Daily answer
Scott Rand
In patients with chronic pulmonary disease, endurance training is often beneficial with improved pulmonary function and less symptoms. Which of the following is true regarding pulmonary rehabilitation?
A. The American Thoracic Society (ATS) recommends a specific strength training program
B. Successful rehabilitation requires optimal medical management including pharmacotherapy
C. Pulmonary rehabilitation resembles cardiac rehabilitation with similar applications
D. In pulmonary rehabilitation the patient is encouraged to exercise to maximal effect without relying on oxygen supplementation
Correct: B
Correct answer: B Successful pulmonary rehabilitation requires optimal medical management including: pharmacotherapy, oxygen supplementation, psychological support. The response to rehab should translate into imporved ADL’s. The exercise program should be based on sound scientific evidence with an understanding of pulmonary response to exercise and pathophysiology of the pulmonary dysfunction. Hypoxemia should be recognized and treated with supplemental oxygen when needed which increases lung exercise capacity and improves life expectancy (Answer D, incorrect). The ATS actually makes no specific recommendation on strength training due to the lack of good supporting literature (Answer A, incorrect). Answer D is incorrect because there are significant differences in pulmonary and cardiac rehab. Cardiac rehab has more immediate, potentially life threatening risks. Pulmonary rehab is more complex due to: older age range, poorer baseline level of conditioning, and compex nature of pathophysiology of chronic pulmonary disease.
1. COOPER CB. Exercise in chronic pulmonary disease: aerobic exercise prescription. MSSE 33(7) Supplement:S671-S679, July 2001.
Scott E Rand, MD FAAFP CAQSM
Director, Primary Care Sports Medicine Fellowship
Co Director of Sports Medicine, Houston Methodist Orthopedics and Sports Medicine Willowbrook
Assistant Professor of Clinical Family Medicine Houston Methodist Academic Institute
Adjunct Assistant Professor of Family and Community Medicine, Texas A&M University
Assistant Professor of Family Medicine in Clinical Medicine Weill Cornell Medical College.
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Houston, TX 77070