Regular Walking and Long-term Maintenance of Outcomes After Pulmonary Rehabilitation

Heppner, Pia; Morgan, Cindy; Kaplan, Robert M.; Ries, Andrew L.

doi:10.1097/00008483-200601000-00010

Cited by 143 publications

(60 citation statements)

References 24 publications

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“…3,[37][38][39][40] We sought to extend those findings by analyzing the effect of ongoing exercise after pulmonary rehabilitation. Contrary to the findings of Heppner et al, 41 who found that subjects who continued to walk regularly after a pulmonary rehabilitation program utilized health care as often as those who did not, our findings show that fewer subjects visited the emergency department or required hospitalization after pulmonary rehabilitation. In the subgroup of subjects who did require an emergency department visit or hospitalization, however, the average number of emergency department visits or hospital days was unchanged after pulmonary rehabilitation.…”

Section: Long-term Exercise Adherence and Health-care Utilizationcontrasting

confidence: 99%

Additional Evidence for the Long-Term Benefits of Pulmonary Rehabilitation

et al. 2015

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BACKGROUND: Pulmonary rehabilitation programs document outcomes to prepare for program certification, to demonstrate the value of the program to upper management, and to provide feedback to pulmonary rehabilitation staff regarding the efficacy of the program. The overall goal of this study was to evaluate the feasibility of using non-research-generated clinical data to report long-term outcomes following a pulmonary rehabilitation program. METHODS: Using a longitudinal descriptive design, all subjects who completed pulmonary rehabilitation at one communitybased pulmonary rehabilitation program in the San Francisco Bay Area were asked to complete a 6-month and subsequent yearly questionnaires. Adherence to pulmonary rehabilitation techniques was described for 7 y following pulmonary rehabilitation participation, health-care utilization from 1 y before pulmonary rehabilitation was compared with subsequent years, and health-care utilization was compared between those who participated in ongoing regular exercise after pulmonary rehabilitation and those who did not exercise. RESULTS: More than 70% of subjects who completed the questionnaire reported adherence to pulmonary rehabilitation techniques, including exercise for at least 7 y following pulmonary rehabilitation. Health-care utilization declined after pulmonary rehabilitation. Subjects who did not exercise regularly required significantly more health care than those who exercised regularly (P < .05). CONCLUSIONS: This study demonstrated the ability of one pulmonary rehabilitation program to accurately monitor extended longterm follow-up after pulmonary rehabilitation. Implementing this long-term monitoring methodology consistently in pulmonary rehabilitation programs could contribute to evaluation of the comparative effectiveness of various treatment options.

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Section: Long-term Exercise Adherence and Health-care Utilizationcontrasting

confidence: 99%

Additional Evidence for the Long-Term Benefits of Pulmonary Rehabilitation

et al. 2015

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“…Of the analyses comparing standard rehabilitation and the standard treatment, only 1 showed that the former had positive effects (10) on the symptoms (Figure 3). One study (28) showed that resistance exercises improved the symptoms of dyspnea in comparison with baseline data, although there were no differences between the groups in terms of patient perception of dyspnea after the 6MWT. Combining rehabilitation with the use of tiotropium, (17) noninvasive ventilation, (15) or hypertonic saline (31) had no additional effect on symptoms when compared with the standard rehabilitation program.…”

Section: Symptomsmentioning

confidence: 99%

Programas de reabilitação pulmonar em pacientes com DPOC

et al. 2011

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Pulmonary rehabilitation programs are aimed at providing benefits to COPD patients, in various aspects. Our objective was to review the literature on COPD patient rehabilitation. This systematic review involved articles written in English, Spanish, or Portuguese; published between 2005 and; and indexed in national and international databases. Articles were classified in accordance with the Global Initiative for Chronic Obstructive Lung Disease criteria for the determination of the level of scientific evidence (grade of recommendation A, B, or C). The outcome measures were exercise, quality of life, symptoms, exacerbations, mortality, and pulmonary function. Treatments were classified as standard rehabilitation, partial rehabilitation, strength exercises, and resistance exercises. Of the 40 articles selected, 4, 18, and 18 were classified as grades A, B, and C, respectively. Of the 181 analyses made in these articles, 61,50,23,23,20, and 4, respectively, were related to the outcome measures quality of life, exercise, symptoms, exacerbations, pulmonary function, and mortality. The standard rehabilitation programs showed positive effects on all of the outcomes evaluated, except for mortality (because of the small number of analyses). However, we found no differences among the various rehabilitation programs regarding their effects on the outcomes studied. Rehabilitation programs can be considered important tools for the treatment of COPD. Therefore, health administrators should implement public policies including such programs in the routine of health care facilities.Keywords: Rehabilitation; Pulmonary disease, chronic obstructive; Review. ResumoProgramas de reabilitação pulmonar visam à melhora do paciente com DPOC em vários aspectos. Esta revisão teve como objetivo avaliar a literatura sobre reabilitação em pacientes com DPOC. Foi realizada uma revisão sistemática incluindo artigos publicados entre 2005 e 2009, indexados em bases de dados nacionais e internacionais e escritos em inglês, espanhol ou português. Os artigos foram classificados segundo o critério da Global Initiative for Chronic Obstructive Lung Disease para nível de evidência científica (grau de recomendação A, B e C). Os desfechos exercício, qualidade de vida, sintomas, exacerbações, mortalidade e função pulmonar foram pesquisados. Os tratamentos foram classificados como reabilitação padrão, reabilitação parcial, exercícios de força e exercícios de resistência. Dos 40 artigos selecionados, 4, 18 e 18 foram classificados com graus A, B e C, respectivamente. Das 181 análises oriundas desses artigos, 61,50,23,23, 20 e 4, respectivamente, foram relacionadas aos desfechos qualidade de vida, exercício, sintomas, exacerbação, função pulmonar e mortalidade. Em todos os desfechos avaliados, os programas de reabilitação padrão tiveram efeitos positivos sobre os desfechos estudados, exceto para mortalidade pelo reduzido número de análises. Entretanto, não foram verificadas diferenças nos efeitos sobre os desfechos estudados quando os diferentes program...

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“…Patients with COPD who maintain activity have less dyspnoea during daily activity, better health-related quality of life [7], and enhanced long-term functional [8], physiological and psychological outcomes [9]. In order to develop and implement cost-effective physical activity maintenance interventions in the clinical setting, however, more information is needed on the sociodemographic and disease-related characteristics of individuals with differing patterns of physical activity following rehabilitation.…”

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confidence: 99%

Trajectories of endurance activity following pulmonary rehabilitation in COPD patients

Soicher¹,

Mayo²,

Gauvin³

et al. 2011

European Respiratory Journal

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Maintenance of physical activity following pulmonary rehabilitation remains a challenge for patients with chronic obstructive pulmonary disease (COPD). The objectives of this study were to identify patterns of endurance activity after completion of pulmonary rehabilitation and to characterise people who succeed and those who have difficulty maintaining endurance activity.In a longitudinal study embedded within a randomised clinical trial, 206 individuals with COPD underwent a 3-month pulmonary rehabilitation programme. Weekly duration of endurance activity was assessed at 4, 6, 8 and 12 months after the start of rehabilitation. Trajectory modelling was used to determine the most common patterns of activity during the post-rehabilitation phase from 4-12 months.Three distinct patterns were identified, two of which indicated difficulty in maintaining endurance activity: 61 individuals reported a high activity level at 4 months (2.7 h?week ) and declined. The low activity group was characterised by more severe disease and greater respiratory impairment. The high and declined group had less severe disease and respiratory impairment, but reported greater barriers to exercise.Pulmonary rehabilitation should include interventions aimed at minimising barriers, in order to induce long-term behaviour change.

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Regular Walking and Long-term Maintenance of Outcomes After Pulmonary Rehabilitation

Cited by 143 publications

References 24 publications

Additional Evidence for the Long-Term Benefits of Pulmonary Rehabilitation

Additional Evidence for the Long-Term Benefits of Pulmonary Rehabilitation

Programas de reabilitação pulmonar em pacientes com DPOC

Trajectories of endurance activity following pulmonary rehabilitation in COPD patients

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