Abstract

SIVORI, Martín. Rehabilitación respiratoria y exacerbaciones de EPOC: ¿una utopía hecha realidad?. Rev. am. med. respir. [online]. 2016, vol.16, n.1, pp.46-55. ISSN 1852-236X.

Exacerbations of COPD are associated with worsening of quality of life, symptoms and physical activity, and therefore with accelerated deterioration of the lung function and increased morbidity and mortality. The reduced physical activity is associated with skeletal muscle dysfunction, especially in the lower limbs and has been associated as an independent risk factor for increased mortality and accelerated decline in lung function. Moreover, physical training, a core part of a respiratory rehabilitation program (RR) is a key intervention in the management of patients with stable COPD. Objectives of the GOLD guidelines are prevention, early detection and adequate treatment of exacerbations. This article reviews the published scientific evidence of appropriately designed studies on preventing COPD exacerbations through RR, its benefits as a complement of acute treatment and the impact if it is prescribed immediately after an exacerbation. RR is a recognized strategy for the prevention of COPD exacerbations (Recommendation 1A). There is strong evidence supporting the implementation of training within one month after a COPD exacerbation (Recommendation 1B) as measured through the improvement of symptoms, exercise tolerance and quality of life. Training during a COPD exacerbation (hospitalized or not) has to be further studied because the evidence shows an intermediate level and the current recommendation is weak (Recommendation 2C).

Keywords : Exacerbation; COPD; Training; Respiratory rehabilitation.

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