pulmonary rehabilitation
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Indications
- disorders
- chronic obstructive pulmonary disease (COPD; chronic bronchitis &/or emphysema)
- recommended for symptomatic patients with COPD & FEV1 < 50% of predicted
- effective in patients with advanced COPD[3]
- hospitalization for COPD exacerbation regardless of lung function[13]
- reduces rate of rehospitalizations after COPD exacerbation[10]
- repeated courses or continuous pulmonary rehabilitation of value[3]
- interstitial lung disease[13]
- pulmonary hypertension recommended but evidence of benefit is lacking[13]
- other indcations not specifically mention by the American Thoracic Society
- chronic obstructive pulmonary disease (COPD; chronic bronchitis &/or emphysema)
- signs/symptoms
- dyspnea during rest or exertion
- hypoxemia; hypercapnia
- reduced exercise tolerance or a decline in ADLs
- worsening dyspnea with reduced but stable exercise tolerance
- chronic respiratory failure with need for mechanical ventilation
- ventilator dependency
- increasing emergency department visits, hospitalization, or unscheduled office visits
- lung surgery for transplantation, volume reduction, or cancer
* noncompletion or nonresponse predicts higher 1-year mortality in patients with idiopathic pulmonary fibrosis[11]
Procedure
- 3-4 months
- education
- nutritional counseling
- exercise training
- exercise at least 3 times a week for the most benefit [NIH:NHBLI]
- functional assessment
- follow-up[3]
- maintenance
- reasonable to consider maintenance pulmonary rehabilitation[13]
- evidence of sustained benefit is lacking
- monthly supervised reinforcement sessions for 1 year[4]
- weekly-session maintenance program for 1 year[6]
- statistically significant benefit in exercise capacity for weekly-session maintenance program for 6 months, but not for 1 year[7]
- regular walking of benefit[5]
- reasonable to consider maintenance pulmonary rehabilitation[13]
- in-person treatment & telerehabilitation have similar benefits
More general terms
More specific terms
Additional terms
References
- ↑ Ries AL, Bauldoff GS, Carlin BW, Casaburi R, Emery CF, Mahler DA, Make B, Rochester CL, Zuwallack R, Herrerias C. Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines. Chest. 2007 May;131(5 Suppl):4S-42S. Corresponding NGC guideline withdrawn Jan 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/17494825 <Internet> http://www.chestjournal.org/content/vol131/5_suppl/index.shtml
- ↑ Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
- ↑ 3.0 3.1 3.2 3.3 Medical Knowledge Self Assessment Program (MKSAP) 16, 17. American College of Physicians, Philadelphia 2012, 2015
- ↑ 4.0 4.1 Ries AL et al Maintenance after Pulmonary Rehabilitation in Chronic Lung Disease. A Randomized Trial. Am J Respir Crit Care Med. 2003. 167:880-888 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/12505859 <Internet> http://www.thoracic.org/assemblies/pr/resources/ries-maintenance-after-pr-in-copd.pdf
- ↑ 5.0 5.1 Heppner PS1, Morgan C, Kaplan RM, Ries AL Regular walking and long-term maintenance of outcomes after pulmonary rehabilitation. J Cardiopulm Rehabil. 2006 Jan-Feb;26(1):44-53. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16617228
Bauldoff GS1, Hoffman LA, Zullo TG, Sciurba FC. Exercise maintenance following pulmonary rehabilitation: effect of distractive stimuli. Chest. 2002 Sep;122(3):948-54. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12226037 - ↑ 6.0 6.1 Roman M et al Efficacy of pulmonary rehabilitation in patients with moderate chronic obstructive pulmonary disease: a randomized controlled trial. BMC Family Practice 2013, 14:21 http://www.biomedcentral.com/1471-2296/14/21
- ↑ 7.0 7.1 Beauchamp MK, Evans R, Janaudis-Ferreira T, et al. Systematic review of supervised exercise programs after pulmonary rehabilitation in individuals with COPD. Chest. 2013;144:1124-1133 PMID: https://www.ncbi.nlm.nih.gov/pubmed/2342993
- ↑ Goldstein RS, Hill K, Brooks D, Dolmage TE. Pulmonary rehabilitation: a review of the recent literature Chest. 2012 Sep;142(3):738-49 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22948578
- ↑ Spruit MA, Singh SJ, Garvey C et al An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013 Oct 15;188(8):e13-64 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24127811
- ↑ 10.0 10.1 Stefan MS, Pekow PS, Priya A et al. Association between initiation of pulmonary rehabilitation and rehospitalizations in patients hospitalized with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2021 Nov 1; 204:1015. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34283694 https://www.atsjournals.org/doi/10.1164/rccm.202012-4389OC
- ↑ 11.0 11.1 11.2 Nolan CM et al. Pulmonary rehabilitation in idiopathic pulmonary fibrosis and COPD: A propensity-matched real-world study. Chest 2022 Mar; 161:728 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34699771 PMCID: PMC8941605 Free PMC article https://journal.chestnet.org/article/S0012-3692(21)04208-2/fulltext
- ↑ NIH: National Heart, Lung and Blood Insitutue (NHLBI) Pulmonary Rehabilitation http://www.nhlbi.nih.gov/health/health-topics/topics/pulreh/
- ↑ 13.0 13.1 13.2 13.3 13.4 Rochester CL et al. Pulmonary rehabilitation for adults with chronic respiratory disease: An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med 2023 Aug 15; 208:e7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37581410 PMCID: PMC10449064 Free PMC article https://www.atsjournals.org/doi/10.1164/rccm.202306-1066ST