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肺康复:我们所知道的与我们需要知道的

Pulmonary rehabilitation: WHAT WE KNOW AND WHAT WE NEED TO KNOW.

作者信息

Nici Linda, Raskin Jonathan, Rochester Carolyn L, Bourbeau Jean C, Carlin Brian W, Casaburi Richard, Celli Bartolome R, Cote Claudia, Crouch Rebecca H, Diez-Morales Luis F, Donner Claudio F, Fahy Bonnie F, Garvey Chris, Goldstein Roger, Lane-Reticker Alison, Lareau Suzanne C, Make Barry, Maltais François, McCormick James, Morgan Michael D L, Ries Andrew, Troosters Thierry, ZuWallack Richard

机构信息

Providence VA Medical Center, Brown University School of Medicine, Providence, Rhode Island, USA.

出版信息

J Cardiopulm Rehabil Prev. 2009 May-Jun;29(3):141-51. doi: 10.1097/HCR.0b013e3181a85cda.

Abstract

The multidisciplinary treatment of pulmonary rehabilitation (PR), which includes exercise training, self-management education, and psychosocial and nutritional intervention, is now a standard of care for chronic obstructive pulmonary disease (COPD) and has been incorporated into major guidelines. We must now focus efforts on improving its impact and widening its applicability. What is the direction of PR; where does it fit in the comprehensive care of the COPD patient; and how can clinicians best apply this important intervention? This was the charge of the roundtable discussion, Pulmonary Rehabilitation: Moving Forward, involving 20 experts from North America and Europe, which was convened in Fort Lauderdale, Florida, in early 2008. It is not meant to be an exhaustive review; rather, this report summarizes the roundtable proceedings, while providing direction to best position PR into the continuum of COPD care. By consensus, it was agreed upon that although PR is effective for other chronic respiratory diseases, the discussion focus was COPD since most of the evidence base and patient referral are for this disease. These proceedings provide insight into 3 broad areas appropriate for investigation or implementation: positioning PR in an integrated care model for COPD patients; improving the effectiveness of this intervention; and expanding the recognition, application, and accessibility to PR. It is the hope that this document will provide a catalyst for clinicians, investigators, and healthcare policy makers to help realize these goals as well as serve to suggest important areas for future research and development in PR.

摘要

肺康复(PR)的多学科治疗包括运动训练、自我管理教育以及心理社会和营养干预,现已成为慢性阻塞性肺疾病(COPD)的标准治疗方法,并已纳入主要指南。我们现在必须集中精力提高其影响力并扩大其适用性。PR的方向是什么;它在COPD患者的综合治疗中处于什么位置;临床医生如何才能最好地应用这一重要干预措施?这就是2008年初在佛罗里达州劳德代尔堡召开的名为“肺康复:向前迈进”的圆桌讨论会议交给与会者的任务,该会议邀请了来自北美和欧洲的20位专家。本报告并非详尽无遗的综述;相反,它总结了圆桌会议的议程,同时为将PR最佳地纳入COPD连续护理提供指导。与会者一致认为,尽管PR对其他慢性呼吸道疾病也有效,但讨论重点是COPD,因为大多数证据基础和患者转诊都是针对这种疾病的。这些议程为适合进行调查或实施的三个广泛领域提供了见解:将PR定位在COPD患者的综合护理模式中;提高这种干预措施的有效性;以及扩大对PR的认识、应用和可及性。希望本文件将促使临床医生、研究人员和医疗保健政策制定者帮助实现这些目标,并为PR未来的研究和发展指明重要领域。

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