Pulmonary rehabilitation (PR) is an evidence-based comprehensive intervention including, but are not limited to, exercise training, education, and behavior change, for patients with chronic respiratory diseases (1). PR is implemented by dedicated, interdisciplinary teams, including physicians and other health care professionals, offering patient-tailored therapies. PR has been clearly demonstrated to reduce dyspnea, increase exercise capacity, and improve quality of life in individuals with chronic obstructive pulmonary disease (COPD) (2). Indeed, most individuals enrolled in PR have COPD (3). However, individuals with chronic respiratory disorders other than COPD experience similar symptom burden and activity limitation. In the last decade, several studies investigated the effects of PR in patients with chronic respiratory disorders, other than COPD (4, 5) . Based on these, there is accumulating evidence to support inclusion of these patient groups in PR programmes.
In this Podcast, dr. Frits Franssen, chair of the PR Assembly Web Committee interviews dr. Klaus Kenn, who is an expert in the field of PR in non-obstructive lung diseases from Schön Klinik in Schönau am Königsee, Germany. Dr. Kenn discusses the current knowledge on the effects of PR in non-obstructive lung diseases and the special considerations and problems for these patient groups. Specific training modalities and safety issues/contra-indications (6) are discussed. Finally, potential predictors for success (7) and topics for future research are outlined.
Thanks for listening!
Frits Franssen, MD, PhD
Klaus Kenn, MD, PhD
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References:
1. Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, ... An Official American Thoracic Society / European Respiratory Society Statement: Key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013.
2. Casaburi R, ZuWallack R. Pulmonary rehabilitation for management of chronic obstructive pulmonary disease. The New England journal of medicine. 2009 Mar 26;360(13):1329-35. PubMed PMID: 19321869.
3. Yohannes AM, Connolly MJ. Pulmonary rehabilitation programmes in the UK: a national representative survey. Clinical rehabilitation. 2004 Jun;18(4):444-9. PubMed PMID: 15180129.
4. Huppmann P, Sczepanski B, Boensch M, Winterkamp S, Schonheit-Kenn U, Neurohr C, et al. Effects of inpatient pulmonary rehabilitation in patients with interstitial lung disease. Eur Respir J. 2013 Aug;42(2):444-53. PubMed PMID: 23100507.
5. Holland AE, Hill CJ, Conron M, Munro P, McDonald CF. Short term improvement in exercise capacity and symptoms following exercise training in interstitial lung disease. Thorax. 2008 Jun;63(6):549-54. PubMed PMID: 18245143.
6. Grunig E, Lichtblau M, Ehlken N, Ghofrani HA, Reichenberger F, Staehler G, et al. Safety and efficacy of exercise training in various forms of pulmonary hypertension. Eur Respir J. 2012 Jul;40(1):84-92. PubMed PMID: 22323570.
7. Kenn K, Gloeckl R, Soennichsen A, Sczepanski B, Winterkamp S, Boensch M, et al. Predictors of success for pulmonary rehabilitation in patients awaiting lung transplantation. Transplantation. 2015 May;99(5):1072-7. PubMed PMID: 25393161.
