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Pulmonary rehabilitation
Affiliation:1. Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;2. Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, Spain;3. Servicio de Neumología, Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense, Madrid, Spain;4. Facultad de Ciencias de la Salud, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain;5. Servicio de Neumología, Hospital Virgen del Rocío, CIBERES, IBIS, Sevilla, Spain;6. Servicio de Neumología, Hospital General Universitario de Elda, Elda, Alicante, Spain;7. Servicio de Neumología, Hospital de Cruces, Ciberes UPV/EHU, Barakaldo, Bizkaia, Spain;8. Servicio de Neumología, Hospital Universitario Central de Asturias, Oviedo, Spain;9. Servicio de Neumología, Hospital Clínico de Valencia, Valencia, Spain;1. Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain;2. Pulmonary Department, Hospital Universitario Miguel Servet, Zaragoza, Spain;3. Pulmonary Department, Hospital Central de Asturias, Oviedo, Spain;4. Pulmonary Department I, Hospital Gregorio Marañon, Madrid, Spain;5. Pulmonary Department, Hospital Son Llátzer, Palma de Mallorca, Madrid, Spain;6. Pulmonary Department, Hospital Son Espases, Palma de Mallorca, Madrid, Spain;7. Pulmonary Department, Fundación Jimenez Diaz, Madrid, Spain;8. Pulmonary Department, Hospital Clinico San Carlos, Madrid, Spain;9. Pulmonary Department, Hospital San Pablo y la Santa Cruz, Barcelona, Spain;10. Pulmonary Department, Hospital Marques de Valdecilla, Santander, Spain;11. Pulmonary Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain;12. Pulmonary Department, Hospital Universitario Reina Sofía, Cordoba, Spain;13. Pulmonary Department, Hospital Universitario de Valme, Sevilla, Spain;14. Pulmonary Department, Hospital de Manacor, Mallorca, Spain;15. Pulmonary Department, Hospital del Mar, Barcelona, Spain;p. Pulmonary Department, Hospital de Terrassa, Terrassa, Spain;q. Pulmonary Department, Hospital de Cruces, UPV/EHU, Bilbao, Spain;r. Pulmonary Department, Hospital General de Castellón, Castellón, Spain;s. Pulmonary Department, Hospital General de Requena, Valencia, Spain;t. Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, Spain;u. Epidemiology and Clinical Research, CIMERA, Bunyola, Mallorca, Spain;v. Pulmonary Department, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain;w. CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain;1. Dept. of Chest Diseases, Faculty of Medicine, Alexandria University, Alexandria, Egypt;2. Dept. of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Alexandria University, Alexandria, Egypt;1. Department of Respiratory Medicine, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Stefan cel Mare Street 165, 2004 Chisinau, Republic of Moldova;2. Chest Centre, Aintree University Hospitals NHS Foundation Trust, Langmoor Lane, Liverpool, Merseyside L9 7AL, United Kingdom;3. University General Hospital, Department of Thoracic Medicine, Stavrakia, 71110 Heraklion, Crete, Greece;1. Hospital del Mar-Hospital de l’Esperança, Grupo de Investigación en Rehabilitación del Institut Hospital del Mar d’Investigacions Mèdiques. Universitat Autònoma de Barcelona, Barcelona, España;2. Hospital Universitari Germans Trias i Pujol, Badalona, España;3. Hospital Universitario La Paz, Madrid, España;4. Hospital Parc Taulí, Sabadell, Universitat Autònoma de Barcelona, Barcelona, España;5. Hospital Comarcal de l’Alt Penedès, Vilafranca del Penedès, Barcelona, España;6. Hospital Universitario Reina Sofía, Córdoba, España;7. Hospital Virgen de las Nieves, Granada, España;8. Hospital del Mar, Barcelona, España;1. Facultad de Salud y Rehabilitación, Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia;2. Facultad de Salud, Escuela de Rehabilitación Humana, Universidad del Valle, Cali, Colombia;3. Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia;4. Facultad de Salud Universidad del Valle, Cali, Colombia
Abstract:Pulmonary rehabilitation (PR) has been shown to improve dyspnea, exercise capacity and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). PR has also shown benefits in diseases other than COPD but the level of evidence is lower. The fundamental components of PR programs are muscle training, education and chest physiotherapy. Occupational therapy, psychosocial support and nutritional intervention should also be considered. Home programs have been shown to be as effective as hospital therapy. The duration of rehabilitation programs should not be less than 8 weeks or 20 sessions. Early initiation of PR, even during exacerbations, has proven safe and effective. The use of oxygen or noninvasive ventilation during training is controversial and dependent on the patient's situation. At present, the best strategy for maintaining the benefits of PR in the long term is unknown. Longer PR programs or telemedicine could play a key role in extending the results obtained.
Keywords:Respiratory therapy  Muscle training  Chronic obstructive pulmonary disease  Diseases other than chronic obstructive pulmonary disease  Location and duration of the programs  Exacerbations  Maintenance  Rehabilitación respiratoria  Entrenamiento muscular  Enfermedad pulmonar obstructiva crónica  Enfermedades distintas de la enfermedad pulmonar obstructiva crónica  Ubicación y duración de los programas  Exacerbaciones  Mantenimiento
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