Anatomy-Physiotherapy-logo

  • Italiano (Italia)
  • Français (France)
  • Portuguese (PT)
  • Deutsch (Deutschland)
  • Spanish (ES)
  • English (UK)
New english website, click here ->

           

  • Articles
    Evidence based articles
    • Musculoskeletal
      • Upper extremity
      • Lower extremity
      • Spine
    • Other
      • Nervous
      • Circulatory
      • Nutrition
      • Aging
      • Pain
      • Various
  • Art & Design
    Anatomy related art
  • Videos
    Webinars & more
  • Create account
    Personal pages & favourites
  • Login
    Login to A&P
Anatomy-Physiotherapy-logo
02 Dec2014

02 December 2014.

Written by Liesbeth Raymakers
Posted in Aging

02-12-2014 08:10:37
Image by: web up ac

Time to adapt exercise training regimens in pulmonary rehab

Exercise intolerance, exertional dyspnea, reduced health-related quality of life, and acute exacerbations are features characteristic of chronic obstructive pulmonary disease (COPD). Patients with a primary diagnosis of COPD often report comorbidities (notably cardiovascular disease, diabetes, depression, osteoporosis, and osteoarthritis) and other secondary manifestations (nutritional deficits, body composition) which diversifies the clinical presentation.

Pulmonary rehabilitation that includes whole body exercise training is a critical part of management, and core programs involve endurance and resistance training for the upper and lower limbs.

Positive outcomes in maximal and submaximal exercise capacity, dyspnea, fatigue, health-related quality of life, and psychological symptoms are well known and widely implemented as standard care across the world.

However, The varying clinical profile of COPD may direct the need for modification to traditional training strategies for some patients.

Pulmonary rehabilitation (PR) is a cornerstone of management of COPD. It is defined as a “comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies that include, but are not limited to, exercise training, education and behaviour change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviours”.

This article discusses the various traditional exercise modalities (endurance, interval and resistance training) and proposes novel ways to individualize training and optimize clinical outcomes. Periodization, partitioning (ie one-legged cycling), inspiratory muscle training, balance training are promising components of PR programs.

The authors propose for clinicians to look at strategies to optimize adherence and outcome of PR: to provide supplemental oxygen or even NIV to selected patients, improve self-efficacy, increase program duration up to 12-18 months, vary settings from hospital to home- or community based programs, consider water-based training for patients with comorbidities and introduce maintenance programs.

Failure to attend initial PR is attributed to inconvenient timing, disruption to usual routine, and influence of their primary health care provider. Suboptimal attendance is commonly related to transport, lack of perceived benefit as well as hospitalization and social isolation. The authors stress the importance of a positive attitude of the referring professional, and involving the patient actively in solutions.

COPD is a heterogeneous condition, with patients demonstrating physical, psychological, and functional disability in addition to comorbidities and complications which increase the complexity of clinical presentation. 

PR ideally should be offered in a stable clinical state and immediately following AE, and training strategies should consider the potential role of comorbidities in exercise training prescription and outcomes.

> From: Lee et al., Int J Chron Obstruct Pulm Dis 9 (2014) 1275-1288. All rights reserved to The Author(s). Click here for the Pubmed summary.

Image by: respiratorydecade

Tags: exercise therapy, COPD, Rehabilitation pulmonary

Please log in or create an account to place comments. It's free and takes only a minute.

About the Author
Liesbeth Raymakers
Liesbeth Raymakers
Liesbeth Raymakers has been working as a Physiotherapist since 1998, mainly in hospital based care, ICU and intensive rehab. Originally from the Nethe...

Latest articles from this auhtor

  • Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: meta-analysis of randomized controlled trials.
  • A framework for fibromyalgia management for primary care providers.
  • Effect of resistance training on physical performance and fear of falling in elderly with different levels of physical well-being
  • Age-related effects of exercise training on diastolic function in heart failure with reduced ejection fraction: the Leipzig Exercise Intervention in Chronic Heart Failure and Aging (LEICA) Diastolic Dysfunction Study.
  • The importance of components of pulmonary rehabilitation, other than exercise training, in COPD
 

 

Login

  • Forgot your password?
  • Forgot your username?
  • Create an account
AP banner Sono 1

Related

  • Long-term effects of medical exercise therapy in patients with patellofemoral pain syndrome.
  • Deficits in physical function among young childhood cancer survivors.
  • Injury prevention for adult male soccer players. [free PhD. thesis + 26 prevention exercise videos]
  • Does effectiveness of exercise therapy and mobilisation techniques offer guidance for the treatment of lateral and medial epicondylitis? A systematic review.
  • Exercise therapy and custom-made insoles are effective in patients with excessive pronation and chronic foot pain--a randomized controlled trial.

Sub Menu

  • Musculoskeletal
    • Upper extremity
      • Shoulder
      • Elbow
      • Wrist
      • Hand
    • Lower extremity
      • Hip
      • Knee
      • Ankle
      • Foot
    • Spine
      • Pelvis
      • Lumbar
      • Thoracic
      • Rib cage
      • Cervical
  • Other
    • Nervous
    • Circulatory
    • Nutrition
    • Aging
    • Pain
    • Various

Newsletter

Subscribe to our weekly newsletter to receive all articles of the week in your mailbox.

 

Partners

enraf nonius

apa

fontys

vpt

kiné care

ICMSU

  • Home
  • About
  • Team
  • Advertise
  • Contact
  • Terms of Service
  • Privacy Policy
  • Jobs
  • Newsletter archive
AP-SMALL-WHITECopyright 2010 - 2021 Anatomy & Physiotherapy. All Rights Reserved.

Privacy Policy

AdBlock detected

We want to keep offering top-notch content for free. In order to keep up with the additional costs that we incurr with scaling our website, we need your help! Please turn off your adblocker or consider donating a small amount.

http://www.anatomy-physiotherapy.com/donate

Close
You can also just close this popup. It shows only once.
isApp.it
  • Articles
    Evidence based articles
    • Musculoskeletal
      • Upper extremity
        • Shoulder
        • Elbow
        • Wrist
        • Hand
      • Lower extremity
        • Hip
        • Knee
        • Ankle
        • Foot
      • Spine
        • Pelvis
        • Lumbar
        • Thoracic
        • Rib cage
        • Cervical
    • Other
      • Nervous
      • Circulatory
      • Nutrition
      • Aging
      • Pain
      • Various
  • Art & Design
    Anatomy related art
  • Videos
    Webinars & more
  • Create account
    Personal pages & favourites
  • Login
    Login to A&P
You are now being logged in using your Facebook credentials