title: Pulmonary rehabilitation: an underutilized resource in primary COPD care.
abstract: Pulmonary rehabilitation (PR) is an important component of chronic obstructive pulmonary disease (COPD) management. Physician use of PR for patients with COPD lags behind national and international guideline recommendations. In this article, we discuss the important components of PR, including exercise training, self-management education, and psychosocial and nutritional interventions, as based on the American Thoracic Society/European Respiratory Society and Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. We also discuss the potential benefits of PR, including reduction of respiratory symptoms, decreased disability, and increased participation in physical and social activities. Increased activity promotes independence, improves quality of life, and reduces the number of COPD exacerbations and hospitalizations. In all stages of COPD, PR has been shown to result in improved exercise tolerance, with reduced dyspnea and fatigue, although the greatest improvement has been seen in patients with GOLD stages II to IV. Pulmonary rehabilitation is now a well-recognized therapy that should be available to all patients with symptomatic COPD. To facilitate inclusion of PR in COPD management, primary care physicians need to recognize and diagnose COPD, and regularly decide when PR best fits in an individual's COPD treatment program.
authors.affiliation: Seton Pulmonary and Cardiac Rehabilitation, Daly City, CA, USA. chrisgarvey@dochs.org
authors.forename: Christine
authors.initials: C
authors.lastname: Garvey
authors.forename: Len
authors.initials: L
authors.lastname: Fromer
authors.forename: Dennis F
authors.initials: DF
authors.lastname: Saver
authors.forename: Barbara P
authors.initials: BP
authors.lastname: Yawn
mesh_terms: D005081:Exercise Therapy; D006801:Humans; D018529:Nutritional Support; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D012017:Referral and Consultation; D012129:Respiratory Function Tests; D012648:Self Care