Journal of cardiopulmonary rehabilitation and prevention
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J Cardiopulm Rehabil Prev · Sep 2013
ReviewPulmonary rehabilitation exercise prescription in chronic obstructive lung disease: US survey and review of guidelines and clinical practices.
Chronic obstructive pulmonary disease is a common, progressive disorder associated with disabling symptoms, skeletal muscle dysfunction, and substantial morbidity and mortality. Current national guidelines recommend pulmonary rehabilitation (PR) to improve dyspnea, functional capacity, and quality of life. Many PR exercise programs are based on guidelines from the American College of Sports Medicine. ⋯ Patients often have comorbidities that may further complicate exercise provision and prescription. This article describes the results of an informal, nonscientific survey of the American Association of Cardiovascular and Pulmonary Rehabilitation members exploring current PR exercise prescription practices as a basis for discussion and reviews current national exercise recommendations for chronic obstructive pulmonary disease. Further, it describes areas of uncertainty regarding exercise prescription in PR and suggests strategies for providing effective exercise training, given the diversity of guidelines, clinician preparedness, and patient complexity.
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Cardiac rehabilitation programs (CRPs) aim to help patients with cardiovascular disease achieve lifestyle changes. However, attendance and completion of programs are poor worldwide. The rationale for this study was to explore patterns of attendance and completion of a CRP located in a private hospital in metropolitan Melbourne, Victoria, Australia. ⋯ The major finding is the need for improvement in referral and recruitment structures to increase awareness of the program and the participation rate. Practices such as automatic referral and followup of patients are recommended. The study outcomes will benefit future research on referral processes to the CRP at the hospital.
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J Cardiopulm Rehabil Prev · Mar 2013
Randomized Controlled TrialDevelopment and feasibility of a self-management intervention for chronic obstructive pulmonary disease delivered with motivational interviewing strategies.
Self-management is proposed as the standard of care in chronic obstructive pulmonary disease (COPD), but details of the process and training required to deliver effective self-management are not widely available. In addition, recent data suggest that patient engagement and motivation are critical ingredients for effective self-management. This article carefully describes a self-management intervention using motivational interviewing skills, aimed to increase engagement and commitment in severe COPD patients. ⋯ A self-management intervention that includes motivational interviewing as the way if guiding patients into behavior change is feasible in severe COPD and may increase patient engagement and commitment to self-management. This provides a very detailed description of the process for the specifics of training and delivering the intervention, which facilitates replicability in other settings and could be translated to cardiac rehabilitation.
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J Cardiopulm Rehabil Prev · Nov 2012
Impact of peak oxygen uptake and muscular fitness on the performance of activities of daily living in patients with chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is a progressively debilitating disease, which, over time, may compromise patient ability to perform activities of daily living (ADL). The purpose of this study was to examine the relationships between selected parameters of physical fitness and performance of ADL in COPD patients. ⋯ The results of this investigation suggest that lower body strength is important in optimizing ADL performance in COPD patients.
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J Cardiopulm Rehabil Prev · Jul 2012
Relationship between acceptance of illness and functional outcomes following cardiac rehabilitation.
Acceptance, a cognitive-behavioral concept successfully applied to chronic pain and chronic illness in an HIV/AIDS population, was examined for applicability in patients in a cardiac rehabilitation program. The study examined the internal reliability of the Activities Engagement (AE) and Illness Willingness (IW) scales of the Chronic Illness Acceptance Questionnaire (CIAQ), their relationships with functional outcomes, and their ability to predict functional outcomes after controlling for demographic and medical variables. ⋯ The AE aspect of acceptance was related to emotional outcomes and predicted these outcomes beyond demographic and medical variables. Lack of a relationship between IW and any outcomes may have been due to a small sample size or that acceptance is a one-dimensional construct.