II. Indications

  1. Moderate to severe COPD with Dyspnea-limited activities or impaired quality of life

III. Components

  1. Pulmonary Rehabilitation Exercise
  2. Nutritional counseling
  3. Education
  4. Behavioral modification

IV. Efficacy

  1. For benefit, program must be if continued for at least 6 months
    1. Reduces Dyspnea and increases Exercise capacity
    2. Improves health status and quality of life
    3. Decreases hospitalizations
    4. Salman (2003) J Gen Intern Med 18(3): 213-21 [PubMed]
    5. Hui (2003) Chest 124:94-7 [PubMed]
  2. Virtual Pulmonary Rehab or Telerehabilitation (phone call, phone app, computer, video conference)
    1. As effective as in-person in reducing breathlessness and increasing walk distance in COPD
    2. Cox (2021) Cochrane Database Syst Rev (1):CD013040 [PubMed]

V. Approach: Exercises

  1. Upper and Lower extremity Exercises
  2. Inspiratory Muscle training
    1. Inspiratory resistance breathing device
  3. Ventilatory therapy and breathing training
  4. Chest physical therapy
  5. Respiratory Muscle rest

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