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Pulmonary rehabilitation for patients with acute chronic obstructive pulmonary disease exacerbations: is the evidence strengthening?

Spencer, Lissa

Current Opinion in Pulmonary Medicine: March 2018 - Volume 24 - Issue 2 - p 147–151
doi: 10.1097/MCP.0000000000000453
OBSTRUCTIVE, OCCUPATIONAL AND ENVIRONMENTAL DISEASES: Edited by Manish Joshi and Basil Varkey

Purpose of review This manuscript aims to review the most recent evidence about the benefits of early pulmonary rehabilitation commenced during an acute exacerbation in people with COPD (AECOPD).

Recent findings A number of RCTs and an observational study, published between 2015 and 2017, have used different exercise interventions compared with usual medical care in people with moderate-to-severe COPD during an AECOPD. The results show short-term improvement in walking distance, muscle strength, quality of life and anxiety and depression.

Summary The evidence about early rehabilitation during AECOPD is growing in strength; however, the outcomes and interventions that were used in the RCTs varied from study to study. Unlike pulmonary rehabilitation for people with stable COPD, there is no ideal model of early rehabilitation for people with AECOPD and little information about long-term benefits, for example, attendance at outpatient-based pulmonary rehabilitation and hospital admissions and length of stay. Because of the risks of deconditioning during an AECOPD and the related healthcare costs, early rehabilitation should commence at the bedside. However, more research is required determine the best way to provide early rehabilitation for people with AECOPD.

Department of Physiotherapy, Royal Prince Alfred Hospital, Sydney, Australia

Correspondence to Dr Lissa Spencer, PhD, Department of Physiotherapy, Royal Prince Alfred Hospital, 59 Missenden Road, Camperdown 2050, Sydney, Australia. Tel: +61 2 9515 9857; mobile: +61 407 268 931; e-mails: lissa.spencer@sswahs.nsw.gov.au; lissa.spencer@health.nsw.gov.au

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