But as general, a review article that compiles few meta-analyses, randomized controlled study, reviews, and the clinical trial showed that pulmonary rehabilitation gives positive impacts in COPD patients according to functional outcomes, dyspnea scale, and quality of life. On the other side, an intervention study with 6 weeks of cardiopulmonary exercise showed an insignificant improvement of dyspnea scale measured with 0–10 Category Ratio (CR) in COPD patients. This is in line with the previous author’s study that showed 4 weeks of upper extremity exercise without strength training had demonstrated the improvement of dyspnea scale using the mMRC scale. It stated that strength training gives an additional impact on muscle force, but not different from endurance training alone in health status. A study that compares endurance training, combined endurance and strength training, and pharmacological alone showed the improvement of dyspnea in endurance and combined training, but not in a pharmacological alone group. A meta-analysis study also suggests including upper extremity exercise in pulmonary rehabilitation because it can relieve dyspnea in COPD, although few studies showed the insignificant difference of Borg scale after the training. Six-week of pulmonary rehabilitation was given to the end-stage of COPD outpatients and provide a significant improvement of dyspnea scale using a visual analog scale. Almost all types of pulmonary rehabilitation have a positive impact on the dyspnea scale of patients with COPD. īesides the pharmacological approach, pulmonary rehabilitation (PR) is considered an important part of comprehensive COPD treatment, particularly in group B-D. All these facts cause dyspnea and exercise tolerance becoming the main focus in COPD management in a few guidelines. Either patients with moderate or severe obstruction can experience dyspnea in their daily activities. Dyspnea can manifest across the degree of pulmonary obstruction. Tele-rehabilitation with teleconference, phone calls, and interactive web based PR can be the good alternative in decreasing hospital admission and improving quality of life in patient with COPD.ĭyspnea is the main symptom of Chronic Obstructive Pulmonary Disease (COPD) that correlates with the limitation of daily activity, anxiety and other psychological impacts, low quality of life, and reduced survival rate. So, the modified supervised and unsupervised training was needed to revise the classic type of PR. As immunocompromised population, COPD patient have higher risk for COVID19 infection and develops more severe complications compare with normal population. However, in this covid era, the restriction of hospital attending PR was significantly affect PR program. ![]() ![]() Regular and gradually increased training gives significant impact in improving lung function, dyspnea scale, and quality of life in patient with stable COPD. Assessment of clinical condition to adjust the type of training, duration, frequency, and intensity of training must be completed before beginning the training session. ![]() The prescription of exercise training is mandatory. Pulmonary rehabilitation consists of exercise training, nutritional support, smoking cessation, and self-management of COPD. Regular and gradually increase exercise training as part of pulmonary rehabilitation (PR) can improve the function of essential muscles in doing daily life so stable Chronic Obstructive Pulmonary Disease (COPD) patient can maintenance their daily activities with minimal limitations. Longer period of inactivity due to dyspnea worsen the destruction of muscle. Systemic inflammation and deconditioning syndrome lead to loss of structural and function of body muscle, particularly in extremity muscle.
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