Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease

Abstract

With an ever-expanding understanding about chronic obstructive pulmonary disease (COPD), it has been realized that it is a respiratory disease with systemic manifestations. Systemic effects of COPD lead to cardiovascular co-morbidities, muscle wasting and osteoporosis that in turn lead to inactivity and physical deconditioning. This development has a direct impact on the health-related quality of life (HRQoL) of patients suffering from this respiratory disease. Pharmacological therapy leads to improvement in shortness of breath and has limited effect on the physical deconditioning. Latest research has shown an additive effect of pulmonary rehabilitation on improving the inactivity and overall HRQoL in COPD patients. Pulmonary rehabilitation (PR) is a comprehensive multimodality program that includes strength and endurance training, nutritional education and psychosocial support. This leads to a holistic approach to management of COPD which results in symptom improvement in patients and decreased utilization of heath care resources. There are several barriers to widespread adoption of pulmonary rehabilitation as a standard treatment. This includes availability, insurance coverage and patient compliance. With inclusion of pulmonary rehabilitation in respiratory society guidelines, there has been a renewed interest among both pulmonary specialist and community physicians. This chapter aims to provide exhaustive evidence based knowledge regarding pulmonary rehabilitation and its beneficial effect on COPD patients.