Pulmonary rehabilitation programs for chronic obstructive pulmonary disease
(2 July 2005: VIDYYA MEDICAL NEWS SERVICE) -- Incremental exercise tests show that the peak work rate in patients who suffer from chronic obstructive pulmonary disease (COPD) and who have participated in a pulmonary rehabilitation program increases an average of 18 percent, according to a "State of the Art" article on COPD pulmonary rehabilitation in the first issue for July 2005 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.
According to the expert article, the goals of pulmonary rehabilitation programs for COPD patients are to reduce symptoms, improve activity and daily function, and restore the highest level of independent function in patients with respiratory disease.
COPD involves persistent obstruction of the airways caused by severe emphysema and chronic bronchitis. Severe emphysema causes enlargement of the tiny air sacs of the lung (alveoli) and the destruction of their walls. In chronic bronchitis, bronchial glands are enlarged, causing excess secretion of mucus. Frequently, the small airways of the lung become inflamed and blocked. Also, bronchitis victims suffer from a persistent cough that produces sputum. Long-term smoking is the root cause of each of the two illnesses involved. In 2002, 11.2 million U.S. adults were estimated to have COPD.
One of the benefits of pulmonary rehabilitation is improved function capacity, as measured by the 6-minute walk test. Patients who underwent rehabilitation, including exercise training, improved their results by a distance of 54 meters (about 48.6 yards).
Also, the authors point out that improved health-related quality of life is also observed even in the absence of clinically significant improvements in exercise capacity.
Although exercise reconditioning is the key to a successful rehabilitation program, exercise training programs need to be adapted to the individual limitations of the COPD patient, taking into consideration cardiovascular, pulmonary, and skeletal muscle limitations.
They note that exercises should be performed 3 to 5 days per week at an intensity above 40 to 85 percent of the oxygen uptake reserve (the difference between resting and peak oxygen intake) for more than 20 minutes per session.
Return to Vidyya Medical News Service for 2 July 2005