title: Effects of pulmonary rehabilitation on quality of life in chronic obstructive pulmonary disease patients.
abstract: OBJECTIVE
  Pulmonary rehabilitation plays a key role in the management of chronic obstructive pulmonary disease (COPD). Although the American Thoracic Society recently provided a grade of 1A for evidence of health-related quality of life (HRQoL) benefits related to pulmonary rehabilitation, knowledge about the psychological and behavioral processes explaining the impact of pulmonary rehabilitation on HRQoL in COPD patients remains limited. This review describes the state of knowledge over the past year concerning HRQoL benefits after pulmonary rehabilitation and suggests avenues for future research.
  
  
  RESULTS
  HRQoL outcomes related to pulmonary rehabilitation explores five themes: optimizing pulmonary rehabilitation components to improve HRQoL; characterization of a responder phenotype; suitability of pulmonary rehabilitation following acute exacerbations; exploration of psychological and behavioral mechanisms explaining pulmonary rehabilitation benefits; and long-term maintenance of HRQoL benefits after pulmonary rehabilitation.
  
  
  CONCLUSIONS
  Evidence supports the use of pulmonary rehabilitation to improve HRQoL in patients with moderate-to-severe COPD. However, it is unclear how pulmonary rehabilitation improves HRQoL and which characteristics confer the greatest HRQoL benefits. Moreover, most studies failed to provide a compelling theoretical rationale for the intervention employed. Future research should focus on improving the understanding of the psychological mechanisms implicated in the adoption and maintenance of healthy behavior.
authors.affiliation: Montreal Behavioural Medicine Centre, Canada. gregory.moullec@crhsc.rtss.qc.ca
authors.forename: Grégory
authors.initials: G
authors.lastname: Moullec
authors.forename: Catherine
authors.initials: C
authors.lastname: Laurin
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
authors.forename: Grégory
authors.initials: G
authors.lastname: Ninot
mesh_terms: D005081:Exercise Therapy / Q000523:psychology; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D010342:Patient Acceptance of Health Care; D010641:Phenotype; D029424:Pulmonary Disease, Chronic Obstructive / Q000235:genetics / Q000523:psychology* / Q000534:rehabilitation*; D011788:Quality of Life; D012008:Recurrence; D040242:Risk Reduction Behavior; D012649:Self Concept; D012944:Social Support; D016896:Treatment Outcome