Whither pulmonary rehabilitation? Will alternative modes help or hurt?

Chronic obstructive pulmonary disease (COPD) causes great misery to those afflicted. While it would be nice to think that a cure is near at hand, this remains only a distant dream. Symptom relief is the best we can do for the time being. We look for therapies to provide important patient-centred benefits such as improved exercise tolerance, reduced dyspnoea and better health-related quality of life. When we consider available therapies, we might consider comparing the magnitude of benefits of bronchodilators with those of pulmonary rehabilitation. A recent informal comparison of these benefits gleaned from meta-analyses in the literature reveals that, for exercise tolerance, dyspnoea and quality of life, the yield of pulmonary rehabilitation is several-fold greater than for bronchodilators [1]. In this analysis, pulmonary rehabilitation benefits well exceed thresholds of clinical importance in all three of these domains. Moreover, over the past 25 years, pulmonary rehabilitation has gained a bulletproof physiological basis [2, 3]; the strategies employed, especially in the area of exercise training, are highly evidence-based.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Editorials Source Type: research