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Identifying Candidates for Pulmonary Rehabilitation

  • Thierry TroostersEmail author
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Abstract

Pulmonary rehabilitation is an evidence-based treatment option for patients with respiratory disorders. The numbers needed to treat in order to have one successful participant on a particular outcome are estimated to be around three. Such low numbers are surely speaking for themselves in terms of the overall effectiveness of rehabilitation, but still a number of patients do not benefit from pulmonary rehabilitation, never start the program, or drop out. In this chapter, we will summarize the current state of the art in terms of patient selection for rehabilitation.

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References

  1. 1.
    Langer D, Hendriks E, Burtin C, Probst V, van der Schans C, Paterson W, Verhoef-de WM, Straver R, Klaassen M, Troosters T, et al. A clinical practice guideline for physiotherapists treating patients with chronic obstructive pulmonary disease based on a systematic review of available evidence. Clin Rehabil. 2009;23:445–62.CrossRefPubMedGoogle Scholar
  2. 2.
    Ries AL, Bauldoff GS, Carlin BW, Casaburi R, Emery CF, Mahler DA, Make B, Rochester CL, ZuWallack R, Herrerias C. Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based clinical practice guidelines. Chest. 2007;131:4S–42S.CrossRefPubMedGoogle Scholar
  3. 3.
    Marciniuk DD, Brooks D, Butcher S, Debigare R, Dechman G, Ford G, Pepin V, Reid D, Sheel AW, Stickland MK, et al. Optimizing pulmonary rehabilitation in chronic obstructive pulmonary disease—practical issues: a Canadian Thoracic Society Clinical Practice Guideline. Can Respir J. 2010;17:159–68.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, Chen R, Decramer M, Fabbri LM, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report: gold executive summary. Eur Respir J. 2017;49(3):1700214.CrossRefPubMedGoogle Scholar
  5. 5.
    National institute for Health and Care Excellence (NICE). Chronic obstructive pulmonary disease in adults. 2016. Ref Type: Online Source.Google Scholar
  6. 6.
    Bolton CE, Bevan-Smith EF, Blakey JD, Crowe P, Elkin SL, Garrod R, Greening NJ, Heslop K, Hull JH, Man WD, et al. British thoracic society guideline on pulmonary rehabilitation in adults. Thorax. 2013;68(Suppl 2):ii1–30.CrossRefPubMedGoogle Scholar
  7. 7.
    Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, Hill K, Holland AE, Lareau SC, Man WD, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188:e13–64.CrossRefPubMedGoogle Scholar
  8. 8.
    Piepoli MF, Conraads V, Corra U, Dickstein K, Francis DP, Jaarsma T, McMurray J, Pieske B, Piotrowicz E, Schmid JP, et al. Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Heart Fail. 2011;13:347–57.CrossRefPubMedGoogle Scholar
  9. 9.
    Piepoli MF, Corra U, Adamopoulos S, Benzer W, Bjarnason-Wehrens B, Cupples M, Dendale P, Doherty P, Gaita D, Hofer S, et al. Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology. Eur J Prev Cardiol. 2014;21:664–81.CrossRefPubMedGoogle Scholar
  10. 10.
    Giangregorio LM, Papaioannou A, Macintyre NJ, Ashe MC, Heinonen A, Shipp K, Wark J, McGill S, Keller H, Jain R, et al. Too fit to fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporos Int. 2014;25:821–35.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Rubin RR, Chasan-Taber L, Albright AL, Broun B, American College of Sports Medicine; American Diabetes Association. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: Joint Position Statement. Diabetes Care. 2010;33:e147–67.Google Scholar
  12. 12.
    Executive Summary: Guidelines. For the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society published by the Obesity Society and American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Based on a systematic review from the obesity expert panel, 2013. Obesity (Silver Spring). 2013;22(Suppl 2):S5–39.Google Scholar
  13. 13.
    Qaseem A, Barry MJ, Kansagara D. Nonpharmacologic versus pharmacologic treatment of adult patients with major depressive disorder: a clinical practice guideline from the American college of physicians. Ann Intern Med. 2016;164:350–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Schols AM, Ferreira IM, Franssen FM, Gosker HR, Janssens W, Muscaritoli M, Pison C, Rutten-van MM, Slinde F, Steiner MC, et al. Nutritional assessment and therapy in COPD: a European Respiratory Society statement. Eur Respir J. 2014;44:1504–20.CrossRefPubMedGoogle Scholar
  15. 15.
    Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2016;12:CD005305.PubMedGoogle Scholar
  16. 16.
    Langer D, Burtin C, Schepers L, Ivanova A, Verleden G, Decramer M, Troosters T, Gosselink R. Exercise training after lung transplantation improves participation in daily activity: a randomized controlled trial. Am J Transplant. 2012;12:1584–92.CrossRefPubMedGoogle Scholar
  17. 17.
    Rochester CL, Vogiatzis I, Holland AE, Lareau SC, Marciniuk DD, Puhan MA, Spruit MA, Masefield S, Casaburi R, Clini EM, et al. An official American Thoracic Society/European respiratory society policy statement: enhancing implementation, use, and delivery of pulmonary rehabilitation. Am J Respir Crit Care Med. 2015;192:1373–86.CrossRefPubMedGoogle Scholar
  18. 18.
    Keating A, Lee A, Holland AE. What prevents people with chronic obstructive pulmonary disease from attending pulmonary rehabilitation? A systematic review. Chron Respir Dis. 2011;8:89–99.CrossRefPubMedGoogle Scholar
  19. 19.
    Hayton C, Clark A, Olive S, Browne P, Galey P, Knights E, Staunton L, Jones A, Coombes E, Wilson AM. Barriers to pulmonary rehabilitation: characteristics that predict patient attendance and adherence. Respir Med. 2013;107:401–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Jones SE, Green SA, Clark AL, Dickson MJ, Nolan AM, Moloney C, Kon SS, Kamal F, Godden J, Howe C, et al. Pulmonary rehabilitation following hospitalisation for acute exacerbation of COPD: referrals, uptake and adherence. Thorax. 2014;69:181–2.CrossRefPubMedGoogle Scholar
  21. 21.
    Cox NS, Oliveira CC, Lahham A, Holland AE. Pulmonary rehabilitation referral and participation are commonly influenced by environment, knowledge, and beliefs about consequences: a systematic review using the theoretical domains framework. J Physiother. 2017;63:84–93.CrossRefPubMedGoogle Scholar
  22. 22.
    Steiner MC, Lowe D, Beckford K, Blakey J, Bolton CE, Elkin S, Man WD, Roberts CM, Sewell L, Walker P, et al. Socioeconomic deprivation and the outcome of pulmonary rehabilitation in England and Wales. Thorax. 2017;72:530–7.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Karmali KN, Davies P, Taylor F, Beswick A, Martin N, Ebrahim S. Promoting patient uptake and adherence in cardiac rehabilitation. Cochrane Database Syst Rev. 2014;6:CD007131.Google Scholar
  24. 24.
    Mathar H, Fastholm P, Lange P, Larsen NS. Why do patients decline participation in offered pulmonary rehabilitation? A qualitative study. Clin Rehabil. 2017:269215517708821.Google Scholar
  25. 25.
    Ko FW, Cheung NK, Rainer TH, Lum C, Wong I, Hui DS. Comprehensive care programme for patients with chronic obstructive pulmonary disease: a randomised controlled trial. Thorax. 2016;72(2):107–8.Google Scholar
  26. 26.
    Janssen DJ, McCormick JR. Palliative care and pulmonary rehabilitation. Clin Chest Med. 2014;35:411–21.CrossRefPubMedGoogle Scholar
  27. 27.
    McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015;2:CD003793.Google Scholar
  28. 28.
    Bouchard C. Genomic predictors of trainability. Exp Physiol. 2012;97:347–52.CrossRefPubMedGoogle Scholar
  29. 29.
    Thomaes T, Thomis M, Onkelinx S, Fagard R, Matthijs G, Buys R, Schepers D, Cornelissen V, Vanhees L. A genetic predisposition score for muscular endophenotypes predicts the increase in aerobic power after training: the CAREGENE study. BMC Genet. 2011;12:84.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Troosters T, Gosselink R, Decramer M. Exercise training in COPD: how to distinguish responders from nonresponders. J Cardpulm Rehabil. 2001;21:10–7.CrossRefGoogle Scholar
  31. 31.
    Walsh JR, Morris NR, McKeough ZJ, Yerkovich ST, Paratz JD. A simple clinical measure of quadriceps muscle strength identifies responders to pulmonary rehabilitation. Pulm Med. 2014;2014:782702.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Burtin C, Saey D, Saglam M, Langer D, Gosselink R, Janssens W, Decramer M, Maltais F, Troosters T. Effectiveness of exercise training in patients with COPD: the role of muscle fatigue. Eur Respir J. 2012;40:338–44.CrossRefPubMedGoogle Scholar
  33. 33.
    Mador MJ, Mogri M, Patel A. Contractile fatigue of the quadriceps muscle predicts improvement in exercise performance after pulmonary rehabilitation. J Cardiopulm Rehabil Prev. 2014;34:54–61.CrossRefPubMedGoogle Scholar
  34. 34.
    Saey D, Debigare R, LeBlanc P, Mador MJ, Cote CH, Jobin J, Maltais F. Contractile leg fatigue after cycle exercise: a factor limiting exercise in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2003;168:425–30.CrossRefPubMedGoogle Scholar
  35. 35.
    Vagaggini B, Costa F, Antonelli S, De SC, De CG, Martino F, Santerini S, Paggiaro P. Clinical predictors of the efficacy of a pulmonary rehabilitation programme in patients with COPD. Respir Med. 2009;103:1224–30.CrossRefPubMedGoogle Scholar
  36. 36.
    Selzler AM, Simmonds L, Rodgers WM, Wong EY, Stickland MK. Pulmonary rehabilitation in chronic obstructive pulmonary disease: predictors of program completion and success. COPD. 2012;9:538–45.CrossRefPubMedGoogle Scholar
  37. 37.
    Maddocks M, Kon SS, Canavan JL, Jones SE, Nolan CM, Labey A, Polkey MI, Man WD. Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study. Thorax. 2016;71:988–95.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Barberan-Garcia A, Rodriguez DA, Blanco I, Gea J, Torralba Y, Arbillaga-Etxarri A, Barbera JA, Vilaro J, Roca J, Orozco-Levi M. Non-anaemic iron deficiency impairs response to pulmonary rehabilitation in COPD. Respirology. 2015;20:1089–95.CrossRefPubMedGoogle Scholar
  39. 39.
    Troosters T, Demeyer H, Hornikx M, Camillo CA, Janssens W. Pulmonary rehabilitation. Clin Chest Med. 2014;35:241–9.CrossRefPubMedGoogle Scholar
  40. 40.
    Paneroni M, Colombo F, Papalia A, Colitta A, Borghi G, Saleri M, Cabiaglia A, Azzalini E, Vitacca M. Is telerehabilitation a safe and viable option for patients with COPD? A feasibility study. COPD. 2015;12:217–25.CrossRefPubMedGoogle Scholar
  41. 41.
    Camillo CA, Burtin C, Hornikx M, Demeyer H, De BK, van RH, Osadnik CR, Janssens W, Troosters T. Physiological responses during downhill walking: a new exercise modality for subjects with chronic obstructive pulmonary disease? Chron Respir Dis. 2015;12:155–64.CrossRefPubMedGoogle Scholar
  42. 42.
    MacMillan NJ, Kapchinsky S, Konokhova Y, Gouspillou G, de Sousa SR, Jagoe RT, Baril J, Carver TE, Andersen RE, Richard R, et al. Eccentric ergometer training promotes locomotor muscle strength but not mitochondrial adaptation in patients with severe chronic obstructive pulmonary disease. Front Physiol. 2017;8:114.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Neder JA, Sword D, Ward SA, Mackay E, Cochrane LM, Clark CJ. Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with chronic obstructive pulmonary disease (COPD). Thorax. 2002;57:333–7.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Puhan MA, Busching G, Schunemann HJ, van Oort E, Zaugg C, Frey M. Interval versus continuous high-intensity exercise in chronic obstructive pulmonary disease: a randomized trial. Ann Intern Med. 2006;145:816–25.CrossRefPubMedGoogle Scholar
  45. 45.
    Puhan MA, Schunemann HJ, Buesching G, van Oort E, Spaar A, Frey M. COPD patients’ ability to follow exercise influences short-term outcomes of rehabilitation. Eur Respir J. 2008;31:304–10.CrossRefPubMedGoogle Scholar
  46. 46.
    Vogiatzis I, Nanas S, Roussos C. Interval training as an alternative modality to continuous exercise in patients with COPD. Eur Respir J. 2002;20:12–9.CrossRefPubMedGoogle Scholar
  47. 47.
    Vogiatzis I, Terzis G, Nanas S, Stratakos G, Simoes DC, Georgiadou O, Zakynthinos S, Roussos C. Skeletal muscle adaptations to interval training in patients with advanced COPD. Chest. 2005;128:3838–45.CrossRefPubMedGoogle Scholar

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© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Rehabilitation Sciences, KU Leuven, Respiratory Division and RehabilitationUniversity Hospital LeuvenLeuvenBelgium

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