PULMONARY REHABILITATION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Since the last statements on pulmonary rehabilitation by the American Thoracic Society (ATS; 1999) and the European Respiratory Society (ERS; 1997), there have been numerous scientific advances both in our understanding of the systemic effects of chronic respiratory disease as well as the changes induced by the process of pulmonary rehabilitation. And the new document had been developed by an international committee and had been endorsed by both the ATS and the ERS in 2006. Individuals with chronic obstructive pulmonary disease (COPD ) still comprise the largest proportion of those referred for pulmonary rehabilitation. Exercise intolerance is one of the main factors limiting participation in activities of daily living among individuals with COPD . The cardinal symptoms of chronic respiratory disease that limit exercise in most patients are dyspnea and/or fatique, which may result from ventilatory constraints, pulmonary gas exchange abnormalities, peripheral muscle dysfunction, cardiac dysfunction, or any combination of the above. Exercise training, widely regarded as the cornerstone of pulmonary rehabilitation is the best available means of improving muscle function in COPD and (probably) other chronic respiratory diseases. Pulmonary rehabilitation programs involve patient assessment, exercise training, education, nutritional intervention, and psychosocial support.