Cardiopulmonary MedicineClinical Practice

Improving Exercise Tolerance and Quality of Life in Patients With Chronic Obstructive Pulmonary Disease

Mark H. Belfer, DO, and Jane Z. Reardon, MSN, APRN, CS
Notes and Affiliations
Notes and Affiliations

Received: March 26, 2008

Accepted: October 20, 2008

Published: May 1, 2009

J Osteopath Med; 109(5): 268-278

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.

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