. Intervention: TEE was assessed by the doubly labelled water method in a 2-week control period and during 2 weeks of physiotherapy. Energy intake was assessed using 7-day dietary record during control and physiotherapy period. Results: Mean TEE during physiotherapy period was 500 kJ (6%) lower than during control period but the difference was not statistically significant. Ten of the 14 patients had lower and four had higher TEE. Mean energy intake during the physiotherapy period did not change from the control period (7700 vs 7600 kJ/day). Conclusions: Since underweight patients with COPD may show variable TEE during physiotherapy compared to a control period, an assessment of individual energy requirements is recommended.

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Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease

Cited by 307 publications

References 0 publications

Systemic manifestations and comorbidities of COPD

Systemic manifestations and comorbidities of COPD

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

Energy expenditure in underweight chronic obstructive pulmonary disease patients before and during a physiotherapy programme

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