HISTORY

Question 1

What are the comprehensive approaches

Answer 1

breathing
techniques, exercise therapy, supplemental
oxygen, and bronchial hygiene techniques

Question 2

the Global Initiative for Chronic Obstructive
Lung Disease (GOLD) workshop consensus report
on COPD prominently listed pulmonary rehabilitation
as an established treatment for COPD

Answer 2

2001

Question 3

O’Donnel and colleagues
demonstrated the physiological change underlying
this improvement in dyspnea

Answer 3

1994

Question 4

the first edition of AACVPR’s Guidelines for
Pulmonary Rehabilitation Programs was published

Answer 4

1993

Question 5

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

Answer 5

2003

Question 6

INDICATIONS OF PULMONARY REHABILITATION

Answer 6

● 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

Question 7

update of this document placed this
intervention prominently in their algorithm for the
management of stable COPD

Answer 7

2003

Question 8

ATS published its first statement of
pulmonary rehabilitation

Answer 8

1981

Question 9

What are the bundled interventions?

Answer 9

walking exercises,
supplemental oxygen therapy
bronchial hygiene
techniques
and breathing retraining)

Question 10

Maltais and colleagues reported that
oxidative capacity in lower-extremity skeletal
muscles of patients with COPD was decreased to
normal subjects

Answer 10

1996

Question 11

Richard Casaburi and colleagues reported
on the physiological effects of exercise training in 19
patients with COPD

Answer 11

1991

Question 12

Griffiths and colleagues reported on a
randomized controlled trial of outpatient pulmonary
rehabilitation versus standard care

Answer 12

2000

Question 13

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.

Answer 13

1994

Question 14

Congress passed a bill making pulmonary
rehabilitation a MEdicare reimbursed benefit for
patients with moderate to severe COPD

Answer 14

2009

Question 15

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

Answer 15

1995

Question 16

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

Answer 16

2004

Question 17

LIST AT LEAST 5 ACCP RECOMMENDATIONS

Answer 17

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.

Question 18

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

Answer 18

1994

Question 19

What are the 3 challenges remain despite achieving stature.

Answer 19

1. Increasing availability
2. Widening applicability
   3 Maintaining long-term benefits and
   promoting self-efficacy

Question 20

Bebout and colleagues demonstrated a
health care utilization benefit from pulmonary
rehabilitation

Answer 20

1983