Pulmonary rehabilitation in chronic obstructive pulmonary disease: A narrative review

Abstract

Background. Chronic obstructive pulmonary disease (COPD) is a potentially fatal respiratory disease characterised by persistent airflow obstruction, hyperinflation and poor pulmonary gas exchange. An important component of its non-pharmacological treatment is pulmonary rehabilitation (PR).

Aim.The aim of this review is to summarize current knowledge on PR and its influence on COPD patients’ condition.

Material and methods. The narrative literature review was conducted using the PubMed and Google Scholar databases. This article included the most recent systematic reviews, meta-analyses,  randomized trials and guidelines.

Results. PR is a multidisciplinary, comprehensive intervention designed to improve physical and psychological condition of patients with COPD. It should be based on an individualized, holistic approach. PR includes exercise training, education, and self-management, often supplemented by psychological and nutritional counseling. Education and self-management interventions support long-term behavioral change leading to optimal outcomes. Evidence shows that rehabilitation improves exercise capacity, reduces dyspnea, decreases anxiety and depression, and may reduce hospitalization rates and mortality following exacerbations and improve quality of life. Exercise training improves ventilatory efficiency, enhances muscle function, and has potential anti-inflammatory effects. Additionally, it can improve balance and reduce skeletal muscle dysfunction. Despite its proven effectiveness, PR is still underused due to various barriers, however its new forms enable easier access.

Conclusions. PR is a crucial component of COPD management. Individualized, multidisciplinary programs significantly improve patient outcomes and quality of life. New models of PR may increase patient participation.