Abstract
Pulmonary rehabilitation has been defined [1] as the ‘art of medical practice where an individually tailored, multidisciplinary program is formulated which through accurate diagnosis, therapy, emotional support and education, stabilizes or reverses both the physio-and psychopathology of pulmonary diseases and attempts to return the patient to the highest possible functional capacity allowed by his pulmonary handicap and overall life situation.’ This global definition indicates the potential difficulties involved in the evaluation of the efficacy of rehabilitation treatment. There is tacit recognition that:
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diagnosis is a component of pulmonary rehabilitation hopefully leading to improved patient characterization before treatment,
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treatment requirements will vary between individuals,
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the program is a process using existing treatments, and designed to integrate together the various components which have proven efficacy, and finally
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at best the patient will remain handicapped by his illness.
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References
Petty, T.L. (1977) Pulmonary rehabilitation. Respir. Care, 22, 68–77.
McSweeny, J. (1988) Quality of life in COPD, in Chronic Obstructive Pulmonary Disease: A Behavioural Perspective. Lung Biology in Health and Disease, (eds J. McSweeny and I. Grant), Vol. 36, Marcel Dekker, New York.
World Health Organization (1977) Manual of the International Classification of Diseases, Injuries and Causes of Death, World Health Organization, Geneva.
Higgins, M. (1993) Epidemiology of obstructive pulmonary disease, in Principles and Practice of Pulmonary Rehabilitation, (eds R. Casaburi and T. Petty), Saunders, Philadelphia.
Petty, T.L. (1993) Pulmonary rehabilitation: a personal historical perspective, in Principles and Practice of Pulmonary Rehabilitation, (eds R. Casaburi and T. Petty), Saunders, Philadelphia.
Hodgkin, J.E., Balchum, O.J., Kass, I. et al. (1975) Chronic obstructive airways diseases. Current concepts in diagnosis and comprehensive care. JAMA, 232, 1243–60.
Proceedings of the Conference on the Scientific Basis of Respiratory Therapy (1974) Am. Rev. Respir. Dis., 110, 51–202.
European Respiratory Society Rehabilitation and Chronic Care Scientific Group (1991). Pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) with recommendations for its use. Eur. Respir. Rev., Review No. 6, 1-568.
Make, B.J. (1986) Pulmonary Rehabilitation, in: Clin. Chest Med., 7, 4th ed., Saunders, Philadelphia.
Clark, C.J. (1994) Setting up a pulmonary rehabilitation programme. Thorax, 49, 270–78.
Barcroft, J. (1934) Features in the Architecture of Physiological Function, Cambridge University Press, Cambridge, England.
American College of Sports Medicine (1980) Guidelines for Graded Exercise Testing and Exercise Prescription, 2nd edn, Lea & Febiger, Philadelphia.
Astrand, P.O. and Rodahl, K (1977) Textbook of Work Physiology, 2nd edn, McGraw-Hill, New York.
Belman, M.J. (1986) Exercise in chronic obstructive pulmonary disease. Clin. Chest Med., 7, 585–97.
Wasserman, K., Hansen, J.E., Sue, D.Y. and Whipp, B.J. (1987) Principles of Exercise Testing and Interpretation, Lea & Febiger, Philadelphia, p. 52.
Casaburi, R., Patessio, A., Loli, F. et al. (1991) Reductions in exercise lactic acidosis and ventilation as a result of exercise training in patients with obstructive lung disease. Am. Rev. Respir. Dis., 143, 9–18.
Casaburi, R. and Wasserman, K. (1986) Exercise training in pulmonary rehabilitation. N. Engl. J. Med., 314, 1509–11.
Casaburi, R. and Petty, T. (eds) (1993) Exercise training in chronic obstructive lung disease, in Principles and Practice of Pulmonary Rehabilitation, Saunders, Philadelphia.
Clausen, J.P. (1976) Circulatory adjustments to dynamic exercise and effect of physical training in normal subjects and patients with coronary artery disease. Prog. Cardiovasc. Dis., 18, 459–95.
Holloszy, J.O. (1976) Adaptations of muscular tissue to training. Prog. Cardiovasc. Dis., 18, 445–58.
Jones, N.L. Kearon, M.C. and Leblanc, P. et al. (1989) Symptoms limiting activity in chronic airflow limitation. Am. Rev. Respir. Dis., 139, A319.
Guell, R., Gimenez, M. and Marchand, M. (1989) Dyspnoea, pain in the legs and quadriceps electro-myographic fatigue at maximal exercise in patients with chronic airway obstruction. Eur. Respir. J., Suppl. 2, 385s.
Allard, C., Jones, N.L. and Killian, K. J. (1989) Static peripheral skeletal muscle strength and exercise capacity in patients with chronic airflow limitation. Am. Rev. Respir. Dis. 138, A90.
Simpson, K., Killian, K., McCartney, N. et al. (1992) Randomised control trial of weight-lifting exercise in patients with chronic airflow limitation. Thorax, 47, 70–5.
Mackay, E., Cochrane, L.M. and Clark, C.J. (1992) The effects of sequential isolated muscle training on peripheral muscle conditioning and exercise tolerance in patients with COPD. Eur. Respir. J., 5 (Suppl. 15): 30S.
Celli, B.R., Rassulo, J. and Make, B.J. (1986) Dyssynchronous breathing during arm but not leg exercise in patients with chronic airflow obstruction. N. Engl. J. Med., 314, 1485–90.
Criner, G.J. and Celli, B.R. (1988) Effect of unsupported arm exercise on ventilatory muscle recruitment in patients with severe chronic airflow obstruction. Am. Rev. Respir. Dis. 138, 856–61.
Ries, A.L., Ellis, B. and Hawkins, R.W. (1988) Upper extremity exercise training in chronic obstructive pulmonary disease. Chest, 93, 688–92.
Lake, F.R., Henderson, K., Briffa, T. et al. (1990) Upper-limb and lower-limb exercise training in patients with chronic airflow obstruction. Chest, 97, 1077–82.
Franklin, B.A. (1985) Exercise testing, training and arm ergometry. Sports Med., 2, 100–19.
Franklin, B.A. (1989) Aerobic exercise training programs for the upper body. Med. Sci. Sports Exerc., 21, S141–S148.
Sue, D.Y., Oren, A., Hansen, J.E. and Wasserman, K. (1987) Diffusing capacity for carbon monoxide as a predictor of gas exchange during exercise. N. Engl. J. Med., 316, 1301–6.
Ries, A.L., Farrow, J.T. and Clausen, J.L. (1988) Pulmonary function tests cannot predict exercise-induced hypoxemia in chronic obstructive pulmonary disease. Chest, 93, 454–9.
Zack, M.B. and Palange, A.V. (1985) Oxygen supplemented exercise of ventilatory and nonventilatory muscles in pulmonary rehabilitation. Chest, 88, 669–74.
Cotes, J.E. and Gilson, J.C. (1956) Effect of oxygen on exercise ability in chronic respiratory insufficiency: Use of portable apparatus. Lancet, 1, 872–6.
Woodcock, A.A., Gross, E.R. and Geddes, D.M. (1981) Oxygen relieves breathlessness in ‘pink puffers’. Lancet, i, 907–9.
Stein, D.A., Bradley, B.L. and Miller, W.C. (1982) Mechanisms of oxygen effects on exercise in patients with chronic obstructive pulmonary disease. Chest, 81, 6–10.
Foster, S., Lopez, D. and Thomas, H.M. (1988) Pulmonary rehabilitation in COPD patients with elevated PCO2. Am. Rev. Respir. Dis., 138, 1519–23.
Pardy, R.L., Reid, D.W. and Belman, M.J. (1988) Respiratory muscle training. Clin. Chest Med., 9, 287–96.
Rochester, D.F. (1988) Does respiratory muscle rest relieve fatigue or incipient failure? Am. Rev. Respir. Dis., 138, 516–7.
Grassino, A. (1989) Inspiratory muscle training in COPD patients. Eur. Respir. J., Suppl. 2, 581s–586s.
Smith, K., Cook, D., Guyatt, G.H. et al. (1992) Respiratory muscle training in chronic airflow limitation: a meta-analysis. Am. Rev. Respir. Dis., 145, 533–9.
Moxham, J. (1990) Respiratory muscle fatigue, mechanisms, evaluation and therapy. Br. J. Anaesth., 65, 43–53.
Laroche, C.M., Moxham, J. and Green, M. (1989) Respiratory muscle weakness and fatigue. Q. J. Med., 71, 373–97.
Dekhuijzen, P.N., Folgering, H.T. and van Herwaarden, C. L. (1991) Target-flow inspiratory muscle training during pulmonary rehabilitation in patients with COPD. Chest, 99, 128–33.
Harver, A., Mahler, D.A. and Daubenspeck, J.A. (1989) Targeted inspiratory muscle training improves respiratory muscle function and reduces dyspnoea in patients with chronic obstructive disease. Ann. Intern. Med., 111, 117–24.
Black, L.F. and Hyatt, R.E. (1969) Maximal respiratory pressures: Normal values and relationship to age and sex. Am. Rev. Respir. Dis., 99, 696–702.
Grimby, G. and Stiksa, J. (1970) Flow-volume curves and breathing patterns during exercise in patients with obstructive lung disease. Scand. J. Clin. Lab. Invest., 25, 303–13.
Potter, W.A., Olafsson, S. and Hyatt, R.E. (1971) Ventilatory mechanics and expiratory flow limitation during exercise in patients with obstructive lung disease. J. Clin. Invest., 50, 910–9.
Stubbing, D.G., Pengelly, L.D., Morse, J.L.C. and Jones, N. (1980) Pulmonary mechanics during exercise in subjects with chronic airflow obstruction. J. Appl. Physiol., 49, 511–5.
Younes, M. (1989) Load responses, dyspnoea and respiratory failure. Chest, 3, 595–685.
Fleury, B., Murciano, C., Talamo, C. et al. (1985) Work of breathing in patients with chronic obstructive pulmonary disease in acute respiratory failure. Am. Rev. Respir. Dis., 131, 822–7.
Haluszka, J., Chartrand, D.A., Grassino, A.E. et al. (1990) Intrinsic PEEP and arterial PCO2 in stable patients with chronic obstructive pulmonary disease. Am. Rev. Respir. Dis., 141, 1194–7.
Smith, T.C. and Marini, J.J. (1988) Impact of PEEP on lung mechanics and work of breathing in severe airflow obstruction. J. Appl. Physiol., 65, 1488–99.
Petrof, B.J., Calderini, E. and Gottfried, S.B. (1990) Effect of CPAP on respiratory effort and dyspnoea during exercise in COPD. J. Appl. Physiol., 69, 179–88.
O’Donnell, D.E., Sanii, R., Gresinecht, G. et al. (1988) Effect of continuous positive airway pressure on respiratory sensation in patients with chronic obstructive pulmonary disease during submaximal exercise. Am. Rev. Respir. Dis., 138, 1185–91.
Barach, A.L. (1955) Breathing exercises in pulmonary emphysema and allied chronic respiratory disease. Arch. Phys. Med. Rehab., 36, 379–90.
Miller, W.F. (1954) A physiologic evaluation of the effects of diaphragmatic breathing training in patients with chronic pulmonary emphysema. Am. J. Med., 17, 471–7.
Faling, J.L. (1993) Controlled breathing techniques and chest physical therapy in chronic obstructive pulmonary disease and allied conditions, in Principles and Practice of Pulmonary Rehabilitation, (eds R. Casaburi and T. Petty), Saunders, Philadelphia.
Mueller, R.E., Petty, T.L. and Filley, G.F. (1970) Ventilation and arterial blood gas changes induced by pursed lip breathing. J. Appl. Physiol., 28, 784–9.
Thoman, R.L., Stoker, G.L. and Ross, J.C. (1966) The efficacy of pursed-lips breathing in patients with chronic obstructive pulmonary disease. Am. Rev. Respir. Dis., 93, 100–5.
Ingram, R.H. Jr and Schilder, D.P. (1967) Effect of pursed lips expiration on the pulmonary pressure-flow relationship in obstructive lung disease. Am. Rev. Respir. Dis., 96, 381–7.
Tiep, B.L., Burns, M., Kao, D. et al. (1986). Pursed lips breathing training using ear oximetry. Chest, 90, 218–21.
Roa, J., Epstein, S., Breslin, E. et al. (1991) Work of breathing and ventilatory muscle recruitment during pursed lip breathing in patients with chronic airway obstruction. Am. Rev. Respir. Dis., 143, A77.
Sharp, J.T., Drutz, W.S., Moisan, T. et al. (1980) Postural relief of dyspnea in severe chronic obstructive pulmonary disease. Am. Rev. Respir. Dis., 122, 201–11.
Delgado, H.R., Braun, SR., Skatrud, J. B. et al. (1982) Chest wall and abdominal motion during exercise in patients with chronic obstructive pulmonary disease. Am. Rev. Respir. Dis., 126, 200–5.
Miller, W.F. (1958) Physical therapeutic measures in the treatment of chronic bronchopulmonary disorders: Methods for breathing training. Am. J. Med. 24, 929–40.
Sinclair, J.D. (1955) The effect of breathing exercises in pulmonary emphysema. Thorax, 10, 246–9.
McNeil, R.S. and McKenzie, J.M. (1955) An assessment of the value of breathing exercises in chronic bronchitis and asthma. Thorax, 10, 250–2.
Willeput, R., Vachaudez, J.P., Lenders, D. et al. (1983) Thoracoabdominal motion during chest physiotherapy in patients affected by chronic obstructive lung disease. Respiration, 44, 204–14.
Brach, B.B., Chao, R.P., Sgroi, V.L. et al. (1977) Xenon washout patterns during diaphragmatic breathing. Studies in normal persons and patients with chronic obstructive pulmonary disease. Chest, 71, 735–9.
Sackner, M.A., Gonzalez, H.F., Jenouri, G. and Rodriguez, M. (1984) Effects of abdominal and thoracic breathing on breathing pattern components in normal subjects and in patients with chronic obstructive pulmonary disease. Am. Rev. Respir. Dis., 130, 584–7.
Wilson, D.O., Rogers, R.M., Hoffman, R.M. (1985) Nutrition and chronic lung disease. Am. Rev. Respir. Dis., 132, 1347–65.
Burrows, B., Niden, A. H., Barclay, W. R. and Kasik, J.E. (1964) Chronic obstructive lung disease. II. Relationship of clinical and physiological findings to the severity of airways obstruction. Am. Rev. Respir. Dis., 91, 665–78.
Renzetti, A.D., McClement, J.H. and Litt, B.D. (1966) The veterans administration cooperative study of pulmonary function. III. Mortality in relation to respiratory function in chronic obstructive pulmonary disease. Am. J. Med., 41, 115–29.
Wilson, D.O., Rogers, R.M., Wright, E.C. and Anthonisen, N. R. (1989) Body weight in chronic obstructive pulmonary disease. The National Institutes of Health intermittent positive-pressure breathing trial. Am. Rev. Respir. Dis., 139, 1435–8.
Boushy, S.F., Adhikari, P.K., Sakamoto, A. and Lewis, B. M. (1964) Factors affecting prognosis in emphysema. Dis. Chest, 45, 402–11.
Thurlbeck, M.M., (1978) Diaphragm and body weight in emphysema. Thorax, 33, 483–7.
Rochester, D.F. and Braun, N.M.T. (1985) Determinants of maximal inspiratory pressure in chronic obstructive pulmonary disease. Am. Rev. Respir. Dis., 132, 42–7.
Donahoe, M., Rogers, R.M., Wilson, D.O. and Pennock, B. E. (1989) Oxygen consumption of the respiratory muscles in normal and in malnourished patients with chronic obstructive pulmonary disease. Am. Rev. Respir. Dis., 140, 385–91.
Sahebjami, H. (1986) Nutrition and the pulmonary parenchyma. Clin. Chest Med., 7, 111–26.
Shennib, H., Chu-Jeng Chiu R., Mulder, D.S. and Lough, J.O. (1984) Depression and delayed recovery of alveolar macrophage function during starvation and refeeding. Surg. Gynecol. Obstet., 158, 535–40.
Goldstein, S.A., Thomashow, B.M., Kvetan, V. et al. (1988) Nitrogen and energy relationships in malnourished patients with emphysema. Am. Rev. Respir. Dis., 138, 636–44.
Fitting, J.W., Frascarolo, Ph., Jequier, E. and Leuenberger, Ph. (1989) Energy expenditure and rib cage-abdominal motion in chronic obstructive pulmonary disease. Eur. Respir. J., 2, 840–5.
Wilson, D.O., Donahoe, M., Rogers, R.M. and Pennock, B.E. (1990) Metabolic rate and weight loss in chronic obstructive lung disease. J. Parenter. Enterai Nutr., 14L, 7–11.
Hugli, O., Schutz, Y., Leuenberger, Ph. and Fitting, J.W. (1991) The daily energy expenditure of COPD patients in confined and free-living conditions. Am. Rev. Respir. Dis., 143, A453.
Lewis, M.I., Belman, M.J. and Door-Uyemura, L. (1987) Nutritional supplementation in ambulatory patients with chronic obstructive pulmonary disease. Am. Rev. Respir. Dis., 135, 1062–8.
Knowles, J.B., Fairbairn, M.S., Wiggs, B.J. et al. (1988) Dietary supplementation and respiratory muscle performance in patients with COPD. Chest, 93, 977–83.
Efthimiou, J., Fleming, J., Gomes, C. and Spiro, S.G. (1988) The effect of supplementary oral nutrition in poorly nourished patients with chronic obstructive pulmonary disease. Am. Rev. Respir. Dis., 137, 1075–82.
Otte, K.F., Ahlburg, P., D’Amore, F. and Stellfield, M. (1989) Nutritional repletion in malnourished patients with emphysema. J. Parenter. Enteral Nutr., 13, 152–6.
Whittaker, J.S., Ryan, C.F., Buckley, P.A. and Road, J.R. (1990) The effects of refeeding on peripheral and respiratory muscle function in malnourished chronic obstructive pulmonary disease patients. Am. Rev. Respir. Dis., 142, 283–8.
Covelli, H.D., Waylon Black, J., Olsen, M.S. and Beekman, J.F. (1981) Respiratory failure precipitated by high carbohydrate loads. Ann. Intern. Med., 95, 579–81.
Angelillo, V.A., Bedi, S., Durfee, D. et al. (1985) Effects of low and high carbohydrate feedings in ambulatory patients with chronic obstructive pulmonary disease and chronic hypercapnia. Ann. Intern. Med., 103, 883–5.
Neish, C.M. and Hopp, J.W. (1988) The role of education in pulmonary rehabilitation. J. Cardiopulmonary Rehabil., 11, 439–41.
Howland, J., Nelson, E.C., Barlow, P.B. et al. (1986) Chronic obstructive airway disease: impact of health education. Chest, 90, 233–8.
Askikaga, T., Vacek, P.M. and Lewis, S.O. (1980) Evaluation of a community-based education programme for individuals with chronic obstructive pulmonary disease. J. Rehabil. Res. Dev., 46, 23–7.
Kaplan, R.M., Eakin, E.G. and Ries, A.L. (1993) Psychosocial issues in the rehabilitation of patients with chronic obstructive pulmonary disease, in Principles and Practice of Pulmonary Rehabilitation, (eds. R. Casaburi and T. Petty), Saunders, Philadelphia.
Clark, C.J. (1993) Evaluating the results of pulmonary rehabilitation treatment, in Principles and Practice of Pulmonary Rehabilitation, (eds. R. Casaburi and T. Petty), Saunders, Philadelphia.
Jones, P.W., Baveystock, C.M. and Littlejohns, P. (1989) Relationships between general health measured with the sickness impact profile and respiratory symptoms, physiological measures and mood in patients with chronic airflow limitation. Am. Rev. Respir. Dis., 140, 1538–43.
Cotes, J.E., Bishop, J.M., Capel, L.H. et al. (1981) Disabling chest disease; prevention and care: a report of the Royal College of Physicians by the College Committee on Thoracic Medicine. J. R. Coll. Physicians Lond., 15, 69–87.
Sackett, D.L. (1976) The magnitude of compliance and non-compliance, in Compliance with Therapeutic Regimens, (eds D.L. Sackett and R.B. Haynes). John Hopkins University Press, Baltimore.
Carmody, T., Senner, J., Malineau, M. and Matarazzo, G. (1980) Physical exercise rehabilitation: long term dropout rate in cardiac patients. J. Behav. Med., 3, 163–8.
Larson, E.B. and Bruce, R.A. (1987) Health benefits of exercise in an aging society. Arch. Intern. Med., 147, 353–6.
Singh, S.J., Morgan, M.D.L., Scott, S. et al. (1992) Development of a shuttle walking test of disability in patients with chronic airways obstructive. Thorax, 47, 1019–24.
McGavin, C.R., Gupta, S.P., Lloyd, E.L. and McHardy, J.R. (1977) Physical rehabilitation of chronic bronchitis; Results of a controlled trial of exercises in the home. Thorax, 32, 307–11.
Ambrosino, N., Paggiaro, P.L., Macchi, M. et al. (1981) A study of short-term effect of rehabilitative therapy in chronic obstructive pulmonary disease. Respiration, 41, 40–4.
Booker, H.A. (1984) Exercise training and breathing control in patients with chronic airflow limitation. Physiotherapy, 70, 258–60.
Sinclair, D.J.M. and Ingram, C.G. (1980) Controlled trial of supervised exercise training in chronic bronchitis. Br. Med. J., 280, 519–21.
Cockroft, A., Bagnall, P., Heslop, A. et al. (1987) Controlled trial of respiratory health worker visiting patients with chronic respiratory disability. Br. Med. J., 294, 225–8.
Tydeman, D.E., Chandler, A.R., Graveling, B.M. et al. (1984) An investigation into the effects of exercise tolerance training on patients with chronic airways obstruction. Physiotherapy, 70, 261–4.
Zack, M.B. and Palange, A.V. (1985) Oxygen supplemented exercise of ventilatory and nonventilatory muscles in pulmonary rehabilitation. Chest, 88, 669–75.
Mohsenifar, Z., Horak, D., Brown, H.V. and Koerner, S. K. (1983) Sensitive indices of improvement in a pulmonary rehabilitation programme. Chest, 83, 189–92.
Mall, R.W. and Medeiros, M. (1989) Objective evaluation of results of a pulmonary rehabilitation programme in a community hospital. Chest, 94, 1156–60.
Bebout, D.E., Hodgkin, J.E., Zorn, E.G. et al. (1983) Clinical and physiological outcomes of a university-hospital pulmonary rehabilitation programme. Respir. Care, 28, 1468–73.
Atkins, C.J., Kaplan, R.M., Timms, R.M. et al. (1984) Behavioral exercise programmes in the management of chronic obstructive pulmonary disease. J. Consult. Clin. Psychol., 52, 591–603.
Dudley, D.L., Glaser, E. M., Jorgenson, B.N. and Logan, D.L. (1980) Psychosocial concomitants to rehabilitation in chronic obstructive pulmonary disease. Part 2. Psychosocial treatment. Chest, 77, 544–684.
Krop, H.D., Block, A.J. and Cohen, E. (1973) Neuropsychologic effects of continuous oxygen therapy in chronic obstructive pulmonary disease. Chest, 64, 317–22.
Williams, S.J. (1989) Chronic respiratory illness and disability: a critical review of the psychosocial literature. Soc. Sci. Med., 28, 791–803.
Renfroe, K.L. (1988) Effect of progressive relaxation on dypnoea and state anxiety patients with chronic obstructive pulmonary disease. Heart Lung, 17, 408–13.
Tandon, M.K. (1978) Adjunct treament with yoga in chronic severe airways obstruction. Thorax, 33, 514–7.
Haas, A. and Cardon, H. (1969) Rehabilitation in chronic obstructive pulmonary disease: a 5 year study of 252 patients. Med. Clin. North Am., 53, 593–606.
Sahn, S.A., Nett, L.M. and Petty, T.L. (1980) Ten year follow-up of a comprehensive rehabilitation programme for severe COPD. Chest, 77, 311–4.
Anthonisen, N.R., Wright, E.C. and Hodgkin, J.E. (1986) Prognosis in chronic obstructive pulmonary disease. Am. Rev. Respir. Dis., 133, 14–20.
Nocturnal Oxygen Therapy Trial Group. (1980) Continuous or nocturnal oxygen therapy in hypoxaemic chronic obstructive lung disease. Ann. Intern. Med., 93, 391–8.
Toevs, C.D., Kaplan, R.M. and Atkins, C.J. (1984) The costs and effects of behavioral programs in chronic obstructive pulmonary disease. Med. Care, 22, 1088–1100.
Petty, T.L., Neff, L.M., Finigan, M.M. et al. (1969) A comprehensive care programme for chronic airways obstruction: methods and preliminary evaluation of symptomatic and functional improvement. Ann. Intern. Med., 70, 1109–20.
Johnson, H.R., Tanzi, F., Balchum, O.J. et al. (1980) Inpatient comprehensive pulmonary rehabilitation in severe COPD. Respir. Ther., May/June, 15–19.
Agle, D.P. Baum, G.L., Chester, E.H. and Wendt, M. (1973) Multidiscipline treatment of chronic pulmonary insufficiency: 1. Psychologic aspects of rehabilitation. Psychosom. Med., 35, 41–9.
Alpert, J.S., Bass, H., Szucs, M.M. et al. (1975) Effects of physical training on hemodynamics and pulmonary function at rest and during exercise in patients with chronic obstructive pulmonary disease. Chest, 66, 647–51.
Hudson, L.D., Tyler, M.L. and Petty, T.L. (1976) Hospitalisation needs during an outpatient rehabilitation programme for severe chronic airway obstruction. Chest, 70, 606–10.
Haas, A. and Cardon, H. (1969) Rehabilitation in chronic obstructive pulmonary disease: a 5 year study of 252 male patients. Med. Clin. North Am., 53, 593–606.
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Clark, C.J. (1995). Pulmonary Rehabilitation. In: Calverley, P.M.A., Pride, N.B. (eds) Chronic Obstructive Pulmonary Disease. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-4525-9_21
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