Rehabilitation for people with COPD and other respiratory diseases.
(SEE ALSO Exercise training)
PRINCIPLES, DEFINITIONS and STANDARDS for PULMONARY REHABILITATION (2008)
www.impressresp.com/Portals/0/IMPRESS/PrinciplesofPR.pdf
PHYSIOTHERAPY GUIDELINES (2003-4) Baines S, Garrod R, Morgan M Standards for outpatient pulmonary rehabilitation. ACPRC Journal, 36, 44-6
AARC GUIDELINES (2002) Respir Care, 47, 5, 622.
www.rcjournal.com/cpgs/pdf/05.02.616.pdf
BTS GUIDELINES (2001) Thorax, 56, 827-34
www.brit-thoracic.org.uk/Portals/0/Clinical%20Information/Pulmonary%20Rehabilitation/Guidelines/Pulmonaryrehab.pdf
ATS/ERS GUIDELINES
Nici L, Donner C, Wouters E et al (2006) American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med, 173, 12, 1390-1413.
ajrccm.atsjournals.org/cgi/content/full/173/12/1390
ACCP GUIDELINES (2007) Chest 131(5 Suppl):4S-42S
www.guidelines.gov/summary/summary.aspx?ss=15&doc_id=10856&nbr=005669&string=pulmonary+AND+rehabilitation#s22
BTS GUIDELINES on INTERMEDIATE CARE: HOSPITAL-AT-HOME IN COPD Thorax (2007) 62, 200-210
www.brit-thoracic.org.uk/Portals/0/Clinical%20Information/Intermediate%20Care%20-%20Hospital%20at%20Home/intermediatecarehospitalathomecopd%20feb07.pdf
ACPRC/BTS GUIDELINES (2009) Physiotherapy management of the adult, medical, spontaneously breathing patient. Thorax, 64, suppl.i1-i52
Ashmore JA (2005) Marital adjustment among patients with COPD who are participating in pulmonary rehabilitation. Heart Lung, 34, 4, 270-8
Bradley J, Moran F (2006) Pulmonary rehabilitation improves exercise tolerance in patients with bronchiectasis. Austr J Physiother, 52, 65.
Bratεs O, Espnes TA, Rannestad T (2010) Pulmonary rehabilitation reduces depression and enhances health-related quality of life in COPD patients. Chronic Resp Dis, 7, 4, 229-37
crd.sagepub.com/content/7/4/229.abstract?etoc
PR depression, exercise capacity and quality of life
Clark CJ, Cochrane L, Mackay E (1996) Low intensity peripheral muscle conditioning improves exercise tolerance and breathlessness in COPD. Eur Respir J, 9, 2590-6.
rehab leads to increased endurance, improved ADL, reduced breathlessness
Collins EG (2001) Breathing pattern retraining and exercise in persons with COPD. AACN Clin Issues, vol.12
literature review
Curtis JR (2000) Communicating with patients and their families about advance care planning and end-of-life care. Respir Care, 45, 1385-98
Foglio K, Bianchi L, Ambrosino N (2001) Is it really useful to repeat outpatient pulmonary rehabilitation programs in patients with chronic airflow obstruction? Chest, 119, 1696-1704
repeat rehab programme tends to lead to reduced exacerbations
Garrod R (1998) The pros and cons of pulmonary rehabilitation at home. Physiother, 84, 603-7
home rehab leads to 24% improvement in ET
Garrod R, Bestall J (2001) Pulmonary rehabilitation: a physiological and psychological perspective. Crit Rev Phys Rehab Med, 265-81
Graves J, Sandrey V, Graves T (2010) Effectiveness of a group opt-in session on uptake and graduation rates for pulmonary rehabilitation. Chr Respir Dis, 7, 159-64
group opt-in session prior to assessment increased graduation rates and improved efficiency by improving knowledge of the benefits of rehabilitation and reducing the fear of failure or discomfort
Griffiths TL, Burr ML (2000) Results at 1 year of outpatient pulmonary rehabilitation: a randomised controlled trial. Lancet, 355, 362-8
rehab halves hospitalization, should be integral to the management of chronic respiratory disability
Griffiths TL, Phillips CJ, Davies S et al (2001) Cost effectiveness of an outpatient multidisciplinary pulmonary rehabilitation programme. Thorax, 56, 779-84
rehab is cost-effective
Hagins M, Lamberg E (2006) Natural breath control during lifting tasks: effect of load. Euro J Appl Physiol, 96, 4, 453-8
automatic breath-holding during lifting increases lumbar stability and is responsive to the timing and magnitude of the load
Heyn P (2003) A systematic review of the effectiveness of exercise rehabilitation for people with dementia. Arch Phys Med Rehabil, 84
download.journals.elsevierhealth.com/pdfs/journals/0003-9993/PIIS0003999303008621.pdf
Hunter J, Singh SJ, Morgan MDL (2006) Objective monitoring of adherence with home exercise training during pulmonary rehabilitation for COPD. Physiotherapy, 92, 50-54
Janssen DJA (2010) Symptoms of anxiety and depression in COPD patients entering pulmonary rehabilitation. Chr Respir Dis, 7, 147-57
anxiety is not associated with lung function or co-existing morbidity, but appears to be more common in current smokers
depression is more common in those with severe breathlessness
both are more common in patients with low BMI
both are under-recognised
both respond better to pulmonary rehabilitation than to drugs
Jenkins S, Hill K, Cecins NM (2011) State of the art: How to set up a pulmonary rehabilitation program. Respirology, 15, 8, 1157-73
onlinelibrary.wiley.com/doi/10.1111/j.1440-1843.2010.01849.x/abstract
a stepwise approach to establish, deliver and evaluate a pulmonary rehabilitation program
Jones PW (2001) Health status measurement in COPD. Thorax, 56,880-7
Patients should be able to provide examples of improvements that they have noticed and think are worthwhile
Karlsdottir AE (2002) Hemodynamic responses during aerobic and resistance exercise. J Cardiopulm Rehab, 22, 170-7
left ventricular function remains stable during moderate exercise even with congestive heart failure
Keles H, Ekici A, Ekici M, Bulcun E, Altinkaya V (2007) Effect of chronic diseases and associated psychological distress on health-related quality of life. Internal Med J, 37, 1, 611
www.blackwell-synergy.com/doi/full/10.1111/j.1445-5994.2006.01215.x
the detection and treatment of psychological distress may provide dramatic improvement in HRQL of patients with chronic disease.
Kortebein P (2009) Rehabilitation for hospital-associated deconditioning. Am J Phys Med Rehabil, 88, 66-77
www.amjphysmedrehab.com/pt/re/ajpmr/abstract.00002060-200901000-00010.htm;jsessionid=JTMLMh9MK5C9NmsrGfYNyFXvS2pJkX1bnkG6xMJ91QqQBDt7Q5hZ!-1035908147!181195628!8091!-1
Kreizman IJ (2003) Intensive medical intervention and pulmonary rehabilitation of patients with advanced restrictive lung disease. Arch Phys Med Rehab, 84, 10, E4
www.archives-pmr.org/article/S0003-9993%2803%2900862-1/abstract
even with advanced restrictive disease, a rehab programme leads to improved quality of life
Lan C, Lai JS, Chen SY (2000) Tai Chi Chuan to improve muscular strength and endurance in elderly individuals. Arch Phys Med Rehab, 81, 604-7
Lareau SC (2006) Functional status: have we found the gold standard? Chronic Respir Dis, 3, 61-2
Shuttle test and 6MD are useful to measure walking distance, but not to measure general activities nor upper limb activities
The relationship between functional status measures and walk tests are modest
Lee AL (2010) The effects of pulmonary rehabilitation in patients with non-cystic fibrosis bronchiectasis. BMC Pulm Med, 10, 5, doi:10.1186/1471-2466-10-5
www.biomedcentral.com/1471-2466/10/5
Liddell F, Webber J (2010) Pulmonary rehabilitation for chronic obstructive pulmonary disease: a pilot study evaluating a once-weekly versus twice-weekly supervised programme. Physiotherapy, 96, 1, 68-74
once-weekly programme may produce equivalent improvements in ET as twice-weekly, but the HRQL outcome appeared to be poorer
Lord VM, Cave P, Hume VJ et al (2010) Singing teaching as a therapy for chronic respiratory disease - a randomised controlled trial and qualitative evaluation. BMC Pulm Med, 10:41.
www.biomedcentral.com/1471-2466/10/41
the control of breathing and posture that accompany singing lead to improved quality of life and reduced anxiety
Maa S, Gauthier D, Turner M (1997) Acupuncture as an adjunct to a pulmonary rehabilitation program. J Cardiopulm Rehab, 17, 268-76
outcomes and detailed information on technique
Man WD, Polkey MI, Donaldson N (2004) Community pulmonary rehabilitation after hospitalisation for acute exacerbations of chronic obstructive pulmonary disease: randomised controlled study. BMJ, 329, 7476, 1209
www.ncbi.nlm.nih.gov/pmc/articles/PMC529363/
early pulmonary rehabilitation after admission for acute exacerbation of COPD is safe and leads to improvements in exercise capacity and health status at three months.
Mukand JA et al (2003) The effects of dehydration on rehabilitation outcomes of elderly orthopedic patients. Arch Phys Med Rehab, 84, 58-61
dehydration has a major effect on rehab outcomes (orthopaedic patients)
Neder JA (2002) Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with COPD. Thorax, 57, 333-7
thorax.bmjjournals.com/cgi/content/full/57/4/333?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=57&firstpage=333&resourcetype=HWCIT
electrical stimulation of leg muscles in patients with COPD improves exercise tolerance and breathlessness
Ng BHP, Tsang HWH (2009) Establishing a health Qigong protocol for rehabilitation of patients with COPD. Internat J Ther Rehabil, 16, 1, 25 - 33
www.ijtr.co.uk/cgi-bin/go.pl/library/article.cgi?uid=37937;article=IJTR_16_1_25_33
Qigong shows potential benefit as an adjunct in rehabilitation of people with COPD
Ngaage DL (2004) The functional impact of an individualized, graded, outpatient pulmonary rehabilitation in end-stage COPD. Heart Lung, 33, 6, 381-9
pulmonary rehabilitation in end-stage COPD can produce a measurable improvement in spirometry and ET
Ninot G et al (2002) Effects of an intensive-period inpatient rehabilitation programme on the perceived physical self in moderate COPD. Intern J Rehab Res, 25, 51-5
depression, anxiety and fear of SOB affect prognosis, severity of illness and ability to cope
NEW
Ong HK, Lee AL, Hill CJ, Holland AE, Denehy L (2011) Effects of pulmonary rehabilitation in bronchiectasis. Chr Respir Dis, 8, 1, 21-31
retrospective study supporting pulmonary rehabilitation for bronchiectasis patients
Ringbaek T et al (2008) Rehabilitation in COPD: the long-term effect of a supervised 7-week program succeeded by a self-monitored walking program. Chr Respir Dis, 5, 2, 75-80
crd.sagepub.com/cgi/content/abstract/5/2/75
follow-up daily walking at home improved ET and health status throughout 1 year
Robertson N (2010) Running up that hill: How pulmonary rehabilitation can be enhanced by understanding patient perceptions of their condition. Chronic Resp Dis, 7, 4, 203-205
importance of patients feeling in control.
Slinde F, Grφnberg et al (2002) Individual dietary intervention in patients with COPD during multidisciplinary rehabilitation. Respir Med, 96, 330-6
dietary intervention might be a prerequisite for physical training
Spruit MA, Franssen FME (2010) What to do before pulmonary
rehabilitation to improve adherence? Chron Respir Dis, 7, 3, 131133
post-exacerbation pulmonary rehab, particularly for those with severe disease, has been shown to improve health status and reduce re-admissions
Stewart DG, Drake DF, Robertson C et al (2001) Benefits of an inpatient pulmonary rehabilitation program. Arch Phys Med Rehabil, 82, 347-52
inpatient rehab improves endurance, decreased oxygen need, reduced hospitalization
Strakowski MM et al (2002) Malnutrition in rehabilitation. Am J Phys Med Rehab, 81, 77-8
Toms J, Harrison K (2002) Living with chronic lung disease and the effect of pulmonary rehabilitation. Physiotherapy, 88, 605-19
Votto J, Bowen J, Scalise P (1996) Short-stay comprehensive inpatient pulmonary rehabilitation for advanced COPD. Arch Phys Med Rehabil, 77, 1115-8
rehab increases 12-minute distance by 66%, increases ADL by 39%, reduces breathlessness by 65%
Ward JA, Akers G, Ward DG (2002) Feasibility and effectiveness of a pulmonary rehabilitation programme in a community hospital setting. Brit J Gen Pract, 52, 480, 539-42
www.pubmedcentral.nih.gov/picrender.fcgi?artid=1314354&blobtype=pdf
Young P, Dewse M (1999) Improvements in outcomes for COPD attributable to a hospital-based respiratory rehabilitation programme. Aust NZ J Med, 29, 59-65
rehab reduces need for steroids and hospitalisation
Williamson A (1997) Benefits of a 12-week outpatient rehabilitation programme are independent of the degree of lung dysfunction in COPD. Thorax, 52, suppl.6, A37
6MD = six-minute distance
AACN = American Association of Critical Care Nurses
AARC = American Association for Respiratory Care
ACCP = American College of Chest Physicians
ACPRC = Association of Chartered Physiotherapists in Respiratory Care
ATS = American Thoracic Society
BMI = body mass index
BMJ = British Medical Journal
BTS = British Thoracic Society
ERS = European Respiratory Society
ET = exercise tolerance
HRQL = health-related quality of life