pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2019-29-2-207-215pulmo-1147Research ArticleОБЗОРЫREVIEWСовременные данные о возможностях улучшения переносимости физической нагрузки и значении физической активности у больных с хронической обструктивной болезнью легкихCurrent data on improvement in physical tolerance and a role of physical activity in patients with chronic obstructive pulmonary diseaseАйсановЗ. Р.AisanovZaurbek R.

Айсанов Заурбек Рамазанович – д. м. н., профессор кафедры пульмонологии Федерального государственного бюджетного образовательного учреждения высшего образования «Российский национальный исследовательский медицинский университет имени Н.И.Пирогова» Министерства здравоохранения Российской Федерации; тел.: (495) 965-34-66;

117997, Москва, ул. Островитянова, 1;

Zaurbek R. Aisanov, Doctor of Medicine, Professor, Department of Pulmonology, N.I.Pirogov Federal Russian National Research Medical University, Healthcare Ministry of Russia; tel.: (495) 965-34-66

ul. Ostrovityanova 1, Moscow, 117997

aisanov@mail.ruБелоцерковскаяЮ. Г.BelotserkovskayaYuliya G.

Белоцерковская Юлия Геннадьевна – к. м. н., доцент кафедры пульмонологии Федерального государственного бюджетного образовательного учреждения дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации; тел.: (499) 728-83-69;

123995, Москва, ул. Баррикадная, 2, стр. 1

Yuliya G. Belotserkovskaya, Candidate of Medicine, Associate Professor, Department of Pulmonology, Russian Federal Academy of Continued Medical Education, Healthcare Ministry of Russia; tel.: (499) 728-83-69;

ul. Barrikadnaya 2/1, Moscow, 123995

belo-yuliya@yandex.ruАвдеевС. Н.AvdeevSergey N.

Авдеев Сергей Николаевич – д. м. н., профессор, член-корр. Российской академии наук, заведующий кафедрой пульмонологии Федерального государственного автономного образовательного учреждения высшего образования «Первый Московский государственный медицинский университет имени И.М.Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет); тел.: (495) 395-63-93;

119991, Москва, ул. Трубецкая, 8, стр. 2

Sergey N. Avdeev, Doctor of Medicine, Professor, Corresponding Member of Russian Academy of Sciences, Head of Department of Pulmonology, I.M.Sechenov First Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University); tel.: (495) 395-63-93;

Trubetskaya ul. 8, build. 2, Moscow, 119991

serg_avdeev@list.ruБелевскийА. С.BelevskiyAndrey S.

Белевский Андрей Станиславович – д. м. н., профессор, заведующий кафедрой пульмонологии Федерального государственного бюджетного образовательного учреждения высшего образования Российский национальный исследовательский медицинский университет имени Н.И.Пирогова Министерства здравоохранения Российской Федерации, президент Российского респираторного общества, главный внештатный специалист-пульмонолог Департамента здравоохранения Правительства Москвы; тел.: (495) 963-24-67;

117997, Москва, ул. Островитянова, 1

Andrey S. Belevskiy, Doctor of Medicine, Professor, Head of Department of Pulmonology, N.I.Pirogov Federal Russian State National Research Medical University, Healthcare Ministry of Russia; Chairmen of Russian Respiratory Society; Chief Pulmonologist of Moscow Healthcare Department; tel.: (495) 963-24-67;

ul. Ostrovityanova 1, Moscow, 117997

pulmobas@yandex.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет имени Н.И.Пирогова» Министерства здравоохранения Российской ФедерацииРоссияN.I.Pirogov Federal Russian State National Research Medical University, Healthcare Ministry of RussiaRussian Federationедеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияRussian Federal Academy of Continued Medical Education, Healthcare Ministry of RussiaRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет имени И.М.Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияI.M.Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of RussiaRussian Federation201901072019292207215Copyright © Айсанов З.Р., Белоцерковская Ю.Г., Авдеев С.Н., Белевский А.С., 20192019Айсанов З.Р., Белоцерковская Ю.Г., Авдеев С.Н., Белевский А.С.Aisanov Z.R., Belotserkovskaya Y.G., Avdeev S.N., Belevskiy A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/1147

При определении тяжести течения и прогноза у пациентов с хронической обструктивной болезнью легких (ХОБЛ) важная роль принадлежит такому фактору, как физическая активность (ФА). По данным современных исследований продемонстрировано, что снижение ФА ассоциировано с увеличением частоты обострений ХОБЛ, летальности и снижением качества жизни больных ХОБЛ. Поскольку основу заболевания составляет ограничение воздушного потока, то при уменьшении легочной гиперинфляции при помощи двойных бронходилататоров переносимость физической нагрузки (ФН) у пациентов с ХОБЛ может улучшиться. Согласно существующим данным о применении комбинации тиотропий / олодатерол убедительно доказано, что при использовании двойных бронходилататоров у больных ХОБЛ увеличиваются время переносимости ФН и период до появления одышки во время ФН. Вместе с тем требуются дальнейшие исследования в области реабилитации и использования ФН в терапии пациентов с ХОБЛ.

Physical activity plays an important prognostic role in patients with chronic obstructive pulmonary disease (COPD). According to published data, decreased physical activity is associated with higher frequency of COPD exacerbations, higher mortality, and lower quality of life in COPD patients. As the airflow limitation is an underlying mechanism of COPD, double bronchodilators can reduce lung hyperinflation and improve exercise tolerance in patients with COPD. According to the robust evidence on the efficacy of tiotropium/olodaterol combination, double bronchodilators can increase exercise duration and time before dyspnea occurrence on exertion. However, further studies are needed in the field of rehabilitation and a role of physical activity in the management of patients with COPD.

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The authors declare that there are no conflicts of interest present.