The progress of COPD is associated with increasing breathlessness, disability, and frequent hospitalizations. An aging population in the developed world and increasing cigarette consumption in developing countries compounds the global impact of this condition. The disability associated with COPD leads to a reduction in physical activity and a loss of functional independence. The disability may not appear in COPD until there has been irretrievable loss of lung function. Treatment aimed at reversing airflow obstruction is frequently ineffective, and therapeutic strategies are better aimed at attenuating symptoms and reducing disability. Recent guidelines for the management of COPD emphasize the importance of pulmonary rehabilitation (PR) as part of an integrated multidisciplinary approach.
PR programs that include physical training and disease education have been shown to improve exercise capacity and health status of individuals with COPD. However, it is not known whether these benefits translate to improved domestic functioning and independence that may reduce the economic and social burden of COPD. The assessment of domestic activity can be achieved by self-reported measures or objectively monitored daily activity. The latter has been explored by using ambulatory activity monitors. However, these ambulatory activity monitors have not yet been applied in studies of PR. COPD is treated effectivey with the help of remedies of My Canadian Pharmacy http://www.drleonedds.com/my-canadian-pharmacy-right-bundle-branch-block-and-frontal-plane-qrs-axis-in-apparently-healthy-men.html.
It is a principle that PR programs should be designed to suit the individual’s requirements. The natural extension of this principle is that highly individualized training that pays attention to the individual’s expressed functional goals would be even more effective, but no trials of agreed, goal-directed or targeted PR have been performed. The need to evaluate individualized PR has been highlighted in the international guidelines.
This article describes a prospective, randomized study that had the following two main objectives: (1) to identify whether rehabilitation that is individually targeted to activities of daily living offered any advantage over a simpler general exercise program (GEP); and (2) to identify whether PR improved domestic activity and increased the level of functional independence in the home.