Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Respirology. 2010 Nov;15(8):1157-73. doi: 10.1111/j.1440-1843.2010.01849.x.
Pulmonary rehabilitation plays an essential role in the management of symptomatic patients with COPD. The benefits of rehabilitation include a decrease in dyspnoea and fatigue, and improvements in exercise tolerance and health-related quality of life. Importantly, rehabilitation reduces hospitalization for acute exacerbations and is cost-effective. Although most of the evidence for pulmonary rehabilitation has been obtained in patients with COPD, symptomatic individuals with other respiratory diseases have been shown to benefit. In this review we outline a stepwise approach to establish, deliver and evaluate a pulmonary rehabilitation program (PRP) that would be feasible in most settings. Throughout the review we have specified the minimum requirements for a PRP to facilitate the establishment of programs using limited resources. Recommendations for staffing and other resources required for a PRP are presented in the first section. Exercise training is a focus of the section on program delivery as this is the component of rehabilitation that has the strongest level of evidence for benefit. Program considerations for patients with respiratory conditions other than COPD are described. Different approaches for delivering the education component of a PRP are outlined and recommendations are made regarding topics for group and individual sessions. The problems commonly encountered in pulmonary rehabilitation, together with recommendations to avoid these problems and strategies to assist in their resolution, are discussed. The review concludes with recommendations for evaluating a PRP.
肺康复在 COPD 症状性患者的管理中起着至关重要的作用。康复的益处包括呼吸困难和疲劳的减轻，以及运动耐量和健康相关生活质量的改善。重要的是，康复可减少急性加重的住院治疗，且具有成本效益。尽管肺康复的大部分证据来自 COPD 患者，但有症状的其他呼吸系统疾病患者也已被证明从中获益。在本综述中，我们概述了建立、实施和评估肺康复计划（PRP）的逐步方法，该方法在大多数环境中都是可行的。在整个综述中，我们规定了 PRP 的最低要求，以促进使用有限资源建立计划。在第一节中提出了对 PRP 所需人员配备和其他资源的建议。运动训练是计划实施部分的重点，因为这是康复中具有最强获益证据的组成部分。描述了针对 COPD 以外的呼吸系统疾病患者的计划注意事项。概述了不同的方法来提供 PRP 的教育部分，并就小组和个人会议的主题提出了建议。讨论了肺康复中常见的问题，并提出了避免这些问题的建议和解决问题的策略。综述最后提出了评估 PRP 的建议。
