That’s where pulmonary rehabilitation comes in. While the influence of pulmonary rehabilitation on dyspnoea, … a home‐based walking programme) seems acceptable for patients with a mild degree of complexity. However, this approach is in line with new initiatives, such as COPDnet, where patients with COPD are referred to different care settings with a different treatment modality and intensity after an extensive screening in the secondary care setting.27, 28, To run a hospital‐based pulmonary rehabilitation programme for the most complex patients with COPD, the involvement of multiple, skilled healthcare professionals with COPD‐specific knowledge seems imperative.1 For example, physiotherapists should be aware of the various treatment possibilities, including neuromuscular electrical stimulation29, 30 and exercise training combined with non‐invasive ventilation31; or dieticians should be trained to modulate patient's nutritional pattern, taking body composition abnormalities (i.e. Patient Educ Couns. Future projects should strive for a standard set of assessment measures to identify patients eligible for pulmonary rehabilitation, taking disease complexity into consideration, which should result in referral to an appropriate rehabilitation setting. However, if you look carefully, it is much more than just a knife and you have to be an expert to carefully apply all its features (Fig. from the pulmonary rehabilitation (PR) organisational audit component of the National Asthma and COPD Audit Programme (NACAP). This approach, applying some of the core components of pulmonary rehabilitation, confers short‐term improvements in the level of breathlessness, exercise tolerance and disease‐specific quality of life, with no significant difference compared to outpatient pulmonary rehabilitation.39 To date, however, it is not possible to exclude non‐inferiority.40, The development of home‐based intervention is, at least in part, the result of (i) a lack of financial resources to start up new rehabilitation locations in rural areas41; (ii) local healthcare policies42; (iii) initiatives by local researchers/clinicians; (iv) the unwillingness of payers to expand the capacity of existing programmes; (v) a reduction of costs of healthcare in general, and pulmonary rehabilitation in particular; (vi) patient choice43; and/or (vii) ignoring the complexity and heterogeneity in a subgroup of patients with high degree of unpredictability of the clinical course.44. Modern and effective pulmonary rehabilitation programs are global, multidisciplinary, individualized and use comprehensive approach acting on the patient as a whole and not only on the pulmonary component of the disease. for a targeted therapy. For many years, PR has been recommended by professional associations around the world as an essential … An individualized session to go over results of tests, program recommendations, exercise prescription and any questions you may have 7. 2010 Jun;28(2):130-45. doi: 10.1037/a0020249. The four-factor structure proposed enables future studies of PRAISE construct convergent validity, by a cross-sectional comparison of scores of other Pulmonary Rehabilitation instruments with PRAISE results,16, 21 such as those presented by Vincent 2 and Song. Further studies are needed in order to define the long-term benefits as well as the optimal programme structure to get the greatest effects. Pulmonary rehabilitation can help you gain strength, reduce symptoms of anxiety or depression, and make it easier to manage routine activities, work, and outings or social activities that you enjoy. Effectiveness of non-pharmacological COPD management on health-related quality of life - a systematic review. Modern literature for rationale, physiopathological basis, structure, exercise training as well challenges for pulmonary rehabilitation programs are addressed. Local circumstances may complicate this crucial endeavour. Professor Dr E.F.M.W. Is the training intensity during the home‐based programme intense enough to improve exercise capacity in COPD patients with a mildly impaired exercise tolerance at the start of the intervention45? Supervision and structure. To date, pulmonary rehabilitation programmes show a lot of variation in setting, content, frequency and duration. 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