title: Pulmonary rehabilitation in the treatment of chronic obstructive pulmonary disease.
abstract: Pulmonary rehabilitation is a nonpharmacologic therapy that has emerged as a standard of care for patients with chronic obstructive pulmonary disease. It is a comprehensive, multidisciplinary, patient-centered intervention that includes patient assessment, exercise training, self-management education, and psychosocial support. In the United States, pulmonary rehabilitation is usually given in outpatient, hospital-based programs lasting six to 12 weeks. Positive outcomes from pulmonary rehabilitation include increased exercise tolerance, reduced dyspnea and anxiety, increased self-efficacy, and improvement in health-related quality of life. Hospital admissions after exacerbations of chronic obstructive pulmonary disease are also reduced with this intervention. The positive outcomes associated with pulmonary rehabilitation are realized without demonstrable improvements in lung function. This paradox is explained by the fact that pulmonary rehabilitation identifies and treats the systemic effects of the disease. This intervention should be considered in patients who remain symptomatic or have decreased functional status despite optimal medical management. Medicare now covers up to 36 sessions of pulmonary rehabilitation in patients with moderate, severe, and very severe chronic obstructive pulmonary disease.
authors.affiliation: Providence (R.I.) Veterans Affairs Medical Center, Providence, Rhode Island, USA. rzuwalla@stfranciscare.org
authors.forename: Linda
authors.initials: L
authors.lastname: Nici
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lareau
authors.forename: Richard
authors.initials: R
authors.lastname: ZuWallack
mesh_terms: D018450:Disease Progression; D004417:Dyspnea / Q000209:etiology / Q000534:rehabilitation*; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D006801:Humans; D010353:Patient Education as Topic; D018802:Patient-Centered Care / Q000379:methods; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D012648:Self Care / Q000379:methods; D012944:Social Support