The components of a respiratory rehabilitation program: a systematic overview.

Abstract:

OBJECTIVE:To determine the contribution of the various components of a rehabilitation program to the improvement of exercise capacity and health-related quality of life (HRQL) in patients with COPD. DATA SOURCES:MEDLINE (1966 to April 1996) was searched. Abstracts presented at international conferences were also hand searched for additional relevant trials. Bibliographies of the retrieved articles were reviewed. Experts in rehabilitation were consulted to uncover unpublished trials. STUDY SELECTION:Randomized controlled trials (RCTs) of exercise training, breathing exercises, education, and psychosocial support in patients with COPD were primarily included if (1) the treatment effect of a specific component of a rehabilitation program could be isolated, and (2) exercise capacity, HRQL, compliance with medical therapy, and/or knowledge about the disease were measured. DATA SYNTHESIS:A best-evidence synthesis was conducted; 22 RCTs contributed to the analysis. We found the following: (1) the patients exposed to interventions that included exercise training improved their functional exercise capacity and HRQL; (2) exercise training was muscle specific; (3) the evidence to support inspiratory muscle training and other breathing exercises as an adjunct to exercise training in COPD remains equivocal; (4) the contribution of education has not been well addressed; and (5) psychosocial support reduced dyspnea acutely and, when used as an adjunct to rehabilitation, promoted compliance with an exercise regimen and improved HRQL. CONCLUSION:Respiratory rehabilitation is likely to improve functional exercise capacity and HRQL if it includes exercise training and psychosocial support. Further research is required to better define the types and intensity of exercise as well as the influence of respiratory muscle training and patient education.

journal_name

Chest

journal_title

Chest

authors

Lacasse Y,Guyatt GH,Goldstein RS

doi

10.1378/chest.111.4.1077

subject

Has Abstract

pub_date

1997-04-01 00:00:00

pages

1077-88

issue

4

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)46872-2

journal_volume

111

pub_type

杂志文章,meta分析

相关文献

CHEST文献大全
  • OSA Syndrome and Posttraumatic Stress Disorder: Clinical Outcomes and Impact of Positive Airway Pressure Therapy.

    abstract:BACKGROUND:We sought to determine the impact of OSA syndrome (OSAS) on symptoms and quality of life (QoL) among patients with posttraumatic stress disorder (PTSD). In addition, we assessed adherence and response to positive airway pressure (PAP) therapy in this population. METHODS:This was a case-controlled observatio...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.15-0693

    authors: Lettieri CJ,Williams SG,Collen JF

    更新日期:2016-02-01 00:00:00

  • Survey of asthma practice among emergency physicians.

    abstract:PURPOSE:The National Asthma Education and Prevention Program (NAEPP) published guidelines for asthma management in 1991. The purpose of this study is to assess the concordance between emergency physicians' practice and the guidelines. DESIGN:Survey mailed to emergency physicians. Non-respondents were mailed a second c...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.109.3.708

    authors: Emerman CL,Cydulka RK,Skobeloff E

    更新日期:1996-03-01 00:00:00

  • Variability of arterial blood gas values over time in stable medical ICU patients.

    abstract::The spontaneous variability of arterial blood gas and pH values (ABGs) was examined in a group of 28 typical stable medical ICU patients under a variety of ventilatory conditions. In each patient, 13 ABG specimens were measured at 5-min intervals during a 1-h study period using a new bedside, extravascular fluorescent...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.106.1.187

    authors: Sasse SA,Chen PA,Mahutte CK

    更新日期:1994-07-01 00:00:00

  • Integration of clinical and hemodynamic parameters in the prediction of long-term survival in patients with pulmonary arterial hypertension.

    abstract:BACKGROUND:Current management guidelines for pulmonary arterial hypertension (PAH) recommend a treatment choice based primarily on World Health Organization (WHO) functional class. This study was designed to assess how the incorporation of readily obtained clinical and test-based information may significantly improve t...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.10-1293

    authors: Kane GC,Maradit-Kremers H,Slusser JP,Scott CG,Frantz RP,McGoon MD

    更新日期:2011-06-01 00:00:00

  • Spontaneous echo contrast in massive pericardial effusion with tamponade.

    abstract::Spontaneous echo contrast is uncommon in pericardial effusion. We report the case of a patient with massive malignant pericardial effusion causing cardiac tamponade in which the intense spontaneous echo contrast was found in the effusion by echocardiography. It was suggested that both the heavy blood content and a lar...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.103.5.1600

    authors: Shyu KG,Cheng JJ,Kuan P,Lien WP

    更新日期:1993-05-01 00:00:00

  • Exhaled nitric oxide in pulmonary diseases: a comprehensive review.

    abstract::The upregulation of nitric oxide (NO) by inflammatory cytokines and mediators in central and peripheral airway sites can be monitored easily in exhaled air. It is now possible to estimate the predominant site of increased fraction of exhaled NO (FeNO) and its potential pathologic and physiologic role in various pulmon...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.09-2090

    authors: Barnes PJ,Dweik RA,Gelb AF,Gibson PG,George SC,Grasemann H,Pavord ID,Ratjen F,Silkoff PE,Taylor DR,Zamel N

    更新日期:2010-09-01 00:00:00

  • Pulmonary emboli in patients receiving chemotherapy for non-Hodgkin's lymphoma.

    abstract::Combination chemotherapy has dramatically improved the prognosis of patients with intermediate and high grade histologic subtypes of non-Hodgkin's lymphomas. Treatment-related complications, however, are considerable, and a common problem encountered is respiratory distress or respiratory insufficiency. Usually these ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.94.3.589

    authors: Glenn LD,Armitage JO,Goldsmith JC,Sorensen S,Howe D,Weisenberger DD

    更新日期:1988-09-01 00:00:00

  • Gastric surgery for respiratory insufficiency of obesity.

    abstract::Morbid obesity is often associated with severe respiratory insufficiency, commonly known as the pickwickian syndrome. This can be divided into the following two primary breathing disorders which can affect patients alone or in combination: the obstructive sleep apnea syndrome (SAS); and the obesity-hypoventilation syn...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.90.1.81

    authors: Sugerman HJ,Fairman RP,Baron PL,Kwentus JA

    更新日期:1986-07-01 00:00:00

  • Airway tissue mast cells in persistent asthma: predictor of treatment failure when patients discontinue inhaled corticosteroids.

    abstract:STUDY OBJECTIVES:To determine if persistent airway tissue mast cells are associated with treatment failure when patients discontinue inhaled corticosteroids (ICS). DESIGN:Double-blind, randomized, placebo-controlled trial. SETTING:Multicenter, tertiary referral centers. PATIENTS OR PARTICIPANTS:Forty-five subjects w...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1378/chest.124.1.42

    authors: Kraft M,Martin RJ,Lazarus SC,Fahy JV,Boushey HA,Lemanske RF Jr,Szefler SJ,Asthma Clinical Research Network.

    更新日期:2003-07-01 00:00:00

  • The effects of flosequinan on hemodynamics and oxygen delivery in cor pulmonale.

    abstract::The hemodynamic effects of a new orally active vasodilator, flosequinan, were compared with placebo (single blind) over 24 h in eight patients with pulmonary hypertension secondary to severe chronic obstructive pulmonary disease. Mean pulmonary artery pressure was reduced by 5.1 (3.4, 6.7) mm Hg (mean 95 percent CI) (...

    journal_title:Chest

    pub_type: 临床试验,杂志文章

    doi:10.1378/chest.102.4.1155

    authors: Elborn JS,Richardson G,Murphy P,MacMahon J

    更新日期:1992-10-01 00:00:00

  • Left atrial function as a reliable predictor of exercise capacity in patients with recent myocardial infarction.

    abstract:STUDY OBJECTIVE:To examine the relation between left atrial (LA) function and exercise performance. DESIGN AND SETTING:Retrospective study at a referral cardiopulmonary exercise laboratory in a university hospital. PATIENTS:Forty-one patients with recent myocardial infarction. INTERVENTIONS:M-mode echocardiography a...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.111.4.922

    authors: Jikuhara T,Sumimoto T,Tarumi N,Yuasa F,Hattori T,Sugiura T,Iwasaka T

    更新日期:1997-04-01 00:00:00

  • Outcomes of Nurse Practitioner-Delivered Critical Care: A Prospective Cohort Study.

    abstract:BACKGROUND:Acute care nurse practitioners (ACNPs) are increasingly being employed in ICUs to offset physician shortages, but no data exist about outcomes of critically ill patients continuously cared for by ACNPs. METHODS:Prospective cohort study of all admissions to an adult medical ICU in an academic, tertiary-care ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2015.12.015

    authors: Landsperger JS,Semler MW,Wang L,Byrne DW,Wheeler AP

    更新日期:2016-05-01 00:00:00

  • Dynamic expiratory tracheal collapse in COPD: correlation with clinical and physiologic parameters.

    abstract:BACKGROUND:COPD has been described as a risk factor for excessive expiratory tracheal collapse, but its prevalence and clinical correlates have not been fully determined. The purpose of this study is to prospectively determine the prevalence of excessive expiratory tracheal collapse among patients with COPD and to test...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.12-0299

    authors: Boiselle PM,Michaud G,Roberts DH,Loring SH,Womble HM,Millett ME,O'Donnell CR

    更新日期:2012-12-01 00:00:00

  • The effect of marital status on the presentation and outcomes of elderly male veterans hospitalized for pneumonia.

    abstract:BACKGROUND:Although marital status has been shown to affect the outcomes of many conditions, there are limited data on the relationships between marital status and the presentation and outcomes of pneumonia. METHODS:We used Veterans Affairs administrative databases to identify a retrospective cohort of male veterans a...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.11-3183

    authors: Metersky ML,Fine MJ,Mortensen EM

    更新日期:2012-10-01 00:00:00

  • A prospective long-term study of 220 patients with a retrievable vena cava filter for secondary prevention of venous thromboembolism.

    abstract:BACKGROUND:The immediate and long-term clinical events associated with the placement and removal of a retrievable filter (ALN filter; ALN Implants Chirurgicaux; Ghisonaccia, France) remain largely unknown. METHODS:This was a prospective cohort study with an 18-month follow-up. All consecutive patients scheduled for pl...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.06-0631

    authors: Mismetti P,Rivron-Guillot K,Quenet S,Décousus H,Laporte S,Epinat M,Barral FG

    更新日期:2007-01-01 00:00:00

  • Serum KL-6 for the evaluation of active pneumonitis in pulmonary sarcoidosis.

    abstract::KL-6, a mucinous high-molecular weight glycoprotein, expressed on type II pneumonocytes, is elevated in the serum of patients with active interstitial pneumonia. Forty-seven patients with histologically confirmed sarcoidosis were analyzed by chest radiography, CT, 67Ga scintigraphy, BAL fluid (BALF), and serum KL-6. S...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.109.5.1276

    authors: Kobayashi J,Kitamura S

    更新日期:1996-05-01 00:00:00

  • Persistent pulmonary granulomas after recovery from varicella pneumonia.

    abstract::A 41-year-old man was found to have a miliary infiltrate on chest roentgenogram two months after recovery from varicella pneumonia. The patient remained in good health and there was no objective sign of pulmonary disease. The infiltrate showed no change in subsequent serial chest films, and after one year, open lung b...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.89.3.457

    authors: Meyer B,Stalder H,Wegmann W

    更新日期:1986-03-01 00:00:00

  • Löffler's syndrome secondary to crack cocaine.

    abstract::Eosinophilic pulmonary infiltration is an uncommon presentation from cocaine abuse. We present a patient with migratory pulmonary infiltrates and eosinophilia consistent with Löffler's syndrome. Our review uncovered two other similar patients. The importance of early recognition is stressed in our report. Either absti...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.105.5.1599

    authors: Nadeem S,Nasir N,Israel RH

    更新日期:1994-05-01 00:00:00

  • Improved accuracy of the exercise electrocardiogram in detection of coronary artery and three-vessel coronary disease.

    abstract::The study objective was to assess the widespread applicability of ST/HR slope for the modified Bruce exercise test using a computerized electrocardiogram (ECG); compare the usefulness of the ST/HR slope with standard ECG criteria in detection of coronary artery disease (CAD) and identification of three-vessel or left ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.94.4.737

    authors: Sato I,Keta K,Aihara N,Ohe T,Shimomura K,Hasegawa Y

    更新日期:1988-10-01 00:00:00

  • Effects of ouabain on early ventricular relaxation in patients with acute myocardial infarction.

    abstract::The effects of the administration of ouabain on the peak negative left ventriculat (LV) dP/dt were studied in 14 patients with acute myocardial infarction. Prior to administration of ouabain, negative LV dP/at was lower than previously reported for patients without coronary arterial disease. One hour after administrat...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.70.2.259

    authors: Loeb HS,Sinno MZ,Rahimtoola SH,Gunnar RM,Blount SG Jr

    更新日期:1976-08-01 00:00:00

  • Prolonged mechanical ventilation: review of care settings and an update on professional reimbursement.

    abstract::The goal of this article is to provide an update on recent changes to current procedural terminology codes used for billing physician services for mechanical ventilation in chronic care facilities. In addition to billing information, background data relevant to prolonged mechanical ventilation are reviewed. Topics cov...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.07-0656

    authors: White AC,O'Connor HH,Kirby K

    更新日期:2008-02-01 00:00:00

  • The clinical utility of flexible bronchoscopy in the evaluation of chronic cough.

    abstract:STUDY OBJECTIVES:To assess the clinical utility of flexible bronchoscopy (FB) in the evaluation of patients with chronic cough and normal or nonlocalizing chest radiographic findings. DESIGN:Retrospective chart review. SETTING:Tertiary referral center. PATIENTS:Forty-eight patients with chronic cough and no other cl...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.126.1.268

    authors: Barnes TW,Afessa B,Swanson KL,Lim KG

    更新日期:2004-07-01 00:00:00

  • Balancing the risks and benefits of oxygen therapy in critically III adults.

    abstract::Oxygen therapy is an integral part of the treatment of critically ill patients. Maintenance of adequate oxygen delivery to vital organs often requires the administration of supplemental oxygen, sometimes at high concentrations. Although oxygen therapy is lifesaving, it may be associated with deleterious effects when a...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.12-1215

    authors: Budinger GRS,Mutlu GM

    更新日期:2013-04-01 00:00:00

  • Coronary artery fistula diagnosed by transesophageal echocardiography.

    abstract::Coronary artery fistulas have been traditionally diagnosed by angiography. This report describes a congenital and a traumatic coronary artery fistula diagnosed by transesophageal echocardiography. Transesophageal echocardiography was superior to transthoracic echocardiography in both cases and to angiography in one ca...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.105.3.959

    authors: Prewitt KC,Smolin MR,Coster TS,Vernalis MN,Bunda M,Wortham DC

    更新日期:1994-03-01 00:00:00

  • Arm exercise and hyperinflation in patients with COPD: effect of arm training.

    abstract:BACKGROUND:Unlike studies on leg exercise, reports on the regulation of dynamic hyperinflation during arm exercise are scanty. We ascertained the following in patients with COPD: (1) whether and to what extent upper-limb exercise results in dynamic hyperinflation, and (2) the mechanism whereby an arm-training program (...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.3.1225

    authors: Gigliotti F,Coli C,Bianchi R,Grazzini M,Stendardi L,Castellani C,Scano G

    更新日期:2005-09-01 00:00:00

  • Frequency spectra of normal breath sounds in childhood.

    abstract::Clinicians who auscultate the chest of normal children note that the frequency content of their breath sounds appears to vary with age. Because these changes have not been systematically documented before, we recorded and analyzed inspiratory breath sounds in 35 children (0 to 13 years) and five adults (34 to 43 years...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.100.4.999

    authors: Hidalgo HA,Wegmann MJ,Waring WW

    更新日期:1991-10-01 00:00:00

  • Preventing ARDS: progress, promise, and pitfalls.

    abstract::Advances in critical care practice have led to a substantial decline in the incidence of ARDS over the past several years. Low tidal volume ventilation, timely resuscitation and antimicrobial administration, restrictive transfusion practices, and primary prevention of aspiration and nosocomial pneumonia have likely co...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.14-0555

    authors: Beitler JR,Schoenfeld DA,Thompson BT

    更新日期:2014-10-01 00:00:00

  • Brief questionnaires for patient-reported outcomes in asthma: validation and usefulness in a primary care setting.

    abstract:UNLABELLED:STUDY OBJECTIVES AND DESIGN: Health-related quality of life (QoL) instruments are generally used for studies of asthma in specialized settings. For primary care use, there is a need for brief and simple questionnaires for structured patient-reported outcomes. We validated the Mini-Asthma Quality of Life Ques...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.129.4.925

    authors: Ehrs PO,Nokela M,Ställberg B,Hjemdahl P,Wikström Jonsson E

    更新日期:2006-04-01 00:00:00

  • Regional Planning for Extracorporeal Membrane Oxygenation Allocation During Coronavirus Disease 2019.

    abstract::Health systems confronting the coronavirus disease 2019 (COVID-19) pandemic must plan for surges in ICU demand and equitably distribute resources to maximize benefit for critically ill patients and the public during periods of resource scarcity. For example, morbidity and mortality could be mitigated by a proactive re...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1016/j.chest.2020.04.026

    authors: Prekker ME,Brunsvold ME,Bohman JK,Fischer G,Gram KL,Litell JM,Saavedra-Romero R,Hick JL

    更新日期:2020-08-01 00:00:00

  • Pulmonary section development influences general medical house officer interests and ABIM certifying examination performance.

    abstract::To determine whether sectional development in pulmonary and critical care medicine influences medical house officers' (HO) interests and knowledge about respiratory medicine, we reviewed HO performance on the American Board of Internal Medicine (ABIM) certifying examination during 4 years before and 5 years after reor...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.110.2.533

    authors: Haponik EF,Bowton DL,Chin R Jr,Adair NE,Lykens MG,Alford PT,Bass DA

    更新日期:1996-08-01 00:00:00