Document Detail


A clinical practice guideline for physiotherapists treating patients with chronic obstructive pulmonary disease based on a systematic review of available evidence.
MedLine Citation:
PMID:  19389745     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Update of a clinical practice guideline for the physiotherapy management of patients with chronic obstructive pulmonary disease supporting the clinical decision-making process. METHODS: A systematic computerized literature search was performed on different modalities for improving physical exercise capacity, reducing exertional dyspnoea, improving airway clearance and encouraging changes in physical activity behaviour. Methodological quality was scored with the PEDro Scale. Scientific conclusions were graded according to the criteria of the; Dutch Evidence Based Guideline Development Platform'. These, together with practical considerations, were used to formulate recommendations for clinical practice. RESULTS: A total of 103 studies were included in the systematic review, consisting of five meta-analyses of randomized controlled trials, 84 randomized controlled trials and 14 uncontrolled studies. Twenty scientific conclusions supported six recommendations on physical exercise training. Nineteen scientific conclusions supported eight recommendations on interventions for reducing dyspnoea. Five scientific conclusions supported seven recommendations concerning treatment modalities to improve mucus clearance, and two scientific conclusions supported two recommendations on strategies for encouraging permanent changes in physical activity behaviour. CONCLUSIONS: Strong recommendations support the use of physical exercise training to improve health-related quality of life and functional exercise capacity. Future research should investigate whether additional interventions for reducing exertional dyspnoea have a place as adjuncts to physical exercise training in selected patients. In addition, treatment of impaired mucus clearance, especially during acute exacerbations, requires further research. With the advance of new technologies for objective measurements of physical activities in daily life more research is needed concerning interventions to initiate and maintain physical activity behaviour change during and after supervised physical exercise training programmes.
Authors:
D Langer; Ejm Hendriks; C Burtin; V Probst; Cp van der Schans; Wj Paterson; McE Verhoef-de Wijk; Rvm Straver; M Klaassen; T Troosters; M Decramer; V Ninane; P Delguste; J Muris; R Gosselink
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2009-04-23
Journal Detail:
Title:  Clinical rehabilitation     Volume:  23     ISSN:  0269-2155     ISO Abbreviation:  Clin Rehabil     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-07     Completed Date:  2009-08-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8802181     Medline TA:  Clin Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  445-62     Citation Subset:  IM    
Affiliation:
Departments of Pneumology and Respiratory Rehabilitation, University Hospital Leuven and Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Dyspnea / rehabilitation
Electric Stimulation Therapy
Exercise
Exercise Tolerance
Health Behavior
Humans
Motor Activity
Mucus
Oxygen Inhalation Therapy
Patient Education as Topic
Practice Guidelines as Topic
Pulmonary Disease, Chronic Obstructive / rehabilitation*
Quality of Life
Respiration
Respiratory Therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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