No abstract available.
Pulmonary Disease, Chronic Obstructive* ; Rehabilitation*

Pulmonary rehabilitation is the standard in care and effective in patients with chronic obstructive pulmonary disease (COPD). The goals of pulmonary rehabilitation are to restore their highest possible levels of independent function and to improve their quality of life. Despite optimal medical therapy, pulmonary rehabilitation is appropriate for any patient with dyspnea and disabling symptoms. Pulmonary rehabilitation improves exercise capacity and reduces dyspnea and fatigue in COPD. The goals and benefits of pulmonary rehabilitation are achieved by education, exercise training, and nutrition counseling.
Counseling ; Dyspnea ; Education ; Fatigue ; Humans ; Pulmonary Disease, Chronic Obstructive* ; Quality of Life ; Rehabilitation*

Pulmonary rehabilitation is a multidisciplinary program of care for patients with chronic respiratory impairment that is individually tailored and designed to optimize physical and social performance and autonomy. It can reduce symptoms, decrease disability, increase participation in physical and social activities, and improve the overall quality of life for individuals with chronic respiratory disease. Pulmonary rehabilitation consists of exercise training, patient and family education, psychosocial and behavioral intervention. The exercise training should be performed at least five times per week for 30 min in each session. The intensity of aerobic exercise training should be more than 60 per cent of the peak oxygen consumption.
Education ; Exercise ; Exercise Therapy ; Humans ; Oxygen Consumption ; Pulmonary Disease, Chronic Obstructive* ; Quality of Life ; Rehabilitation*

It is known that a pulmonary rehabilitation program improves dyspnea and exercise tolerence in patients with chronic obstructive pulmonary disease. However, it is also known that although it does not improve pulmonary function. This study was performed to evaluate the effect of a 4 week pulmonary rehabilitation on pulmonary function, gas exchange, and exercise tolerance in patients with chronic obstructive pulmonary disease. The pulmonary rehabilitation programs included breathing exercises, such as pursed-lip breathing and diaphragmatic breathing, upper-limb exercises, and inspiratory muscle training. These activities were performed for 4 weeks in twenty one patients with chronic obstructive pulmonary disease. Pre and post-rehabilitation pulmonary function and exercise capacities were compared after the 4 week period. Results are as follows: 1) Before the rehabilitation, the predicted value of FVC and FEV1 of the patients were 70.3+/-16.7% and 41.1+/-11.9% respectively. These pulmonary functions did not change after pulmonary rehabilitation. 2) Aloility of walking a 6 minute distance (325.29+/-122.24 vs 363.03+/-120.01 p=.01) and dyspnea (p=.00) were significantly improved after rehabilitation. Thus showing that pulmonary rehabilitation for 4 weeks can improve exercise performance and dyspnea in patients with chronic obstructive pulmonary disease.
Breathing Exercises ; Dyspnea ; Exercise ; Exercise Tolerance ; Humans ; Pulmonary Disease, Chronic Obstructive* ; Rehabilitation* ; Respiration ; Walking

PURPOSE: The purpose of this study was to develop a home-based self-management support intervention (SMSI) for enhancing pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD) in Korea. METHODS: This methodological study was conducted by following these 4 steps: constructing the preliminary draft of a home-based SMSI from existing recommendation and a literature review on PR and self-management interventions; testing content validity with 6 experts in COPD; exploring clinical applicability of the intervention by applying it to 4 COPD patients; determining the final intervention. RESULTS: The final intervention included 4 components and contents identified from the literature review as essentials for self-management of COPD patients: education; exercise training and practice including breathing, muscle strengthening and aerobic exercises; cognitive behavioral strategies including informative self-decision making, collaborative goal setting and supportive advice; and action planning for exacerbation. The intervention was designed to be run by a trained nurse and had 8 weekly sessions consisting of three 60-minute face-to-face sessions and five 20-minute phone-call sessions. CONCLUSION: The intervention developed in this study incorporates essential components of self-management, i.e. action plan and cognitive behavioral strategies, and will contribute to enhancing and maintaining effects of PR by increasing self-management in COPD patients.
Education ; Exercise ; Humans ; Korea ; Methods ; Pulmonary Disease, Chronic Obstructive* ; Quality of Life ; Rehabilitation* ; Respiration ; Self Care*

Chronic obstructive pulmonary disease (COPD) is a severe respiratory disease characterized by airway obstruction with high mortality and rate of recurrence. Rehabilitation exercise can lessen the possibility of the progressive exacerbation of the patient's condition, exerting an active role in improving their lung function and the quality of the patients' life. Therefore, we have designed a lung function exercise bottle, which is capable of adjusting the pressure according to the patient's needs. It is easy to operate and apply in practice. The exercise bottle is composed of three components, including bottle body, threaded round cap and air blow pipe. The bottle body is formed in rectangle shape, and utilized to contain liquid. The filling opening is designed on the top of the bottle. Outside of the filling opening, there is a screw thread round cap, which can adjust the pressure according to the patient's tolerance, gradually increasing the training intensity,and improving the training effect thereby. The blowpipe can be inserted into the bottle body and the patient can blow the air through the tube. Compared with the traditional rehabilitation training, when the newly invented lung function exercise bottle has been used for rehabilitation exercise, the air pressure in the bottle can be adjusted, with the advantage of wider range of application, lower cost and more convenient. It provides a good solution for clinical and home-based rehabilitation and is worth of popularizing.
Equipment Design ; Exercise Therapy/instrumentation* ; Humans ; Lung/physiology* ; Pulmonary Disease, Chronic Obstructive/rehabilitation*

OBJECTIVE: To compare the respiratory muscle strength between patients with stable and acutely exacerbated (AE) chronic obstructive pulmonary disease (COPD) at various stages. METHODS: A retrospective medical record review was conducted on patients with COPD from March 2014 to May 2016. Patients were subdivided into COPD stages 1–4 according to the Global Initiative for Chronic Obstructive Lung Disease guidelines: mild, moderate, severe, and very severe. A rehabilitation physician reviewed their medical records and initial assessment, including spirometry, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), COPD Assessment Test, and modified Medical Research Council scale. We then compared the initial parameters in patients with a stable condition and those at AE status. RESULTS: The AE group (n=94) had significantly lower MIP (AE, 55.93±20.57; stable, 67.88±24.96; p=0.006) and MIP% (AE, 82.82±27.92; stable, 96.64±30.46; p=0.015) than the stable patient group (n=36). MIP, but not MEP, was proportional to disease severity in patients with AE and stable COPD. CONCLUSION: The strength of the inspiratory muscles may better reflect severity of disease when compared to that of expiratory muscles.
Dyspnea ; Humans ; Medical Records ; Muscle Strength ; Muscles ; Pulmonary Disease, Chronic Obstructive* ; Rehabilitation ; Respiratory Muscles* ; Retrospective Studies ; Spirometry

The purpose of the study was to investigate two areas as a basis for providing an educational program for pulmonary rehabilitation. A) the learning needs about chronic obstructive pulmonary disease in patients with chronic obstructive pulmonary disease and B) the perception of nurses of the same learning needs. The subjects consisted of 57 patients, with chronic obstructive pulmonary disease, at the general hospital in Seoul and 71 nurses, who were working in the medical ward. Data was obtained from a "learning need" questionnaire between October 29 and November 19, '99. Data was analyzed using SAS program for t-test, ANOVA, Scheff test. The result were as follows: 1. The learning needs of the nurses(mean 4.36 +/- .38) were higher than those of the patients (mean 3.56 +/- .83). (t=6.78, P=.001) 2. The highest ranked patient education needs were as follows ; a)"how to control dyspnea", b)"cause for activating dyspnea", and c)"how to minimize the necessity of oxygen in daily living": and nurses' learning needs were ; a)"how to cope with the risk situation", b)"management after discharge", and c)"how to control dyspnea". 3. In the patient group, those who had a college degree or higher education and paid their own hospital expenses were higher in the learning needs. According to the above results, we should consider an educational program which is realistic and effective for patients by evaluating the items the patients really want to learn about and how much they know about the evaluated items.
Education ; Hospitals, General ; Humans ; Learning* ; Oxygen ; Patient Education as Topic ; Pulmonary Disease, Chronic Obstructive* ; Rehabilitation ; Seoul ; Surveys and Questionnaires

Chronic obstructive pulmonary disease (COPD) is characterized by a not entirely reversible limitation in the airflow. An airflow limitation is progressive and associated with an abnormal inflammatory response of the lung to gases and harmful particles. In COPD, the weight loss is commonly observed and there is a negative impact on the respiratory as well as skeletal muscle function. The pathophysiological mechanisms that result in weight loss in COPD are not fully understood. However, the mechanisms of weight loss in COPD may be the result of an increased energy expenditure unbalanced by an adequate dietary intake. The commonly occurring weight loss and muscle wasting in COPD patients adversely affect the respiratory and peripheral muscle function, the exercise capacity, the health status, and even the survival rates. Therefore, it is very valuable to include management strategies that the increase energy balance in order to increase the weight and fat free mass. A Better understanding of the molecular and cellular pathological mechanisms of COPD can improve the many new directions for both the basic and clinical investigations. The Nutritional supply is an important components of a multidisciplinary pulmonary rehabilitation program. Future studies combining an exercise program, the role of anabolic steroids, nutritional individualization, a more targeted nutritional therapy, and the development of new drugs including anti-cytokines is needed for the effective management of COPD.
Energy Metabolism ; Gases ; Humans ; Lung ; Muscle, Skeletal ; Pulmonary Disease, Chronic Obstructive* ; Rehabilitation ; Steroids ; Survival Rate ; Weight Loss

BACKGROUND: The aim of this study was to determine the effectiveness of self-efficacy promoting pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). METHODS: thirty six patients, with clinically stable COPD were randomly assigned: 18 to a rehabilitation group and another 18 as a control group, The subjects participated in a the self-efficacy promoting pulmonary rehabilitation program for 8 weeks. This program consisted of education, breathing retraining, exercise training, relaxation and counseling. The control group received education only. The outcome variables were self-efficacy, dyspnea, exercise endurance, pulmonary function, and quality of life. Dyspnea was measured using the modified Borg scale. Exercise endurance was measured by the six minute walking distance. The quality of life was measured by the quality of life index for pulmonary disease patients. RESULTS: In the rehabilitation group after performing the self-efficacy promoting pulmonary rehabilitation program, the self-efficacy score, exercise endurance, and quality of life score were higher than the control group (p=0.007, p=0.038, and p=0.039, respectively). and the exertional dyspnea score was significantly lower than controls(p=0.045). However, the dyspnea score and FEV1 were similar after performing the self-efficacy promoting pulmonary rehabilitation program. CONCLUSION: The self-efficacy promoting pulmonary rehabilitation program is effective to in improve self-efficacy, exertional dyspnea, exercise endurance and quality of life in patients with COPD.
Counseling ; Dyspnea ; Education ; Humans ; Lung Diseases ; Outpatients* ; Pulmonary Disease, Chronic Obstructive* ; Quality of Life ; Rehabilitation* ; Relaxation ; Respiration ; Walking