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A clinical practice guideline for physiotherapists treating patients with chronic obstructive pulmonary disease based on a systematic review of available evidence

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Langer, D. [UCL] Hendriks, E. J. M. Burtin, C. [UCL] Probst, V. van der Schans, C. P. Troosters, T. [UCL] Decramer, M. [UCL] Delguste, Pierre [UCL] Gosselink, R. [UCL]

Purpose: Update of a clinical practice guideline for the physiotherapy management of patients with chronic obstructive pulmonary disease supporting the clinical decision-making process. Methods: A systematic computerized literature search was performed on different modalities for improving physical exercise capacity, reducing exertional dyspnoea, improving airway clearance and encouraging changes in physical activity behaviour. Methodological quality was scored with the PEDro Scale. Scientific conclusions were graded according to the criteria of the 'Dutch Evidence Based Guideline Development Platform'. These, together with practical considerations, were used to formulate recommendations for clinical practice. Results: A total of 103 studies were included in the systematic review, consisting of five meta-analyses of randomized controlled trials, 84 randomized controlled trials and 14 uncontrolled studies, Twenty scientific conclusions supported six recommendations on physical exercise training. Nineteen scientific conclusions supported eight recommendations on interventions for reducing dyspnoea. Five scientific conclusions supported seven recommendations concerning treatment modalities to improve mucus clearance, and two scientific conclusions supported two recommendations on strategies for encouraging permanent changes in physical activity behaviour. Conclusions: Strong recommendations support the use of physical exercise training to improve health-related quality of life and functional exercise capacity. Future research should investigate whether additional interventions for reducing exertional dyspnoea have a place as adjuncts to physical exercise training in selected patients. In addition, treatment of impaired mucus clearance, especially during acute exacerbations, requires further research. With the advance of new technologies for objective measurements of physical activities in daily life more research is needed concerning interventions to initiate and maintain physical activity behaviour change during and after supervised physical exercise training programmes

Document type Article de périodique (Journal article) – Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review
Access type Accès restreint
Publication date 2009
Language Anglais
Journal information "Clinical Rehabilitation" - Vol. 23, no. 5, p. 445-62 (2009)
Peer reviewed yes
Publisher Sage Publications Ltd (London)
issn 0269-2155
e-issn 1477-0873
Publication status Publié
Affiliation UCL - MD/IEPR - Institut d'éducation physique et de réadaptation
MESH Subject Respiratory Therapy ; Respiration ; Quality of Life ; Pulmonary Disease, Chronic Obstructive - rehabilitation ; Practice Guidelines as Topic ; Patient Education as Topic ; Oxygen Inhalation Therapy ; Mucus ; Motor Activity ; Humans ; Health Behavior ; Exercise Tolerance ; Exercise ; Electric Stimulation Therapy ; Dyspnea - rehabilitation
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Permanent URL http://hdl.handle.net/2078.1/35571