Rehabilitation

Abstract

Pulmonary rehabilitation programmes are increasingly popular with chest physicians and chronic obstructive pulmonary disease (COPD) patients. It is now clearly established that these programmes improve exercise capacity, reduce symptoms and improve quality of life in COPD patients. At present there is no conclusive evidence that these programmes would improve survival or reduce medical consumption, although suggestive evidence is present. Pulmonary rehabilitation programmes are multidisciplinary and consist of exercise training, peripheral muscle training, ventilatory muscle training, chest physiotherapy, ergotherapy, education, psychosocial and nutritional support. The elements that are best supported by evidence available in the literature are exercise training, peripheral muscle training and nutritional support. At present there is little evidence available in the literature to select the best possible candidates for rehabilitation. It appears intuitively logical to select patients with poor exercise capacity, preferentially limited by cardiocirculatory factors with peripheral muscle weakness and associated with severe complaints and poor quality of life. Prospective studies, however, attempting to identify the best possible candidates for rehabilitation still need to be performed.