Exercise Training and Pulmonary Rehabilitation in COPD

Abstract

Systemic inflammation and deconditioning syndrome lead to loss of structural and function of body muscle, particularly in extremity muscle. Longer period of inactivity due to dyspnea worsen the destruction of muscle. Regular and gradually increase exercise training as part of pulmonary rehabilitation (PR) can improve the function of essential muscles in doing daily life so stable Chronic Obstructive Pulmonary Disease (COPD) patient can maintenance their daily activities with minimal limitations. Pulmonary rehabilitation consists of exercise training, nutritional support, smoking cessation, and self-management of COPD. The prescription of exercise training is mandatory. Assessment of clinical condition to adjust the type of training, duration, frequency, and intensity of training must be completed before beginning the training session. Regular and gradually increased training gives significant impact in improving lung function, dyspnea scale, and quality of life in patient with stable COPD. However, in this covid era, the restriction of hospital attending PR was significantly affect PR program. As immunocompromised population, COPD patient have higher risk for COVID19 infection and develops more severe complications compare with normal population. So, the modified supervised and unsupervised training was needed to revise the classic type of PR. Tele-rehabilitation with teleconference, phone calls, and interactive web based PR can be the good alternative in decreasing hospital admission and improving quality of life in patient with COPD.