https://cyberleninka.org/article/n/1006802.pdf

Pulmonary rehabilitation in chronic obstructive pulmonary disease

Pulmonary rehabilitation (PR) remains grossly underutilised by suitable patients worldwide We investigated whether home-based maintenance tele-rehabilitation will be as effective as hospital-based maintenance rehabilitation and superior to usual care in reducing the risk for acute chronic obstructive pulmonary disease (COPD) exacerbations, hospitalisations and emergency department (ED) visits Following completion of an initial 2-month PR programme this prospective, randomised controlled trial (between December 2013 and July 2015) compared 12 months of home-based maintenance tele-rehabilitation (n=47) with 12 months of hospital-based, outpatient, maintenance rehabilitation (n=50) and also to 12 months of usual care treatment (n=50) without initial PR In a multivariate analysis during the 12-month follow-up, both home-based tele-rehabilitation and hospital-based PR remained independent predictors of a lower risk for 1) acute COPD exacerbation (incidence rate ratio (IRR) 0517, 95% CI 0389–0687, and IRR 0635, 95% CI 0473–0853), respectively, and 2) hospitalisations for acute COPD exacerbation (IRR 0189, 95% CI 0100–0358, and IRR 0375, 95% CI 0207–0681), respectively However, only home-based maintenance tele-rehabilitation and not hospital-based, outpatient, maintenance PR was an independent predictor of ED visits (IRR 0116, 95% CI 0072–0185) Home-based maintenance tele-rehabilitation is equally effective as hospital-based, outpatient, maintenance PR in reducing the risk for acute COPD exacerbation and hospitalisations In addition, it encounters a lower risk for ED visits, thereby constituting a potentially effective alternative strategy to hospital-based, outpatient, maintenance PR

https://erj.ersjournals.com/content/erj/49/5/1602129.full.pdf

Home-based maintenance tele-rehabilitation reduces the risk for acute exacerbations of COPD, hospitalisations and emergency department visits

With an ever-expanding understanding about chronic obstructive pulmonary disease (COPD), it has been realized that it is a respiratory disease with systemic manifestations. Systemic effects of COPD lead to cardiovascular co-morbidities, muscle wasting and osteoporosis that in turn lead to inactivity and physical deconditioning. This development has a direct impact on the health-related quality of life (HRQoL) of patients suffering from this respiratory disease. Pharmacological therapy leads to improvement in shortness of breath and has limited effect on the physical deconditioning. Latest research has shown an additive effect of pulmonary rehabilitation on improving the inactivity and overall HRQoL in COPD patients. Pulmonary rehabilitation (PR) is a comprehensive multimodality program that includes strength and endurance training, nutritional education and psychosocial support. This leads to a holistic approach to management of COPD which results in symptom improvement in patients and decreased utilization of heath care resources. There are several barriers to widespread adoption of pulmonary rehabilitation as a standard treatment. This includes availability, insurance coverage and patient compliance. With inclusion of pulmonary rehabilitation in respiratory society guidelines, there has been a renewed interest among both pulmonary specialist and community physicians. This chapter aims to provide exhaustive evidence based knowledge regarding pulmonary rehabilitation and its beneficial effect on COPD patients.

/pdf/pulmonary-rehabilitation-in-chronic-obstructive-pulmonary-1bjcvgxkkv.pdf

Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease

Introduction: Human everyday life is full of stress and strain, so that the present century is called stress era. Unfortunately, here is no literature integration about stress. The aim of the present paper is to make a theoretical integrative consensus in stress modalities . Methods:  The design of the present study was systematic review. Inclusion criteria were subjective relevance to study keywords (include stress, stress control, stress reduction, social stress, community stress, group stress, stress increase, stress side effects, stress resources, stress stages, stress types), being published by academic and/or scientific resource, and publication period (between January, 1, 1990 and March, 20, 2015). Using Jadad scale, those clinical trial papers with 2 and upper were selected. Delphi method used to form the structure of final results. Results were collected by content analysis. Results:  Eleven major definitions, three main classifications, three fundamental explanatory perspectives, occupational stress and related issues, job burnout and related issues, biological and neuropsychological bases, related constructs (anxiety, homeostasis, allostasis), spiritual/religious/Islamic perspectives, stress outcomes, and multiple relations between stress and culture were presented and  discussed. Conclusion:  The ppresent study was an effort to make a theoretical unity of thought in studies about stress. According to the results, it appears that stress cannot be investigated via unimodal studies, and there is a great need to incorporate BioPsychoSocioSpiritual perspective in analyses and future frameworks of stress studies. Normal 0 false false false EN-US X-NONE AR-SA /* Style Definitions */
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 69

http://www.ijmedrev.com/article_68654_37adc02e9432adfa017b8d6095cb6760.pdf

Stress: Facts and Theories through Literature Review

Purpose To assess the trends in pulmonary rehabilitation (PR) utilization and factors associated with its use in older adults with chronic obstructive pulmonary disease (COPD). Methods We examined data for Medicare beneficiaries with COPD who received PR from January 1, 2003, to December 31, 2012. Persons with COPD were identified by (1) ≥2 outpatient visits >30 days apart within 1 year with an encounter diagnosis of COPD or (2) an acute care hospitalization with COPD as the primary diagnosis or a primary diagnosis of acute respiratory failure with a secondary discharge diagnosis of COPD. PR utilization was the study outcome identified by health care common procedure coding system codes G0237, G0238, G0239, and G0424 (after year 2010) or current procedural terminology codes (97001, 97003, 97110, 97116, 97124, 97139, 97150, 97530, 97535, and 97537) in a calendar year. Results Patients with COPD who received PR increased from 2.6% in 2003 to 3.7% in 2012 (P = .001). In a multivariable analysis, factors associated with receipt of PR were younger age, non-Hispanic white race, high socioeconomic status, multiple comorbidities (OR = 1.20; 95% CI = 1.13-1.27), and evaluation by a pulmonary physician (OR = 2.23; 95% CI = 2.13-2.33). Increased use of PR was attributed to prior users rather than new users of PR. Conclusions Utilization of PR during the study period increased only 1.1% in these Medicare beneficiaries with COPD and remained low.

/pdf/pulmonary-rehabilitation-utilization-in-older-adults-with-33nx9xv5rb.pdf

Pulmonary Rehabilitation Utilization in Older Adults With Chronic Obstructive Pulmonary Disease, 2003 to 2012.

https://www.archives-pmr.org/article/S0003-9993(09)00933-2/pdf

Effectiveness of Pulmonary Rehabilitation in Reducing Health Resources Use in Chronic Obstructive Pulmonary Disease

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Effectiveness of Pulmonary Rehabilitation in Reducing Health Resources Use in Chronic Obstructive Pulmonary Disease