Mark H. Belfer, Jane Z. Reardon. Improving Exercise Tolerance and Quality of Life in Patients With Chronic Obstructive Pulmonary Disease. J Am Osteopath Assoc 2009;109(5):268–278. doi: 10.7556/jaoa.2009.109.5.268.
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Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of mortality in the United States. Its symptoms, comorbidities, and sequelae also result in high morbidity and healthcare costs. The impact of progressive dyspnea, fatigue, exercise intolerance, and recurrent exacerbations in patients with COPD can be devastating to their quality of life. Unaddressed, these symptoms often result in depression and social isolation, causing further decline in exercise tolerance and functional performance. Assessing the physiologic, pharmacologic, and psychosocial factors that influence these elements can be challenging in the primary care setting. The present article describes a practical approach to assess functional performance and outlines pharmacologic and nonpharmacologic strategies—particularly self-management education and pulmonary rehabilitation—to improve quality of life indicators.
[A] preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.
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