Journal Mobile

R Evans, M Morgan
Journal Issue: 
Volume 37: Issue 4: 2007




Chronic  lung  diseases  such  as  COPD  are  typically  characterised  by progressive  disability  arising  from  dyspnoea  and  reduced  exercise  capacity. Although the underlying cause of disability is the irreversible loss of lung function, there  are  compounding  systemic  complications,  such  as  skeletal  muscle dysfunction, that  contribute.  Pulmonary  rehabilitation  is  a  therapy  that  aims  to improve  physical  functioning  and  health  status  without  necessarily  reversing  the impairment of lung function.  The key components of a pulmonary rehabilitation programme  are  individually  prescribed  physical  training  and  self-management education. These therapies are delivered by a multi-professional team in a variety of  settings.  The  physical  training  generally  includes  lower  limb  endurance  and resistance  exercises.   Higher  intensity  training, where  tolerated, will  result  in greater improvement though some gains can be achieved even with low intensity training.   Pulmonary  rehabilitation  seems  to  work  through  a  combination  of genuine  physiological  training, reduced  dyspnoea, and  better  self-management. Recent  studies  have  now  shown  conclusively  that  a  comprehensive  pulmonary rehabilitation programme can produce improvements in walking performance and quality of life. These benefits translate to increased activities of daily living, reduced hospital  length  of  stay,  and  possibly  increased  survival.   Although  pulmonary rehabilitation  is  effective  and  popular  with  patients  it  is  not  widely  available. In future it will be necessary to explore ways of increasing capacity to meet demand.