The pulmonary rehabilitation treatment of patients with chronic obstructive pulmonary disease (COPD) has become a current research hotspot. Pulmonary rehabilitation can effectively improve the lung function, quality of life, and physical and mental health, reduce the risk of death, but there are still certain limitations in the implementation of pulmonary rehabilitation for COPD. Based on existing research, this article introduces the benefits of pulmonary rehabilitation for COPD, and elaborates on the timing, location selection, and course of pulmonary rehabilitation, aiming to provide a basis for developing personalized pulmonary rehabilitation plans for COPD.
Objective To determine if supervised hospital-based exercise can maintain the benefits of functional exercise ability and quality of life gained from a pulmonary rehabilitation program in COPD.Methods A prospective and randomized study was carried out. Following completion of an eight-week pulmonary rehabilitation program in hospital, 43 COPD patients were recruited and randomized into either a supervised group ( supervised, every 10 days, hospital-based exercise, 22 cases ) or a control group ( unsupervised home exercise,21 cases) and followed for 12 months. Measurements were taken at baseline and 12 months later. Exercise measurements include six-minute walk test( 6MWT) and pulmonary function test. Quality of life was measured using the Chronic Respiratory Questionnaire ( CRQ) . Results After 12 months of different exercise program,6MWT in the supervised group was significantly longer than that in the unsupervised group[ ( 532. 0 ±168. 4) m vs ( 485. 0 ±151. 6) m, P lt; 0. 05] . There was no significant difference in pulmonary function between the two groups. The quality of life of the supervised group was higher than that of the unsupervised group( 114. 6 ±20. 8 vs 105. 6 ±21. 7, P lt;0. 05) . Conclusions After the completion of pulmonary rehabilitation program, a supervised, every 10 days, hospital-based following exercise program can maintain better functional exercise capacity and quality of life compared to home exercise in COPD patients.
Pulmonary rehabilitation therapy is gaining more attention. The recent systematic review of domestic and foreign relevant literature indicates pre-operative pulmonary rehabilitation exercise training performs an important role in per-operative period. The rehabilitation therapy can efficiently improve exercise tolerance and quality of life of patients with lung cancer, reduce post-operative complications, shorten hospitalization time, and increase opportunity of operation. However, the evidence comes from small samples reported by present clinical study, and a standard treatment guideline of pulmonary rehabilitation has not been established until now. Further researches are expected to provide demonstration and promote pulmonary rehabilitation. It is an important part of comprehensive treatment of lung cancer. The therapy will benefit more patients suffering from lung cancer.
Due to the coronavirus disease 2019 pandemic, the traditional outpatient and medical center pulmonary rehabilitation models for chronic obstructive pulmonary disease have been limited, while pulmonary rehabilitation technology has always been the focus of clinical and scientific research in rehabilitation. This article reviews the application status of remote pulmonary rehabilitation for chronic obstructive pulmonary disease under the coronavirus disease 2019 epidemic in recent years. From the selection and method of remote pulmonary rehabilitation equipment before the epidemic, to the development of rehabilitation forms and equipment innovation after the epidemic, the current status and problems of remote pulmonary rehabilitation are clarified. Establishing a remote pulmonary rehabilitation model in line with China’s national conditions is the direction and goal of future development.
Surgery is an essential method of comprehensive treatment for lung cancer, but it also impairs patients’ cardiopulmonary function. A subset of patients who undergo surgery may suffer from postoperative complications, and even death. Preoperative pulmonary rehabilitation is a part of enhanced recovery after surgery, and can improve patients' cardiopulmonary function, reduce postoperative complication rate and shorten hospital stay. It has been already demonstrated a great value in lung cancer surgery. In this review, we summarized the three important components of preoperative pulmonary rehabilitation, including smoking cessation, chest physical therapy, and preoperative exercise training. Moreover, this review outlined the development of pulmonary rehabilitation for lung malignancies, aiming to promote its application and standardization.
ObjectiveTo clarify the effectiveness of preoperative pulmonary rehabilitation (PPR) and provide evidence for the application of PPR on lung cancer patients by meta-analysis.MethodsAccording to inclusion and exclusion criteria, literatures related to PPR on lung cancer patients were retrieved from major databases between the date of establishment of each database and January 2019, and then data required were extracted from the selected literatures. Meta-analysis was conducted by RevMan 5.0.ResultsTwelve randomized controlled trials were involved in meta-analysis, including 658 patients who were well-diagnosed and prepared for surgery, with 307 patients in the PPR group and 351 patients in the control group. The results of the meta-analysis showed that in the PPR group, the pulmonary function including forced vital capacity [MD=0.31, 95%CI (0.21, 0.42), P<0.01], forced expiratory volume in one second [MD=0.27, 95%CI (0.20, 0.34), P<0.01] and activity tolerance including 6-minute walk distance [MD=50.55, 95%CI (35.98, 65.13), P<0.01] were significantly better than the control group, and the postoperative complication rate was lower ［MD=0.28, 95%CI (0.18, 0.43), P<0.01］, postoperative hospital stay was shorter [MD=–2.09, 95%CI (–2.41, –1.77), P<0.01].ConclusionsA period of PPR on lung cancer patients can improve postoperative pulmonary function and activity tolerance, and reduce postoperative complications and hospital stay, which is beneficial to postoperative recovery.
Objective To research the relationship between decrease of serum surfactant protein D (SP-D) level reduced by pulmonary rehabilitation training and postoperative pulmonary complications (PPC). Methods From May 2015 through December 2015, 80 consecutive non-small cell lung cancer (NSCLC) patients with surgical treatment in West China Hospital, who were at least with a high risk factor, were randomly divided into two groups including a group R and a group C. There were 36 patients with 25 males and 11 females at age of 63.98±8.32 years in the group R and 44 patients with 32 males and 12 females at age of 64.58±6.71 years in the group C.The group R underwent an intensive preoperative pulmonary rehabilitation (PR) training for one week, and then with lobectomy. The group C underwent only lobectomy with conventional perioperative managements. Postoperative pulmonary complications, average days in hospital, other clinic data and the serum SP-D level in a series of time from the date of admission to discharge (5 time points) were analyzed. Results The incidence of PPC in the group R was 5.56%(2/36),which was lower than that in the group C (P=0.032). The descender of the serum SP-D level of the patients in the group R (30.75±5.57 ng/mlvs. 24.22±3.08 ng/ml) was more obvious than that in the group C (31.16±7.81 ng/mlvs. 30.29±5.80 ng/ml,P=0.012). The descender of the serum SP-D level of the patients with PPC was more obvious than that of patients without PPC (P=0.012). Conclusion The preoperative PR training could reduce the PPC of lung cancer surgery with high risk factors. The serum SP-D level could reflect the effect of preoperative pulmonary rehabilitation training.
Objective To investigate the knowledge level about pulmonary rehabilitation in respiratory physicians in Shanghai. Methods A self-designed questionnaire about pulmonary rehabilitation was sent to respiratory physicians in 18 tertiary-care referral hospitals of Shanghai from June to September 2011. Results A total of 237 valid questionnaires were collected. Accuracy rate of single-answer questions was(62.1±18.3)% , while correct rate of multiple-answer questions ( more than one answer) was ( 35.5±15.6) % . Neither working years nor doctor rank had correlation with accuracy of questionnaires. Conclusion The knowledge about pulmonary rehabilitation in respiratory physicians of Shanghai was poor. We need to strengthen the relevant training and continuing education.
ObjectiveTo systematically analyse the application of pulmonary rehabilitation in patients with stroke-associated pneumonia (SAP), in order to provide reference for clinical healthcare professionals to carry out relevant interventions. Methods PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were systematically searched, with a search period from database establishment until December 31, 2023. The scoping review method was used to analyze the included studies. Results A total of 16 studies were included, mainly randomized controlled trials and quasi-experimental studies. The research mainly focuses on China and South Korea. The sample size was generally 40-80 cases. The duration of intervention is mostly 2-4 weeks. Six different lung rehabilitation interventions were involved. The main outcome measures included lung function, incidence of SAP, mortality rate, cognitive function, severity of stroke, length of intensive care unit stay, duration of antibiotic use, and daily living activity. Most studies had shown that lung rehabilitation has a significant impact on SAP patients.Conclusions The effectiveness of pulmonary rehabilitation in SAP patients has been preliminarily validated. Future research needs to cover a wider range of regions and larger samples, and conduct long-term tracking studies and multidimensional evaluations to enhance the universality and reliability of the results.
ObjectiveTo understand the obstacles in the practice of pulmonary rehabilitation between doctors and patients.MethodsMedical staff and patients with chronic obstructive pulmonary disease (COPD) in public hospitals in this region were randomly sampled, and a questionnaire survey was conducted on possible obstacles to the practice of pulmonary rehabilitation.ResultsTotal of 265 medical staff and 120 COPD patients were recruited in this survey. The obstacles of pulmonary rehabilitation practice of medical staff in clinical work are poor cooperation of patients and their families (84.2%), medical staff’s insufficient awareness of pulmonary rehabilitation (82.3%), and lack of practice and guidelines (78.9%), lack of objective conditions such as site, equipment and equipment (75.1%), lack of multidisciplinary teams (74.3%), pulmonary rehabilitation has fallen by the wayside (73.6%) etc. The main obstacles for COPD patients in pulmonary rehabilitation are lack of access to relevant knowledge (52.4%), insufficient knowledge (36.5%), inconvenient transportation, economic problems and other objective conditions (33.3%). After multiple correspondence analysis, there are differences in the degree of correlation between obstacle factors and groups with different characteristics.ConclusionsThere are many factors hindering the development of pulmonary rehabilitation and there are certain differences among different populations, but the lack of understanding of pulmonary rehabilitation between doctors and patients is the primary problem. It is necessary to improve the cognition of both doctors and patients on pulmonary rehabilitation, and then to solve the obstacles in the implementation of pulmonary rehabilitation.