Rouen University Hospital, School of Physiotherapy, Rouen, France.
ADIR Association, Rouen University Hospital, Rouen, France.
Phys Ther. 2021 Mar 3;101(3). doi: 10.1093/ptj/pzaa217.
Pulmonary rehabilitation (PR) is an evidence-based intervention to manage symptoms related to chronic obstructive respiratory diseases (CORD). Paradoxically, few people with CORD actually engage in PR, and of those, up to one-third do not complete the program. Additionally, some of those who complete the program do not achieve worthwhile benefits. Therefore, the main challenge for the next decades is to offer PR to as many people (that would potentially benefit from it) as possible. This raises questions about factors influencing participation, completion, and responsiveness to PR programs. Among these factors, urinary incontinence (UI) is highly prevalent among people with CORD (much more than in the general population) and may worsen during PR exercise sessions. Paradoxically, UI is poorly explored in routine and scarcely assessed in research, and none of the actual guidelines about PR mention it. However, its potential influence on engagement, completion, and response to PR is of real concern. Therefore, the aim of this perspective is to describe the mechanisms of UI, particularly in the context of CORD, as well as to highlight its prevalence among people with CORD, their burden, and how it could affect a PR approach based on sustained and regular physical activity.
肺康复（PR）是一种基于证据的干预措施，用于管理与慢性阻塞性呼吸系统疾病（CORD）相关的症状。矛盾的是，实际上很少有 CORD 患者真正接受 PR，而在这些患者中，多达三分之一的人无法完成该计划。此外，完成该计划的人中有些人并未获得有价值的益处。因此，未来几十年的主要挑战是为尽可能多的（可能从中受益的）人提供 PR。这引发了关于影响 PR 计划参与、完成和反应的因素的问题。在这些因素中，尿失禁（UI）在 CORD 患者中非常普遍（比一般人群多得多），并且可能在 PR 运动期间恶化。矛盾的是，UI 在常规情况下研究得很少，在研究中也很少评估，目前关于 PR 的实际指南都没有提到它。然而，它对 PR 参与、完成和反应的潜在影响确实令人担忧。因此，本观点的目的是描述 UI 的机制，特别是在 CORD 背景下，以及强调其在 CORD 患者中的普遍性、他们的负担以及它如何影响基于持续和有规律的体育活动的 PR 方法。
