Trajectories of endurance activity following pulmonary rehabilitation in COPD patients

Soicher, Judith; Mayo, Nancy E.; Gauvin, Lise; Hanley, James A.; Bernard, Sarah; Maltais, F.; Bourbeau, Jean

doi:10.1183/09031936.00026011

Cited by 59 publications

(44 citation statements)

References 42 publications

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“…Remaining challenges are the limited access to PR programs 52 as well as maintaining initial benefits and their translation into active lifestyles. 48 In this paper we have shared our own views about PR but we clearly encourage the creation of a diversity of programs and intervention to promote an active life style in a larger COPD population. These programs, however small they might be, should be well structured, done by a multidisciplinary team specifically trained in PR and tailored to the patients' needs.…”

Section: Discussionmentioning

confidence: 88%

“…16,19,24,48 Because home-based rehabilitation may be the most convenient, it may appear to be superior to center-based programs in terms of long term adherence to exercise. 49 Thus, patients are encouraged to continue their training by either remaining in a hospital-or community-based program, or by initiating a home-based program.…”

Section: Home-rehabilitation Programmentioning

confidence: 99%

See 1 more Smart Citation

Prescribing exercise training in pulmonary rehabilitation: A clinical experience

Bernard

Ribeiro

Maltais

et al. 2014

Revista Portuguesa de Pneumologia (English Edition)

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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.

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Section: Discussionmentioning

confidence: 88%

Section: Home-rehabilitation Programmentioning

confidence: 99%

Prescribing exercise training in pulmonary rehabilitation: A clinical experience

Bernard

Ribeiro

Maltais

et al. 2014

Revista Portuguesa de Pneumologia (English Edition)

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“…Pulmonary rehabilitation and chronic care have received a lot of attention in the literature [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. In turn, several interesting research abstracts were presented at the 2013 European Respiratory Society Congress, of which many were on the topic of comorbidities [29][30][31][32][33].…”

Section: Rehabilitation and Chronic Carementioning

confidence: 99%

Clinical highlights from the 2013 ERS Congress in Barcelona

Spruit¹,

Marvisi

Coolen³

et al. 2014

European Respiratory Journal

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This article reviews a selection of scientific presentations in the area of clinical problems, which were presented at the 2013 European Respiratory Society Annual Congress in Barcelona, Spain. This article discusses the most relevant topics of interest in the field of clinical respiratory medicine, including breakthrough reports and studies of particular interest to the healthcare professionals. Topics are presented and discussed in the context of the most up-to-date literature, including basic science and translational research. In particular, the reviewed topics deal with the areas of complex chronic obstructive pulmonary disease and asthma (even in the primary care setting), idiopathic pulmonary fibrosis (pathogenesis and therapy), advances in functional chest imaging, interventional pulmonology, pulmonary rehabilitation and chronic care.

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“…These authors have shown that specific arm performance may improve arm capacities, a result still maintained over 6 months. This is particularly important as maintenance of daily activities after rehabilitation is a difficult task for COPD patients [14]. JANUDIS-FERREIRA et al [15] demonstrated that resistance-based arm training improved arm function, strength and exercise capacity although this did not translate into lower dyspnoea during domestic activities.…”

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confidence: 99%

Impaired arm activity in COPD: a questionable goal for rehabilitation

Clini

Ambrosino²

2014

European Respiratory Journal

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The most common extrapulmonary problems in chronic obstructive pulmonary disease (COPD) patients are cardiovascular comorbidities, muscle weakness and dysfunction [1][2][3]. Indeed, the reduced peripheral muscle mass and strength increase patient's symptoms during effort (fatigue and or dyspnoea) and progressively lead to disability. Furthermore, both lower and upper limb dysfunction has been shown to independently predict the long-term prognosis of COPD patients [2].The use of arms is involved in many daily domestic tasks and activities. To date, it has been shown that daily arm activities needing elevation above the shoulders may interfere with regular breathing and are associated with dynamic hyperinflation in COPD patients [4]. The research by MEIJER et al. [5], published in this issue of the European Respiratory Journal, investigated whether, and in which proportion of muscle effort, arm activities during daily life are different in COPD patients compared with matched healthy individuals. Notably, this study is the first to characterise arm activities associated with daily living in the COPD population.Daily arm and leg domestic activities were measured by accelerometers in moderate-to-severe COPD patients and controls. After correcting for the daily walking time, the time spent on arm activities was similar in COPD patients and healthy controls, whereas the intensity of these activities was lower in COPD patients. In addition, the authors assessed the relative effort of the trapezius, deltoid and biceps muscles using electromyography during 12 standard domestic activities involving upper limbs in both populations. COPD patients performed seven arm activities at a lower intensity compared to control subjects, while the degree of arm elevation was similar. Moreover, in COPD patients compared with controls, muscle effort was found to be performed at a higher proportion of the maximum for the trapezius during six activities (writing on a board, shaking hands, folding towels, putting towels on the shelf, walking at preferred speed and sweeping the floor) and for the biceps during only one activity (folding towels). Overall, the total effort over the total effort spent by the trapezius muscle during these specific arm activities in COPD patients was roughly twice that required in subjects without COPD.The findings by MEIJER et al. [5] challenge the anecdotal observation that arm activities may be problematic and poorly tolerated in patients suffering from COPD [6]. As a matter of fact, this study clearly indicates that domestic arm activities in COPD patients are performed differently from the point of view of intensity (less) but not time (same duration). Although mechanical efficiency and exercise capacity of the upper limb muscles are usually preserved in COPD patients, it is likely that repeated domestic arm activities may enhance their symptoms and ventilator constrains [7].

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Trajectories of endurance activity following pulmonary rehabilitation in COPD patients

Cited by 59 publications

References 42 publications

Prescribing exercise training in pulmonary rehabilitation: A clinical experience

Prescribing exercise training in pulmonary rehabilitation: A clinical experience

Clinical highlights from the 2013 ERS Congress in Barcelona

Impaired arm activity in COPD: a questionable goal for rehabilitation

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