REHABILITATION IN THE OLDER PATIENT WITH PULMONARY DISEASE

Rehabilitation—dehned as an evidence-based, multidisciplinary comprehensive intervention to reduce symptoms, optimize function by encouraging adherence to health-enhancing behaviors, and reduce healthcare utilization—is an important management tool for all patients with chronic lung disease, irrespective of age. Although the focus of this chapter was not on pulmonary rehabilitation per se, burgeoning interest in this modality in the management of COPD has bolstered our knowledge of the importance of exercise training for patients with chronic lung disease. In COPD, there is robust evidence that pulmonary rehabilitation confers signihcant improvements in exercise capacity, in symptoms such as dyspnea and fatigue, and in health-related quality of life. It also appears to reduce healthcare use, in both patients with stable disease and in the immediate period following an exacerbation.133 These improvements likely relate not only to muscle strengthening, as manifested by improvements in objective markers of walking distance and general activity level, but also to favorable effects on other aspects of general functional status, including education on managing a chronic disease and its symptoms, and its role in alleviating isolation and improving depression. The aging of our population, the prevalence of chronic respiratory disease, and the need for a multipronged approach will place rehabilitation at the forefront of our efforts to minimize disability and promote quality of life in the older population.

 
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