ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 49 of 67
Up
JMBS 2020, 5(3): 366–377
https://doi.org/10.26693/jmbs05.03.366
Physical Therapy and Ergotherapy

Pulmonary Rehabilitation Program for Patients with COPD

Tymruk-Skoropad K., Pavlova Iu.
Abstract

Pulmonary rehabilitation is known to improve the mental, physical health and quality of life of people with chronic diseases and pathological conditions of the respiratory system. Due to the high prevalence of chronic respiratory diseases in the world and Ukraine, the number of people who need pulmonary rehabilitation is huge. This situation is exacerbated by the outbreak of the SARS-CoV-2 virus pandemic and respiratory complications of COVID-19. A number of pathological changes in the lungs after pneumonia caused by COVID-19 are irreversible and will potentially increase need to involve people after pneumonia with effective rehabilitation programs. The introduction of the qualitative, evidence-based system of pulmonary rehabilitation in Ukraine is at an early stage. Although it is absolutely topical to substantiate a pulmonary rehabilitation program, taking into account existing clinical guidelines and their adaptation to domestic conditions. The purpose of the study was to substantiate the structure and program of pulmonary rehabilitation for patients with respiratory diseases (on example of chronic pulmonary disease). Results and discussion. The organization and implementation of a pulmonary rehabilitation program requires specialists who are able to work closely with each other (multidisciplinary team), are competent in the tasks of pulmonary rehabilitation, understand the patient's needs and are focused on them. The general and special competencies of the specialists providing the pulmonary rehabilitation program, the obligatory components and stages of the program realization are formulated, the content of education and physical therapy measures are given. A plan for the implementation of major components for chronic pulmonary disease patients within the 8-week pulmonary rehabilitation program is proposed. Today in Ukraine it is difficult to implement such mandatory measures of leading western pulmonary rehabilitation programs as physical capacity assessment with maximum load tests, aerobic training in clinics, additional oxygen supply during physical therapy, attracting as much as possible different specialists, except for the pulmonologist and physical therapist (for example, occupational therapist, speech therapist, psychologist, etc.). Conclusion. The main components of pulmonary rehabilitation are assessment, educational component, physical therapy, psychosocial support, change and adherence to health behaviors. The stages of the program are assessment, planning intervention, re-evaluation, completion / follow-up. The proposed program is patient-oriented, aimed at managing the patient's adherence to treatment, enhancing daily functioning and quality of life.

Keywords: physical therapy, chronic pulmonary disease, physical exercises, breathing exercises, COVID-19

Full text: PDF (Ukr) 262K

References
  1. Spruit MA, Pitta F, McAuley E, ZuWallack RL, Nici L. Pulmonary Rehabilitation and Physical Activity in Patients with Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2015; 192: 924-33. https://www.ncbi.nlm.nih.gov/pubmed/26161676. https://doi.org/10.1164/rccm.201505-0929CI
  2. Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. An Official American Thoracic Society/European Respiratory Society Statement: Key Concepts and Advances in Pulmonary Rehabilitation. Am J Respir Crit Care Med. 2013; 43: 1326-37. https://www.ncbi.nlm.nih.gov/pubmed/24127811. https://doi.org/10.1164/rccm.201309-1634ST
  3. World health Organization. Coronavirus disease 2019 (COVID-19): Situation Report - 39. 2020; 2. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200228-sitrep-39-covid-19.pdf?sfvrsn=5bbf3e7d_4
  4. Singhal T. A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr. 2020; 87: 281. https://www.ncbi.nlm.nih.gov/pubmed/32166607. https://www.ncbi.nlm.nih.gov/pmc/articles/7090728. https://doi.org/10.1007/s12098-020-03263-6
  5. Huang P, Liu T, Huang L, Liu H, Lei M, Xu W, et al. Use of Chest CT in Combination with Negative RT-PCR Assay for the 2019 Novel Coronavirus but High Clinical Suspicion. Radiology. 2020; 295: 22-3. https://www.ncbi.nlm.nih.gov/pubmed/32049600. https://doi.org/10.1148/radiol.2020200330
  6. Yang F, Liu N, Wu JY, Hu LL, Su GS, Zheng NS. Pulmonary rehabilitation guidelines in the principle of 4S for patients infected with 2019 novel coronavirus (2019-nCoV). Zhonghua Jie He Hu Xi Za Zhi. 2020; 43: E004. https://doi.org/10.3760/cma.j.issn.1001-0939.2020.0004
  7. Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The Clinical and Chest CT Features Associated with Severe and Critical COVID-19 Pneumonia. Invest Radiol. 2020; 1. https://www.ncbi.nlm.nih.gov/pubmed/32118615. https://doi.org/10.1097/RLI.0000000000000672
  8. Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020; 1-9. https://www.ncbi.nlm.nih.gov/pmc/articles/7088323. https://doi.org/10.1007/s00330-020-06801-0
  9. Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology. 2020; 200463. https://www.ncbi.nlm.nih.gov/pubmed/32077789. https://doi.org/10.1148/radiol.2020200463
  10. Wu J, Wu X, Zeng W, Guo D, Fang Z, Chen L, et al. Chest CT Findings in Patients with Corona Virus Disease 2019 and its Relationship with Clinical Features. Invest Radiol. 2020; 1. https://www.ncbi.nlm.nih.gov/pubmed/32091414. https://doi.org/10.1097/RLI.0000000000000670
  11. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020 Feb 24; 20(4): P425-34. https://doi.org/10.1016/S1473-3099(20)30086-4
  12. Pan Y, Guan H, Zhou S, Wang Y, Li Q, Zhu T, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol. 2020 Feb; 1-4. https://doi.org/10.1007/s00330-020-06731-x
  13. Bissett B, Hodgson C. Physiotherapy Management for COVID-19 in the Acute Hospital Setting: Recommendations to guide clinical practice. 2020.
  14. Wang J, Wang BJ, Yang JC, Wang MY, Chen C, Luo GX, et al. Advances in the research of mechanism of pulmonary fibrosis induced by Corona Virus Disease 2019 and the corresponding therapeutic measures. Zhonghua shaoshang zazhi, Chinese J Burn. 2020; 36: E006.
  15. Collins EG, Bauldoff G, Carlin B, Crouch R, Emery CF, Garvey C, et al. Clinical Competency Guidelines for Pulmonary Rehabilitation Professionals. J Cardiopulm Rehabil Prev. 2014; 34(5): 291-302. https://www.ncbi.nlm.nih.gov/pubmed/25098438. https://doi.org/10.1097/HCR.0000000000000077
  16. Institute of Medicine. Committee on the Health Professions Education S, Greiner A, Knebel E, et al. Health professions education: a bridge to quality. National Academies Press. 2003. https://doi.org//10.17226/10681.
  17. Zeind CS, Blagg JD, Amato MG, Jacobson S. Incorporation of institute of medicine competency recommendations within doctor of pharmacy curricula. Am J Pharm Educ.2012; 76(5): 83. https://www.ncbi.nlm.nih.gov/pubmed/22761524. https://www.ncbi.nlm.nih.gov/pmc/articles/3386034. https://doi.org/10.5688/ajpe76583
  18. Global Initiative for Chronic Obstructive Lung Disease Global Initiative for Chronic Obstructive Lung Disease. Pocket guide to copd diagnosis, management, and prevention: A Guide for Health Care Professionals. 2019. Available from: www.goldcopd.org
  19. Yang IA, Brown JL, George J, Jenkins S, McDonald CF, McDonald VM, et al. COPD-X Australian and New Zealand guidelines for the diagnosis and management of chronic obstructive pulmonary disease: 2017 update. Med J Aust. 2017; 207(10): 436-42. https://www.ncbi.nlm.nih.gov/pubmed/29129177. https://doi.org/10.5694/mja17.00686
  20. Qaseem A, Wilt TJ, Weinberger SE, Hanania NA, Criner G, van der Molen T, et al. Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med. 2011; 155(3): 179-91. https://www.ncbi.nlm.nih.gov/pubmed/21810710. https://doi.org/10.7326/0003-4819-155-3-201108020-00008
  21. Tymruk-Skoropad K, Pavlova Yu. Kryteriyi vyboru ta zmist fizychnoyi terapiyi osib iz khronichnym obstruktyvnym zakhvoryuvannyam legen [Selection criteria and content of physical therapy for people with chronic obstructive pulmonary disease]. Fizychne vykhovannya, sport i kultura zdorov'ya u suchasnomu suspilstvi. 2019; 4: 96-108. [Ukrainian]
  22. Tarigan AP, Pandia P, Mutiara E, Pradana A, Rhinsilva E, Efriyandi E. Impact of Lower-Limb Endurance Training on Dyspnea and Lung Functions in Patients with COPD. Open access Maced J Med Sci. 2018; 6(12): 2354-8. https://www.ncbi.nlm.nih.gov/pubmed/30607190. https://www.ncbi.nlm.nih.gov/pmc/articles/6311482. https://doi.org/10.3889/oamjms.2018.381
  23. Tymruk-Skoropad KA. Metody doslidzhennya efektyvnosti fizychnoyi terapiyi ta legenevoyi reabilitatsiyi osib z khronichnym obstruktyvnym zakhvoryuvannyam legen (analiz systematychnykh oglyadiv). Zdorov'ya, sport, reabilitatsiya. 2018; 4: 148-157. [Ukrainian]
  24. Champaign I. Guidelines for Pulmonary Rehabilitation Programs. 2020.
  25. Tymruk-Skoropad KA. Pervynne otsinyuvannya ta planuvannya fizychnoyi terapiyi patsiyentiv iz khronichnym obstruktyvnym zakhvoryuvannyam legen z vykorystannyam instrumentiv na osnovi Mizhnarodnoyi klasyfikatsiyi funktsionuvannya. Fizychna aktyvnist, zdorov'ya i sport. 2018; 1: 45-53. [Ukrainian]
  26. Tymruk-Skoropad KA, Pavlova IO, Mazepa MA. System of control in the organization of pulmonary rehabilitation of persons with chronic obstructive pulmonary disease. Health, Sport, Rehabilitation. 2019; 5: 69-79. https://doi.org/10.34142/HSR.2019.05.03.08
  27. ICF Case Studies - Introduction to ICF-based Documentation Tools and Rehab-Cycle. Available from: https://www.icf-casestudies.org/introduction/introduction-to-icf-based-documentation-tools-and-rehab-cycle-2/introduction-to-icfbased-documentation-tools-and-rehab-cycle
  28. ACSM Guidelines for Exercise Testing and Prescription 10th | Nicolas Sepulveda Cisternas - Academia.edu. Available from: https://www.academia.edu/36843773/ACSM_Guidelines_for_Exercise_Testing_and_Prescription_10th (accessed 27 March 2020).
  29. Pauwels RA, Buist AS, Calverley PMA, Jenkins CR, Hurd SS; GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) workshop summary. In: American Journal of Respiratory and Critical Care Medicine. Am J Respir Crit Care Med. 2001 Apr; 163(5): 1256-76. https://www.ncbi.nlm.nih.gov/pubmed/11316667. https://doi.org/10.1164/ajrccm.163.5.2101039
  30. Singh SJ, Steiner MC. Pulmonary rehabilitation; what's in a name? Thorax 2013; 68: 899-901. https://www.ncbi.nlm.nih.gov/pubmed/23843356. https://doi.org/10.1136/thoraxjnl-2013-203716