HISTORY Flashcards
What are the comprehensive approaches
breathing
techniques, exercise therapy, supplemental
oxygen, and bronchial hygiene techniques
the Global Initiative for Chronic Obstructive
Lung Disease (GOLD) workshop consensus report
on COPD prominently listed pulmonary rehabilitation
as an established treatment for COPD
2001
O’Donnel and colleagues
demonstrated the physiological change underlying
this improvement in dyspnea
1994
the first edition of AACVPR’s Guidelines for
Pulmonary Rehabilitation Programs was published
1993
Bourbeau and colleagues showed that an
outpatient self-management educational program
can have substantial benefits for patients with
COPD, including a 40% reduction in hospitalization
and a 59% reduction in unscheduled physician visits
2003
INDICATIONS OF PULMONARY REHABILITATION
● Symptomatic patients with COPD - usually GOLD
stage III (severe) and stage IV (very severe), but
stage Ii (moderate) may also be considered
● Patients with bronchial asthma and associated
bronchitis (asthmatic bronchitis)
● Patients with combined obstructive and
restrictive ventilatory defects
● Patients with chronic mucociliary clearance
problems
● Patients with exercise limitations because of
severe dyspnea
update of this document placed this
intervention prominently in their algorithm for the
management of stable COPD
2003
ATS published its first statement of
pulmonary rehabilitation
1981
What are the bundled interventions?
walking exercises,
supplemental oxygen therapy
bronchial hygiene
techniques
and breathing retraining)
Maltais and colleagues reported that
oxidative capacity in lower-extremity skeletal
muscles of patients with COPD was decreased to
normal subjects
1996
Richard Casaburi and colleagues reported
on the physiological effects of exercise training in 19
patients with COPD
1991
Griffiths and colleagues reported on a
randomized controlled trial of outpatient pulmonary
rehabilitation versus standard care
2000
Goldstein and colleagues
demonstrated that pulmonary rehabilitation improves
health-related quality of life, further demonstrating
that pulmonary rehabilitation leads to improvement in
patient-centered outcomes.
1994
Congress passed a bill making pulmonary
rehabilitation a MEdicare reimbursed benefit for
patients with moderate to severe COPD
2009
Ries and colleagues reported on 119 COPD
patients who were randomized to either 8 weeks of
comprehensive outpatient pulmonary rehabilitation
or 8 weeks of education only
1995
American Thoracic Society/European Respiratory
Society COPD guidelines clearly place pulmonary
rehabilitation among their interventions for COPD.
these documents represent a monumental step in
the acceptance of pulmonary rehabilitation as a gold
standard of the care of COPD
2004
LIST AT LEAST 5 ACCP RECOMMENDATIONS
1 A program of exercise training of
the muscles of ambulation is recommended as a
mandatory component of pulmonary rehabilitation for
patients with COPD
2. Pulmonary Rehabilitation
improves the symptom of dyspnea in patients with
COPD
3. Pulmonary Rehabilitation
improves health-related quality of life in patients with
COPD.
4. Pulmonary Rehabilitation
reduces the number of hospital days and other
measures of health care utilization in patients with
COPD.
5. Pulmonary Rehabilitation is costeffective in patients with COPD
6. There is insufficient evidence to
determine if pulmonary rehabilitation improves
survival in patients with COPD.
Reardon and colleagues showed that a
group of patients completing outpatient pulmonary
rehabilitation had less exertional dyspnea than a
control group who received otherwise standard care
1994
What are the 3 challenges remain despite achieving stature.
- Increasing availability
- Widening applicability
3 Maintaining long-term benefits and
promoting self-efficacy
Bebout and colleagues demonstrated a
health care utilization benefit from pulmonary
rehabilitation
1983
