Montreal Chest Institute, Montréal, Canada.
Swiss Med Wkly. 2010 Sep 1;140:w13067. doi: 10.4414/smw.2010.13067. eCollection 2010.
A truly successful pulmonary rehabilitation entails implementing physical activity maintenance. This article reviews the current knowledge on pulmonary rehabilitation and the expected benefits, the setting, the relationship between self-management and pulmonary rehabilitation, in order to develop and implement clinically-effective physical activity maintenance interventions. The effectiveness of pulmonary rehabilitation is well-established. However, access to pulmonary rehabilitation is limited. Home-based pulmonary rehabilitation has been shown to be an effective, equivalent alternative to outpatient pulmonary rehabilitation in COPD patients. The opportunity to offer different pulmonary rehabilitation settings tailored to individual needs should improve accessibility to this intervention. Sustained long-term physical activity remains the most important challenge for COPD patients. We need a dependable system of coordinated health care interventions and communication, and components that include self-management support. Self-management should be an integrated part of pulmonary rehabilitation and remain long after the pulmonary rehabilitation is completed. By early identification of patients who may have difficulty maintaining exercise and implementing appropriate self-management interventions during and after the rehabilitation program, it may be possible to promote better long-term involvement in physical activity. Pulmonary rehabilitation should not stand alone; the best program is that which can be maintained to translate into a continuous increase in the activities of daily living. Future research should evaluate the effect of self-management interventions combined with pulmonary rehabilitation to improve long-term activity and exercise maintenance.
真正成功的肺康复需要实施体力活动维持。本文综述了肺康复的现状和预期效益、环境、自我管理与肺康复的关系，以便开发和实施临床有效的体力活动维持干预措施。肺康复的有效性已得到充分证实。然而，获得肺康复的机会有限。家庭为基础的肺康复已被证明是 COPD 患者门诊肺康复的有效、等效替代方法。提供针对个人需求的不同肺康复环境的机会，应提高这种干预措施的可及性。长期持续的体力活动仍然是 COPD 患者面临的最大挑战。我们需要一个可靠的协调医疗干预和沟通系统，以及包括自我管理支持的组成部分。自我管理应该是肺康复的一个组成部分，并在肺康复完成后长期存在。通过早期识别可能难以维持运动的患者，并在康复计划期间和之后实施适当的自我管理干预措施，可能有助于促进更好的长期参与体力活动。肺康复不应孤立存在；最好的方案是能够维持的方案，以转化为日常生活活动的持续增加。未来的研究应评估自我管理干预与肺康复相结合对改善长期活动和运动维持的效果。
