L'optimisation de la réadaptation pulmonaire en cas de maladie pulmonaire obstructive chronique - des enjeux pratiques: Directives cliniques de la Société canadienne de thoracologie

Pulmonary rehabilitation (PR) participation is the standard of care for patients with chronic obstructive pulmonary disease (COPD) who remain symptomatic despite bronchodilator therapies. However, there are about specific aspects of PR programming including optimal site of rehabilitation delivery, components of rehabilitation programming, duration of rehabilitation, target populations and timing of rehabilitation. The present document was compiled to specifically address these important issues, using an evidence-based, systematic review process led by a questions representative interprofessional panel of experts. The evidence reveals there are no differences in major patient-related out-comes of PR between nonhospital- (community or home sites) or hospital based sites. - There is strong support to recommend that COPD patients initiate PR within one month following an acute exacerbation due to benefits of improved dyspnea, exercise tolerance and health-related quality of life relative to usual care. Moreover, the benefits of PR are evident in both men and women, and in patients with moderate, severe and very severe COPD. The current review also suggests that longer PR programs, beyond six to eight weeks duration, be provided for COPD patients, and that while aerobic training is the foundation of PR, endurance and functional ability may be further improved with both aerobic and resistance training.