Physical rehabilitation of patients with chronic respiratory diseases: the optimal organization under limited resources
https://doi.org/10.18093/0869-0189-2018-28-1-110-117
Abstract
Pulmonary rehabilitation (PR) is an important part of management of patients with chronic respiratory diseases. Physical exercise is a key issue of rehabilitation programs in patients with chronic respiratory diseases. The aim of this review was to describe potential ways to organize effective physical rehabilitation programs for patients with chronic respiratory diseases in a medical institution with limited resources. The choice of rehabilitation mode is related to the needs and the goals of the patient and available equipment. Medical facilities are often limited in their resources and failed to use all modern rehabilitation techniques. Nevertheless, the most physiological and inexpensive rehabilitation techniques, such as (breathing techniques, dosed walking, strength training, could improve functional status and daily activity of patients with chronic respiratory diseases and encourage them to wellness management.
About the Author
M. G. SychevaRussian Federation
Marina G. Sycheva, Candidate of Medicine, Senior Researcher, Division of Medical Rehabilitation for Patients with Respiratory Diseases.
ul. Zemlyanoy val 53, Moscow, 105120.
References
1. Gröne O., Garcia-Barbero M. Integrated care: a position paper of the WHO European Office for Integrated Health Care Services. In. J. Integr. Care. 2001; 1 (1): 21.
2. Spruit M.A., Singh S.J., Garvey C. et al. An Official American Thoracic Society/European Respiratory Society Statement: key concepts and advances in pulmonary rehabilitation. Am. J. Respir. Crit. Care Med. 2013; 188 (8): 13–64. DOI: 10.1164/rccm.201309-1634ST.
3. Kruis A.L., Smidt N., Assendelft W.J.J. et al. Integrated disease management interventions for patients with chronic obstructive pulmonary disease. Cochrane Database Syst. Rev. 2013; (10): CD009437. DOI: 10.1002/14651858.CD009437.pub2.
4. Nici L., ZuWallack R. Pulmonary rehabilitation: today and tomorrow. Breathe. 2010; 6 (4): 305–311. DOI: 10.1183/18106838.0604.305.
5. Santus P., Bassi L., Radovanovic D. et al. Pulmonary rehabilitation in COPD: a reappraisal (2008–2012). Pulm. Med. 2013; 2013: 374283. DOI: 10.1155/2013/374283.
6. Jenkins S., Hill K., Cecins N. State of the art: how to set up a pulmonary rehabilitation program. Respirology. 2010; 15 (8): 1157–1173. DOI: 10.1111/j.1440-1843.2010.01849.x.
7. Currie G.P., Douglas J.G. Non-pharmacologic management. Br. Med. J. 2006; 332 (7554): 1379–1381. DOI: 10.1136/bmj.332.7554.1379
8. Guell M.R., Cejudo P., Rodriguez-Trigo G. et al. Estandares de calidad asistencial en rehabitacion respiratoria en pacientes con enfermedad pulmonar cronica. Arch. Bronconeumol. 2012; 48 (11): 396–404. DOI: 10.1016/j.arbres.2012.05.009.
9. Bubnova M.G., Aronov D.M. Providing physical activity in disabled patients. Methodological guidelines. Cardiosomatics. 2016; 7 (1): 5–50 (in Russian).
10. Santos C., Santos J., Morais L. et al. Pulmonary rehabilitation in COPD: effects of two aerobic exercise intensity in patient-centered outcomes – a randomized study. Chest. 2011; 140 (4): 853A. DOI: 10.1378/chest.1119544.
11. Zainuldin R., Mackey M.G., Alison J.A. Optimal intensity and type of leg exercise training for people with chronic obstructive pulmonary disease. Cochrane Database Syst. Rev. 2011; (11): CD008008. DOI: 10.1002/14651858.CD008008.pub2.
12. Bubnova M.G., Aronov D.M., Boytsov S.A. Providing physical activity in disabled patients: Methodological guidelines. Moscow: Gosudarstvennyy nauchno-issledovatel'skiy tsentr profilakticheskoy meditsiny; 2015 (in Russian).
13. Malyarenko T.N, Malyarenko Yu.E., Bykov A.T. et al. Dosed walking as a reliable method of rehabilitation. Voennaya meditsina. 2010 (3): 119–127 (in Russian).
14. Breyer M.K., Breyer-Kohansal R., Funk G.C. et al. Nordic walking improves daily physical activities in COPD: a randomised controlled trial. Respir. Res. 2010; 11 (1): 112. DOI: 10.1186/1465-9921-11-112.
15. Annegarn J., Meijer K., Lima Passos V. et al. Problematic activities of daily life are weakly associated with clinical characteristics in COPD. J. Am. Med. Dir. Assoc. 2012; 13 (3): 284–290. DOI: 10.1016/j.jamda.2011.01.002.
16. Bernard S., Whittom F., Leblanc P. et al. Aerobic and strength training in patients with chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 1999; 159 (3): 896–901. DOI: 10.1164/ajrccm.159.3.9807034.
17. Tout R., Tayara L., Halimi M. The effects of respiratory muscle training on improvement of the internal and external thoraco-pulmonary respiratory mechanism in COPD patients. Ann. Phys. Rehabil. Med. 2013; 56 (3): 193–211. DOI: 10.1016/j.rehab.2013.01.008.
18. O’Brien K., Geddes E.L., Reid W.D. et al. Inspiratory muscle training compared with other rehabilitation interventions in chronic obstructive pulmonary disease: a systematic review update. J. Cardiopulm. Rehabil. Prev. 2008; 28 (2): 128–141. DOI: 10.1097/01.HCR.0000314208.40170.00.
19. Gosselink R., De Vos J., van den Heuvel S.P. et al. Impact of inspiratory muscle training in patients with COPD: what is the evidence? Eur. Respir. J. 2011; 37 (2): 416–425. DOI: 10.1183/09031936.00031810.
20. Crisafulli E., Costi S., Fabbri L.M., Clini E.M. Respiratory muscles training in COPD patients. Int. J. Chron. Obstruct. Pulmon. Dis. 2007; 2 (1): 19–25.
21. Geddes E.L., O’Brien K., Reid W.D. et al. Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review. Respir. Med. 2008; 102 (12): 1715–1729. DOI: 10.1016/j.rmed.2008.07.005.
22. Hill K., Jenkins S.C., Hillman D.R., Eastwood P.R. Dyspnoea in COPD: can inspiratory muscle training help? Aust. J. Physiother. 2004; 50 (3): 169–180. DOI: 10.1016/S0004-9514(14)60155-0.
23. Lötters F., van Tol B., Kwakkel G., Gosselink R. Effects of controlled inspiratory muscle training in patients with COPD: a meta-analysis. Eur. Respir. J. 2002; 20 (3): 570–577. DOI: 10.1183/09031936.02.00237402.
24. Lisboa C., Villafranca C., Leiva A. et al. Inspiratory muscle training in chronic airflow limitation: effect on exercise performance. Eur. Respir. J. 1997 10 (3): 537–542.
25. Chernyak A.V. Inspiratory muscle training in patients with obstructive lung diseases. Atmosfera. Allergologiya i pul'monologiya. 2009 (2): 2–7 (in Russian).
26. Romer L.M., McConnell A.K. Specificity and reversibility of inspiratory muscle training. Med. Sci. Sports Exerc. 2003; 35 (2): 237–244. DOI: 10.1249/01.MSS.0000048642.58419.1e.
27. Abrosimov V.N. Rehabilitation of patients with COPD. Moscow: GEOTAR-Media; 2016 (in Russian).
28. Laciuga H., Rosenbek J.C., Davenport P.W. et al. Functional outcomes associated with expiratory muscle strength training: narrative review. J. Rehabil. Res. Dev. 2014: 51 (4): 535–546. DOI: 10.1682/JRRD.2013.03.0076.
29. Beauchamp M.K., Nonoyama M., Goldstein R.S. et al. Interval versus continuous training in individuals with chronic obstructive pulmonary disease: a systematic review. Thorax. 2010; 65 (2): 157–164. DOI: 10.1136/thx.2009.123000.
30. Morgan M.D.L. British Thoracic Society Standards of Care Subcommittee on Pulmonary Rehabilitation. Thorax. 2001; 56 (11): 827–834. DOI: 10.1136/thorax.56.11.827.
31. Osadnik C.R., Rodrigues F.M.M., Camillo C.A. et al. Principles of rehabilitation and reactivation. Respiration. 2015; 89 (1): 2–11. DOI: 10.1159/000370246.
32. Turner L.A., Mickleborough T.D., McConnell A.K. et al. Effect of inspiratory muscle training on exercise tolerance in asthmatic individuals. Med. Sci. Sports Exerc. 2011; 43 (11): 2031–2038. DOI: 10.1249/MSS.0b013e31821f4090.
33. Silva I.S., Fregonezi G.A.F., Dias F.A.L. et al. Inspiratory muscle training for asthma. Cochrane Database Syst. Rev. 2013; (9): CD003792. DOI: 10.1002/14651858.CD003792.pub2.
34. Chuchalin A.G., Aisanov Z.R., Belevskiy A. et al. Federal Guidelines on Diagnosis and Treatment of Bronchial Asthma. Moscow: RRO; 2016. Available at: http://pulmo.ru/wp-content/uploads/2016/12/Entsiklopediya_04_astma.pdf (in Russian).
35. Weiner P., Magadle R., Massarwa F. et al. Influence of gender and inspiratory muscle training on the perception of dyspnea in patients with asthma. Chest. 2002; 122 (1): 197–201. DOI: 10.1378/chest.122.1.197.
36. Sterzi S., Cesario A., Cusumano G. et al. Post-operative rehabilitation for surgically resected non-small cell lung cancer patients: serial pulmonary functional analysis. J. Rehabil. Med. 2013; 45 (9): 911–915. DOI: 10.2340/16501977-1192.
37. Bradley A., Marshall A., Stonehewer L. et al. Pulmonary rehabilitation programme for patients undergoing curative lung cancer surgery. Eur. J. Cardiothorac. Surg. 2013; 44 (4): 266–e271. DOI: 10.1093/ejcts/ezt381.
38. Vandenbos F., Fontas É., Dunais B. et al. Pulmonary rehabilitation after lung resection for tumor – a feasibility study. Rev. Mal. Respir. 2013. 30 (1): 56–61. DOI: 10.1016/j.rmr.2012.12.002.
Review
For citations:
Sycheva M.G. Physical rehabilitation of patients with chronic respiratory diseases: the optimal organization under limited resources. PULMONOLOGIYA. 2018;28(1):110-117. (In Russ.) https://doi.org/10.18093/0869-0189-2018-28-1-110-117