Pulmonary Rehabilitation

Cover
Half Title
Title Page
Copyright Page
Contents
Foreword
About the Book
Preface
Editors
Contributors
Part 1: The foundation of pulmonary rehabilitation
	1. A framework for medical rehabilitation: Restoring function and improving quality of life
		Introduction
		A unifying model for rehabilitation: The International Classification of Functioning, Disability and Health
		The approach to rehabilitation assessment
		Unpacking the black box of rehabilitation: Important service delivery considerations and questions
		Measuring the benefits of rehabilitation
		Summary
		Conflict of interest
		References
	2. Pulmonary rehabilitation: The development of a scientific discipline
		Introduction
		Definition and concepts
		History
		Summary
		References
	3. Key concepts in pulmonary rehabilitation
		Definition and concept
		Exercise training
		Non-exercising interventions
		Future perspectives for PR
		Summary
		References
	4. Enhancing use and delivery of pulmonary rehabilitation
		Introduction
		Knowledge and awareness of pulmonary rehabilitation
		Access, uptake and adherence to pulmonary rehabilitation
		Use of pulmonary rehabilitation services compared to other effective therapies in COPD
		Ensuring quality of PR programmes
		Conclusion
		Summary
		References
	5. Pathophysiological basis, evaluation and rationale of exercise training
		Introduction
		Pathophysiological basis of exercise training
		Rationale of exercise testing
		Exploring factors explaining exercise limitation
		Rationale of exercise training
		Benefits of exercise training
		Summary
		References
	6. Education: Realizing the potential for learning in pulmonary rehabilitation
		Overview
		History of education in pulmonary rehabilitation
		Examining outcomes from education
		Educational design for pulmonary rehabilitation
		Factors that influence learning
		Digital pulmonary rehabilitation education
		Summary
		References
	7. Self-management
		Introduction
		Definition of self-management interventions
		Self-management interventions in COPD
		Gap between the current best evidence, guidelines and practice
		Model of care that includes pulmonary rehabilitation enhanced with self-management
		Summary and clinical implications
		References
	8. Dual therapy: Pharmacologic management in pulmonary rehabilitation
		Introduction
		Bronchodilators
		Supplemental oxygen and heliox
		Anabolic agents
		Nutritional supplements
		Other pharmacologic agents
		Summary
		References
Part 2: Evaluation and management
	9. Respiratory muscle function in rehabilitation
		Introduction
		Indications
		Respiratory muscle assessment, theoretical considerations
		Place of assessment of respiratory muscle function in some typical rehabilitation scenarios
		Summary
		References
	10. Peripheral muscles
		Introduction
		Epidemiology and natural history
		Causes
		Structural and biological changes
		Evaluation of limb muscle mass
		Evaluation of limb muscle strength
		Evaluation of muscle endurance
		Effects of interventions on limb muscle function in COPD
		Summary
		References
	11. Anxiety and depression in patients with chronic respiratory disease
		Introduction
		Depression
		Anxiety
		Barriers to depression and anxiety management in COPD
		Treatment approaches for depression and anxiety in patients with COPD
		Clinical tips
		Summary
		References
	12. Dyspnoea
		Introduction
		What is dyspnoea?
		Impact of dyspnoea in patients who have respiratory disease
		Descriptors of dyspnoea
		Measurements of dyspnoea for pulmonary rehabilitation
		Effects of pulmonary rehabilitation on relieving dyspnoea
		Responders versus non-responders
		Mechanisms for relief of dyspnoea with pulmonary rehabilitation
		Summary
		References
	13. Nutritional management in pulmonary rehabilitation
		Introduction
		Nutritional risk
		Nutritional risk for development and progression of COPD
		Nutritional risk for decreased physical performance
		Nutritional risk for cardiovascular disease
		Pharmaconutrients
		Nutrition as part of integrated disease management
		Summary
		References
	14. Balance impairment
		Introduction
		Balance and its assessment
		Balance deficits in chronic lung disease
		Balance assessment in pulmonary rehabilitation
		Approaches to balance training as part of pulmonary rehabilitation
		Conclusion
		summary
		References
	15. Monitoring of physical activity
		Physical activity: A clinically relevant (new) measure in pulmonary rehabilitation
		Measurement of physical activity
		Interpretation of PA in the context of pulmonary rehabilitation
		Sedentary behaviour, a closely related concept
		Summary
		References
	16. Monitoring health status
		Why measure health status?
		Measuring and monitoring health status
		St. George’s Respiratory Questionnaire
		Chronic Respiratory Questionnaire
		COPD Assessment Test
		Clinical COPD Questionnaire
		Pulmonary rehabilitation and health status in COPD: Randomized, controlled trials
		Comparison of pulmonary rehabilitation and pharmacologic therapy on health status in COPD
		Pulmonary rehabilitation following exacerbations of COPD
		Pulmonary rehabilitation and health status in respiratory patients with diseases other than COPD
		Summary
		References
Part 3: How, Who and Where?
	17. Establishing a pulmonary rehabilitation programme
		Introduction
		The process
		Outcome data
		Conclusion
		Summary
		References
	18. Quality assurance and control in pulmonary rehabilitation
		Introduction
		Quality control and assurance in PR
		Quality standards
		Pulmonary rehabilitation audit
		Pulmonary rehabilitation certification and accreditation schemes
		Pulmonary rehabilitation accreditation, certification and supporting processes in the US and UK
		The dissemination of audit data and the development of quality improvement in PR
		Broader impacts and future direction
		Quality improvement resources
		References
	19. The ideal candidate
		Introduction
		Guidance criteria for inclusion in pulmonary rehabilitation
		Responders and non-responders to PR
		Contraindications to pulmonary rehabilitation
		Adapting the pulmonary rehabilitation programme to different candidates
		Final remarks
		Summary
		References
	20. Rehabilitation team
		Definition
		Composition of the interdisciplinary PR team
		Interdisciplinary pulmonary rehabilitation programme
		Advantages
		Barriers
		Summary
		References
	21. Modalities of exercise training
		Introduction
		Exercise assessment tests
		Modalities of exercise types
		Exercise prescription
		Supervision during training
		Safety and recording during training
		Oxygen supplementation
		Summary
		References
	22. Physiotherapy and airway clearance
		Introduction
		Impairment of mucus elimination and clinical indications for airway clearance physiotherapy techniques
		Control of mucus and airway clearance techniques
		Mechanical respiratory muscle aids for secretion management
		Summary
		References
	23. Smoking cessation
		Introduction
		Smoking cessation: An overview
		Smoking cessation in pulmonary rehabilitation
		Summary
		References
	24. Early rehabilitation following exacerbation of COPD
		Introduction
		Consequences of acute exacerbations
		Early pulmonary rehabilitation in the exacerbation setting – the evidence base
		Challenges in delivering early rehabilitation following exacerbation
		Implementation of early rehabilitation after an exacerbation
		Further research
		Summary
		References
	25. Personalized rehabilitation
		Introduction
		Definitions
		Personalized rehabilitation
		Personalized comprehensive management
		Awareness
		Present evidence
		Future
		Summary
		References
	26. Pulmonary rehabilitation and primary care
		Introduction
		Epidemiology of the problem
		Barriers to adaptation
		Outcomes
		Outlook
		Summary
		References
	27. Home rehabilitation
		What is the rationale for home-based rehabilitation?
		Patient factors and perceptions
		Alternative forms of rehabilitation
		Supervision of participants
		Access to staff
		The evidence
		Studies in the literature
		Technology
		Post exacerbation home-based studies
		Maintenance programmes
		Non-COPD populations
		Conclusion
		Summary
		References
	28. Telerehabilitation
		Definition, rationale and opportunities for telerehabilitation
		Telerehabilitation: Signals and models used
		Telerehabilitation in COPD
		Telerehabilitation in chronic respiratory insufficiency patients
		Risk/disadvantages
		Economic considerations  (cost-effectiveness data)
		Future directions and conclusions
		Summary
		References
	29. Living with chronic lung disease: The experiences and needs of patients and caregivers
		Introduction
		Living with a chronic lung disease from the perspective of patients and caregivers
		Pulmonary rehabilitation to support the family through the chronic lung disease journey
		Real-world testimonials of patients and caregivers
		Conclusion
		Summary
		Acknowledgements
		References
Part 4: New Approaches to Exercise Training
	30. Partitioned aerobic exercise training of ventilatory-limited patients with chronic respiratory disease
		Overview
		Background
		Application
		Summary
		References
	31. Whole-body vibration training
		Introduction
		WBVT platforms techniques
		Summary
		References
	32. Neuromuscular electrical stimulation
		Introduction
		Principles of NMES
		Clinical effects of NMES
		Role in rehabilitation toolkit
		Summary
		References
	33. A role for water-based rehabilitation
		Introduction
		Aquatic therapy
		Water-based exercise for people with COPD
		Conditions affecting the lower limbs and aquatic therapy
		Special considerations for exercise in the aquatic environment
		Special considerations for people with COPD for exercise in the aquatic environment
		Summary
		References
	34. Sedentarism and light-intensity physical activity (in COPD)
		Introduction
		What do we know about sedentary time in people with COPD?
		What are the health consequences of sedentary behaviour in the general population and those with COPD?
		What is the physiological basis for sedentary behaviour being harmful?
		Considerations when applying an intervention to reduce sedentary time in COPD
		A behavioural science approach to sedentarism in COPD
		Summary and conclusions
		References
Part 5: Diseases Other than COPD
	35. The multi-morbidity patient
		Multi-morbidity in patients with COPD
		The multi-morbid COPD patient: A model in rehabilitation
		How multi-morbidity might impact outcomes of pulmonary rehabilitation
		The effects of tailored pulmonary rehabilitation in multi-morbid patients
		Conclusion
		Summary
		References
	36. Is there any role for pulmonary rehabilitation in asthma?
		Introduction
		Patients
		Types of intervention
		Summary
		References
	37. Neuromuscular disorders
		Introduction
		Pathophysiology
		What are respiratory muscle aids?
		Patient evaluation
		The intervention objectives
		Long-term management
		Glossopharyngeal breathing (GPB)
		Oximetry monitoring and feedback protocol
		Long-term outcomes
		Extubation of unweanable patients
		Decannulation of unweanable patients
		Summary
		References
	38. Interstitial lung diseases
		Introduction
		Comprehensive symptom management
		Pulmonary rehabilitation
		Conclusion
		Summary
		References
	39. Management of suppurative lung diseases
		Background
		Healthcare utilization in non-cystic fibrosis bronchiectasis
		The implications of chronic sputum
		Physiological consequences of bronchiectasis
		Benefits of airway clearance techniques
		Pulmonary rehabilitation in non-CF bronchiectasis
		Physical activity in cystic fibrosis
		Effect of cystic fibrosis on skeletal muscle dysfunction
		Airway clearance techniques in cystic fibrosis
		Summary
		Financial support
		Conflicts of interest
		References
	40. Rehabilitation in the intensive care unit
		Introduction
		Consequences of acute illness
		Management of muscle weakness
		Management of airway secretions
		Prevention of cognitive impairment
		Technical considerations
		Conclusion
		Summary
		References
	41. Chronic respiratory failure – pathophysiology
		Introduction and definition
		Overview
		Causes of chronic hypercapnic respiratory failure
		Chronic respiratory failure - diagnosis
		Summary
		References
		Further Reading
	42. Lung transplantation
		Introduction
		Rehabilitation before transplantation
		Immediate post-transplant rehabilitation
		Outpatient rehabilitation phase (hospital discharge up to 12 months post-transplant)
		Long-term post-transplant phase (greater than 12 months post-transplant)
		Conclusions and research needs
		Summary
		References
	43. Lung volume reduction - old and new approaches
		Introduction
		Rationale for reducing lung volume reduction
		Lung volume reduction surgery
		Nonsurgical approaches to lung volume reduction
		Summary
		References
Part 6: Add-on interventions
	44. Supplemental oxygen and heliox
		Introduction
		Dynamic hyperinflation of the lung during exercise
		Supplemental oxygen breathing
		Low-density gas mixture breathing
		Relevance to rehabilitation programmes
		Summary
		References
	45. Noninvasive ventilation during exercise training
		Introduction
		Exercise training for patients with chronic respiratory failure
		Physiological effects of NIV on exercise
		Noninvasive ventilation and exercise training
		Technicalities
		Future research
		Alternative strategies
		Summary
		References
	46. COPD patients requiring chronic nocturnal noninvasive ventilation
		Introduction
		Mechanisms of action
		Chronic noninvasive ventilation in stable COPD
		Chronic noninvasive ventilation after acute respiratory failure
		Issues to be solved
		Summary
		References
	47. More tools in the toolbox
		Introduction
		Music listening during PR
		Singing
		Tai Chi
		Yoga
		Active video games
		Dance in COPD
		Conclusion
		Summary
		References
	48. Palliative care and end of life
		Introduction
		Palliative care
		Dyspnoea
		Fatigue
		Cough
		Pain
		Integration of palliative care with pulmonary rehabilitation
		Decision making
		A place to die
		Conclusion
		Summary
		References
	49. Economical evaluation
		Introduction
		COPD
		Interstitial lung disease and pulmonary fibrosis
		Bronchiectasis
		Summary
		References
	50. Pulmonary rehabilitation in the integrated care of the chronic respiratory patient
		Introduction
		Integrated care and the chronic care model
		Similar, but not identical, concepts
		Telemedicine
		Pulmonary rehabilitation
		Pulmonary rehabilitation and integrated care
		Summary
		References
	51. Pulmonary rehabilitation in post-acute patients with COVID-19
		Introduction
		General recommendations
		Principles of rehabilitation
		Lessons from ARDS and other pandemics
		Prevention of spread of infection
		The intervention
		Future directions
		Conclusion
		References
Index