CRC PULM REHAB PDF

Preface

Chronic obstructive pulmonary disease (COPD) is the most widespread non-communicable respiratory disease in the world. It is also one of the major causes of morbidity worldwide and the only cause of mortality whose incidence continues to rise. Although COPD has been recognized by the World Health Organization as a major public health problem, governments and health authorities are only just beginning to acknowledge its impact on society. By 2020, COPD will rank fifth, globally, as a cause of disability, and third as cause of mortality.

In the last decade, important advances in our understanding of the primary and secondary impairments associated with chronic respiratory diseases have led to a better appreciation of the role of pulmonary rehabilitation as an integral part of disease management. Randomized controlled trials, using valid, reproducible and interpretable outcome measures, have provided sufficient evidence of effectiveness for pulmonary rehabilitation to be endorsed by professional societies around the world. This recognition appears increasingly in the form of international statements, such as the joint European Respiratory Society and American Thoracic Society 2005 "Statement on Pulmonary Rehabilitation".

Pulmonary rehabilitation programmes are included, as the prevailing standard of care, in the clinical management of patients with chronic respiratory diseases. Ongoing advances in basic and clinical research are helping to better define the components and likely outcomes associated with this treatment modality.

This textbook provides a detailed review of the major aspects of pulmonary rehabilitation, taken from recent, peer-reviewed reports, which have contributed to its establishment as a scientific discipline. The major goal of the book is to provide those interested in this area with useful tools that will help them to establish and evaluate a programme of pulmonary rehabilitation. Contributing authors have been asked to include specific outcome measures, whenever possible, and to identify key articles in support of their conclusions.

Pulmonary rehabilitation involves integrating health care habits into the lifelong management of patients with chronic respiratory disease. Systemic manifestations (secondary impairments) are often more amenable to treatment than the damaged airways and lung parenchyma (primary impairment). To be successful, rehabilitation requires a dynamic collaboration between the patient, the family and the health care providers.

Each chapter addresses a different aspect of what becomes a comprehensive strategy for pulmonary rehabilitation, aimed at improving functional exercise capacity and healthrelated quality of life as well as reducing the health care resources required per patient. The authors have condensed an enormous amount of literature, drawn mainly from the last decade, to provide the best possible support to clinical practice for health care providers working in the challenging field of pulmonary rehabilitation. We hope that readers will find this area of health care as rewarding to their patients and themselves as we, the editors, have.