Rehabilitation in chronic respiratory diseases: In-hospital and post-exacerbation pulmonary rehabilitation: Peri-exacerbation pulmonary rehabilitation

Ibrahim, Wadah; Harvey-Dunstan, Theresa C.; Greening, Neil J.

Abstract

Exacerbations of chronic obstructive pulmonary disease (COPD) that require hospitalization are important events for patients. Functional impairment and skeletal muscle dysfunction can increase the risk of hospitalization and readmission, independent of lung function. In addition, once a patient is admitted, multiple factors can lead to worsening outcome including immobility, systemic inflammation and nutritional depletion. These non‐pulmonary factors are potentially amenable to exercise therapy, as part of pulmonary rehabilitation (PR). Peri‐exacerbation PR has an important role in the management of exacerbations of COPD. In this review, we explore how functional limitation and skeletal muscle dysfunction affect patients having a severe exacerbation of COPD, the systemic impact of hospitalization on patients including potential aetiologies and the role of PR around the time of an exacerbation. This includes rehabilitation during the inpatient phase, post‐exacerbation rehabilitation and rehabilitation bridging hospital discharge. We also describe potential future developments in peri‐exacerbation PR.

Citation

Ibrahim, W., Harvey-Dunstan, T. C., & Greening, N. J. (2019). Rehabilitation in chronic respiratory diseases: In-hospital and post-exacerbation pulmonary rehabilitation: Peri-exacerbation pulmonary rehabilitation. Respirology, 24(9), 889-898. https://doi.org/10.1111/resp.13516

• Journal Article Type: Article
• Acceptance Date: Feb 13, 2019
• Online Publication Date: Mar 5, 2019
• Publication Date: 2019-09
• Deposit Date: Apr 10, 2019
• Publicly Available Date: Mar 6, 2020
• Journal: Respirology
• Print ISSN: 1323-7799
• Electronic ISSN: 1440-1843
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 24
• Issue: 9
• Pages: 889-898
• DOI: https://doi.org/10.1111/resp.13516
• Keywords: Pulmonary and Respiratory Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/1775388
• Publisher URL: https://onlinelibrary.wiley.com/doi/full/10.1111/resp.13516
• Additional Information: This is the peer reviewed version of the following article: [Orme, MW, Harvey‐Dunstan, TC, Boral, I, et al. Changes in physical activity during hospital admission for chronic respiratory disease. Respirology. 2019; 1– 6, which has been published in final form at https://doi.org/10.1111/resp.13516. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.