The Role of Physical Therapy in the System of Pulmonary Rehabilitation in the Case of Chronic Obstructive Pulmonary Disease (the Analysis of Clinical Guidelines)

Abstract

Topicality. Currently, pulmonary rehabilitation is an intervention recommended to all chronic obstructive pulmonary disease patients, regardless of the disease severity, and physical therapy is an integral part of effective pulmonary rehabilitation programs. Although there is a sheer number of studies on the impact of pulmonary rehabilitation programs (both in its general context and individual components), as well as on the physical, functional and psycho-emotional state of patients, the number of the detailed clinical guidelines on PR inthe case of chronic obstructive pulmonary disease is limited. The purpose of the study is to analyse clinical guidelines for management and pulmonary rehabilitation and to evaluate the role of physical therapy in the system of pulmonary rehabilitation in the case of chronic obstructive pulmonary disease. Clinical guidelines selected on the basis of the research conducted on databases of PubMed (data over the past 5 years), PEDro, Cochrane (January, 2018), dedicated to clinical guidelines on treatment, management, pulmonary rehabilitation and physical therapy of chronic obstructive pulmonary disease patients, were chosen as the subject of the analysis. It has been established that physical therapy is an integral part of pulmonary rehabilitation programs for COPD patients. The main means of physical therapy recommended by the clinical guidelines for COPD patients are the following: physical training, respiratory exercises, training of respiratory muscles, chest physical therapy and electrostimulation of peripheral muscles. Methods of the use of physical training for chronic obstructive pulmonary disease patients are the most extensively described. Recommendations regarding special features of physical therapy in the case of exacerbation and under conditions of inpatient treatment are either absent or insufficient; the amount of information on the role and specifics of the use of respiratory exercises and chest physical therapy for COPD patients at different stages of treatment is inadequate.