Pulmonary Rehabilitation for Patients with Chronic Airways Obstruction

Nici, Linda; ZuWallack, Richard

doi:10.1016/j.jaip.2015.05.023

Cited by 10 publications

(7 citation statements)

References 56 publications

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“…Some of the systemic consequences or co-morbid associations contribute significantly to dyspnea; these include reductions in ambulatory muscle mass or oxidative enzymes, associated cardiovascular disease, fear of dyspnea-producing activities, and improper pacing techniques, to name a few. [ 6 , 7 , 8 ] Although exercise training, as delivered in a comprehensive pulmonary rehabilitation program, does not affect airflow limitation, it nevertheless results in reductions in dyspnea—presumably through mitigating the effects of the above-mentioned conditions.…”

Section: A Brief Review Of Copdmentioning

confidence: 99%

The Role of Telemedicine in Extending and Enhancing Medical Management of the Patient with Chronic Obstructive Pulmonary Disease

2021

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Medical management of a chronic obstructive pulmonary disease (COPD) patient must incorporate a broadened and holistic approach to achieve optimal outcomes. This is best achieved with integrated care, which is based on the chronic care model of disease management, proactively addressing the patient’s unique medical, social, psychological, and cognitive needs along the trajectory of the disease. While conceptually appealing, integrated care requires not only a different approach to disease management, but considerably more health care resources. One potential way to reduce this burden of care is telemedicine: technology that allows for the bidirectional transfer of important clinical information between the patient and health care providers across distances. This not only makes medical services more accessible; it may also enhance the efficiency of delivery and quality of care. Telemedicine includes distinct, often overlapping interventions, including telecommunication (enhancing lines of communication), telemonitoring (symptom reporting or the transfer of physiological data to health care providers), physical activity monitoring and feedback to the patient and provider, remote decision support systems (identifying “red flags,” such as the onset of an exacerbation), tele-consultation (directing assessment and care from a distance), tele-education (through web-based educational or self-management platforms), tele-coaching, and tele-rehabilitation (providing educational material, exercise training, or even total pulmonary rehabilitation at a distance when standard, center-based rehabilitation is not feasible). While the above components of telemedicine are conceptually appealing, many have had inconsistent results in scientific trials. Interventions with more consistently favorable results include those potentially modifying physical activity, non-invasive ventilator management, and tele-rehabilitation. More inconsistent results in other telemedicine interventions do not necessarily mean they are ineffective; rather, more data on refining the techniques may be necessary. Until more outcome data are available clinicians should resist being caught up in novel technologies simply because they are new.

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Section: A Brief Review Of Copdmentioning

confidence: 99%

The Role of Telemedicine in Extending and Enhancing Medical Management of the Patient with Chronic Obstructive Pulmonary Disease

2021

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“…Complementary to this advice, we recommend that GPs should (be able to) refer patients with high disease burden for nonpharmacologic treatments or pulmonary rehabilitation, as this treatment appears to have a moderate to very good effect in 89.5% of the patients. This results in substantial improvements in functional mobility, health status and respiratory symptoms [40,41]. Subsequently, the updated guidelines advise to refer patients back to primary care solely when the reason(s) for referral and/or diagnostics have been addressed and/or when the chest physician is not able to contribute to reducing the disease burden.…”

Section: What Can We Learn From These Data?mentioning

confidence: 99%

Burden of COPD in patients treated in different care settings in the Netherlands

Smid

Spruit

Houben-Wilke

et al. 2016

Respiratory Medicine

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“…The study by Freeman et al 21 differs from the present study in that it was composed of mild asthmatic patients who practiced regular physical activity, and a dosage of 5mg of salbutamol in nebulized form was applied. The present study included patients with moderate or severe asthma, who are the most indicated for pulmonary rehabilitation 22 . Also, we included only sedentary patients, which is the most prevalent lifestyle in this population.…”

Section: Discussionmentioning

confidence: 99%

Efeito agudo do salbutamol no sistema cardiovascular durante o exercício físico em pacientes com asma moderada ou grave: estudo aleatorizado, duplo-cego e cruzado

et al. 2018

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Acute effect of salbutamol on the cardiovascular system during exercise in patients with moderate or severe asthma: a randomized, double-blind, and cross-over study Efeito agudo do RESUMO | Salbutamol é um β 2 -agonista de curta duração frequentemente utilizado em pacientes com asma para prevenir os sintomas durante ou após exercício físico. Alterações hemodinâmicas em repouso estão bem descritas. Contudo são escassos os dados sobre os efeitos na frequência cardíaca (FC) e pressão arterial (PA) durante o exercício e na fase de recuperação em pacientes com asma moderada ou grave. Foi realizado um estudo aleatorizado, duplo-cego e cruzado, em que foram inclusos 15 indivíduos com asma moderada e grave, com média de idade de 46,4±9,3 anos. Os pacientes realizaram um teste de esforço máximo em dois dias não consecutivos, com administração de 400mcg de salbutamol ou 4 "puffs" de placebo. Durante todo o protocolo foi monitorada a FC, a PA, a percepção de esforço e o pico de fluxo expiratório (PFE). Após o uso do salbutamol, o valor do PFE aumentou em média de 28,0±47,7L/m, permanecendo maior nos tempos de 5, 10 e 15 minutos de recuperação passiva em relação ao placebo (p<0,05). As variáveis FC, PA e percepção de esforço foram semelhantes entre as intervenções em todas as fases do protocolo (p>0,05). Esses resultados sugerem que o uso de salbutamol é seguro, e que a FC não necessita de ser ajustada para prescrever a intensidade do exercício após a administração de salbutamol em indivíduos com asma moderada ou grave. Descritores |

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Pulmonary Rehabilitation for Patients with Chronic Airways Obstruction

Cited by 10 publications

References 56 publications

The Role of Telemedicine in Extending and Enhancing Medical Management of the Patient with Chronic Obstructive Pulmonary Disease

The Role of Telemedicine in Extending and Enhancing Medical Management of the Patient with Chronic Obstructive Pulmonary Disease

Burden of COPD in patients treated in different care settings in the Netherlands

Efeito agudo do salbutamol no sistema cardiovascular durante o exercício físico em pacientes com asma moderada ou grave: estudo aleatorizado, duplo-cego e cruzado

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