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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.

Authors

Wadah Ibrahim

Theresa C. Harvey-Dunstan

Neil J. Greening



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‚ÄźDunstan, 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.