Temerty Faculty of Medicine, Respirology, University of Toronto, Toronto, ON, Canada; Respirology, University Health Network, Toronto, ON, Canada; Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
Chest. 2024 Oct;166(4):721-732. doi: 10.1016/j.chest.2024.05.027. Epub 2024 Jun 18.
Cognitive and physical limitations are common in individuals with chronic lung diseases, but their interactions with physical function and activities of daily living are not well characterized. Understanding these interactions and potential contributors may provide insights on disability and enable more tailored rehabilitation strategies.
This review summarizes a 2-day meeting of patient partners, clinicians, researchers, and lung associations to discuss the interplay between cognitive and physical function in people with chronic lung diseases. This report covers four areas: (1) cognitive-physical limitations in patients with chronic lung diseases; (2) cognitive assessments; (3) strategies to optimize cognition and motor control; and (4) future research directions. Cognitive and physical impairments have multiple effects on quality of life and daily function. Meeting participants acknowledged the need for a standardized cognitive assessment to complement physical assessments in patients with chronic lung diseases. Dyspnea, fatigue, and age were recognized as important contributors to cognition that can affect motor control and daily physical function. Pulmonary rehabilitation was highlighted as a multidisciplinary strategy that may improve respiratory and limb motor control through neuroplasticity and has the potential to improve physical function and quality of life.
There was consensus that cognitive function and the cognitive interference of dyspnea in people with chronic lung diseases contribute to motor control impairments that can negatively affect daily function, which may be improved with pulmonary rehabilitation. The meeting generated several key research questions related to cognitive-physical interactions in individuals with chronic lung diseases.
主题重要性：认知和身体限制在慢性肺部疾病患者中很常见，但它们与身体功能和日常生活活动的相互作用尚未得到很好的描述。了解这些相互作用和潜在的影响因素可能有助于了解残疾情况，并为更有针对性的康复策略提供依据。
综述发现：本次综述总结了为期两天的患者伙伴、临床医生、研究人员和肺部协会的会议，以讨论慢性肺部疾病患者认知和身体功能之间的相互作用。本报告涵盖四个方面：（1）慢性肺部疾病患者的认知-身体限制；（2）认知评估；（3）优化认知和运动控制的策略；（4）未来的研究方向。认知和身体损伤对生活质量和日常功能有多种影响。会议参与者承认需要一种标准化的认知评估来补充慢性肺部疾病患者的身体评估。呼吸困难、疲劳和年龄被认为是认知的重要影响因素，会影响运动控制和日常身体功能。肺部康复被强调为一种多学科策略，通过神经可塑性提高呼吸和肢体运动控制能力，并有可能改善身体功能和生活质量。
总结：会议达成共识，认为慢性肺部疾病患者的认知功能和呼吸困难的认知干扰会导致运动控制障碍，从而对日常生活功能产生负面影响，而肺部康复可能会改善这种情况。会议提出了几个与慢性肺部疾病患者认知-身体相互作用相关的关键研究问题。
