Embedding Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease in the Home and Community Setting: A Rapid Review

被引:6
作者
de Oliveira, Tulio Medina Dutra [1 ]
Pereira, Adriano Luiz [1 ]
Costa, Giovani Bernardo [2 ]
Mendes, Liliane de Souza P. [3 ,4 ]
de Almeida, Leonardo Barbosa [2 ]
Velloso, Marcelo [3 ]
Malaguti, Carla [1 ]
机构
[1] Univ Fed Juiz de Fora, Dept Cardioresp & Skeletal Muscle Physiotherapy, Juiz De Fora, Brazil
[2] Univ Fed Juiz de Fora, Empresa Brasileira Serv Hosp Hosp Univ, Juiz De Fora, Brazil
[3] Univ Fed Minas Gerais, Dept Physiotherapy, Belo Horizonte, Brazil
[4] Terapia Respiratoria & Sono, Pesquisa & Ensino, Belo Horizonte, Brazil
来源
FRONTIERS IN REHABILITATION SCIENCES | 2022年 / 3卷
关键词
community health; home care services; pulmonary rehabilitation; chronic obstructive pulmonary disease; telerehabilitation; QUALITY-OF-LIFE; MAINTENANCE PROGRAM; EXERCISE CAPACITY; PHYSICAL-ACTIVITY; HEALTH-CARE; COPD PATIENTS; SHORT-TERM; FOLLOW-UP; TELEREHABILITATION; IMPROVES;
D O I
10.3389/fresc.2022.780736
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
This paper presents a rapid review of the literature for the components, benefits, barriers, and facilitators of pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) people in-home and community-based settings. seventy-six studies were included: 57 home-based pulmonary rehabilitation (HBPR) studies and 19 community-based pulmonary rehabilitation (CBPR) studies. The benefits of HBPR on exercise capacity and health-related quality of life were observed in one-group studies, studies comparing HBPR to usual care, and studies comparing to hospital-based pulmonary rehabilitation, although the benefits were less pronounced in the latter. HBPR reduced hospital admissions compared to usual care and was more cost-effective than hospital pulmonary rehabilitation. Most HBPRs were designed with low-density or customized equipment, are minimally supervised, and have a low intensity of training. Although the HBPR has flexibility and no travel burden, participants with severe disease, physical frailty, and complex comorbidities had barriers to complying with HBPR. The telerehabilitation program, a facilitator for HBPR, is feasible and safe. CBPR was offered in-person supervision, despite being limited to physical therapists in most studies. Benefits in exercise capacity were shown in almost all studies, but the improvement in health-related quality of life was controversial. Patients reported the benefits that facilities where they attended the CBPR including social support and the presence of an instructor. They also reported barriers, such as poor physical condition, transport difficulties, and family commitments. Despite the minimal infrastructure offered, HBPR and CBPR are feasible, safe, and provide clinical benefits to patients with COPD. Home and community settings are excellent opportunities to expand the offer of pulmonary rehabilitation programs, as long as they follow protocols that ensure quality and safety following current guidelines.
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页数:12
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