Rehabilitation in chronic respiratory diseases: In-hospital and post-exacerbation pulmonary rehabilitation.
Wadah IbrahimTheresa C Harvey-DunstanNeil J GreeningPublished in: Respirology (Carlton, Vic.) (2019)
Exacerbations of chronic obstructive pulmonary disease (COPD) that require hospitalization are important events for patients. Functional impairment and skeletal muscle dysfunction can increase the risk of hospitalization and readmission, independent of lung function. In addition, once a patient is admitted, multiple factors can lead to worsening outcome including immobility, systemic inflammation and nutritional depletion. These non-pulmonary factors are potentially amenable to exercise therapy, as part of pulmonary rehabilitation (PR). Peri-exacerbation PR has an important role in the management of exacerbations of COPD. In this review, we explore how functional limitation and skeletal muscle dysfunction affect patients having a severe exacerbation of COPD, the systemic impact of hospitalization on patients including potential aetiologies and the role of PR around the time of an exacerbation. This includes rehabilitation during the inpatient phase, post-exacerbation rehabilitation and rehabilitation bridging hospital discharge. We also describe potential future developments in peri-exacerbation PR.
Keyphrases
- chronic obstructive pulmonary disease
- lung function
- skeletal muscle
- end stage renal disease
- ejection fraction
- newly diagnosed
- pulmonary hypertension
- stem cells
- type diabetes
- healthcare
- metabolic syndrome
- air pollution
- mental health
- patient reported outcomes
- physical activity
- bone marrow
- risk assessment
- human health
- acute care
- extracorporeal membrane oxygenation
- patient reported
- smoking cessation