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What to do after a Pulmonary Rehabilitation Program?

What to do after a Pulmonary Rehabilitation Program?

The American College of Chest Physician and the American Association of Cardiovascular and Respiratory Rehabilitation recommend that COPD patients to continue their rehabilitation in order to maintain their gains.

The American College of Chest Physician (ACCP) and the American Cardiovascular Rehabilitation and Respiratory (AACVPR) Association published in the journal Chest in 2007 guidelines based on consensus conferences. The guide points out that if the benefits of rehabilitation phase in patients with COPD are many, they gradually decline between 12 and 18 months. Experts recommend professionals to help patients find structures of post-rehabilitation proximity to maintain the gains made during a period of intensive rehabilitation.


The Study Rationale

The Chronic Obstructive Pulmonary Disease (COPD) is the fifth leading cause of death worldwide. It affects 1.5 million people in France alone. The cause of COPD is primarily active smoking and/or liabilities. This disease is currently not curable. The American College of Chest Physician (ACCP) and the American Cardiovascular Rehabilitation and Respiratory (AACVPR) Association did a state of knowledge about the benefits of rehabilitation and post-rehabilitation. They then made ​​recommendations in this guide. Rehabilitation must be designed according to the expert committee as multidisciplinary (exercise, nutrition, patient education, counseling), individual (program tailored to individual needs) and carrying as much attention on the physical, psychological and social aspects. The report provides different views with levels of evidence. Of all the advice given in the guide, one in particular is worth noting.

Progress in a rehabilitation program fade after a year if nothing is done by the patient with COPD.

The Question

How long persist the benefits of undergoing rehabilitation for people with COPD?

The Protocol

This review question based on consensus conferences is based on a systematic review of the scientific and medical literature published between 1996 and 2004 This work lasted two years.

The Main Results

American learned societies ACCP and AACVPR conclude that phase of rehabilitation in patients with COPD is beneficial to patients on biological shots, physical, psychological and social (Grade A, Evidence Based Medicine). The authors recommend that COPD patients to participate in a rehabilitation program. However, these benefits gradually decrease between 12 and 18 months after a period of rehabilitation (Grade A, Evidence Based Medicine). Experts recommend patients to find structures of post-rehabilitation proximity to maintain their gains.

COPD patients should find local structures of post-rehabilitation to maintain the benefits acquired in a rehabilitation program.


What it means for Patients

A pardon is not an end in itself. Rehabilitation does not cure COPD, but improves breath, physical autonomy, mood and quality of life. American learned societies ACCP and AACVPR recommend that all patients who participated in a rehabilitation program to continue their efforts through specialized structures.

What it means for the Healthcare Professionals

A rehabilitation program improves clinical factors, life, quality of life and reduced hospital days in COPD. The inherent multidisciplinary program can address all aspects of COPD. Think about the after rehabilitation is central to maintain the gains. It would thus be able to offer each patient a solution to continue his rehabilitation near his home.

What it means for Researchers

Participation in this type of synthesis process is very formative for a researcher. It requires an analytical mind, synthetic, pragmatic, multidisciplinary (or corporatist) and ethics. She also consider what can be expected and extracted clinical research.

What it means for Policymakers

This notice was given in 2007 by two American learned societies, the American College of Pulmonologists (ACCP) and the American Association of Cardiovascular and Respiratory Rehabilitation (AACVPR). The Respiratory Society of French Language (SPLF) followed the same kind of approach in 2009 in a publication which will be mentioned later in this blog.


The reference

Ries AL, Bauldoff GS, Carlin BW, Casaburi R, Emery CF, Mahler DA, Make B, Rochester CL, ZuWallack R, Herrerias C (2007). Pulmonary Rehabilitation: Joint American College of Chest Physicians and American Association of Cardiovascular and Pulmonary Rehabilitation Evidence-Based Clinical Practice Guidelines. Chest, 131, 4-42.


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To reference this Blog en Sante © article.

Ninot G (2014). What to do after a Pulmonary Rehabilitation Program? Blog en Sante, A5.

© Copyright 2014 Grégory Ninot. All rights reserved.

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