Принципы легочной реабилитации больных хронической обструктивной болезнью легких (обзор литературы)

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Цель обзора - проанализировать современные данные литературы по подходам и принципам реализации легочной реабилитации (ЛР) в программе лечения больных хронической обструктивной болезнью легких (ХОБЛ). На настоящий момент ЛР представляет собой научно обоснованный метод лечения ХОБЛ, достоверно улучшающий течение заболевания. Показано, что в программы ЛР целесообразно включать всех пациентов c ХОБЛ. На основании большого количества исследований подчеркивается, что наибольший эффект достигается при использовании программ, которые включают в себя все четыре основные типа воздействия - физические тренировки, коррекцию нутритивного статуса, обучение пациентов и психосоциальные мероприятия. Рассмотрены различные принципы организации программ ЛР, и представлена необходимость индивидуального подхода к программам ЛР с учетом типов реагирования на заболевание.

Об авторах

Светлана Ивановна Овчаренко

ФГАОУ ВО «Первый МГМУ им. И.М.Сеченова»

Email: svetftk@mail.ru
д-р мед. наук, проф. каф. факультетской терапии №1 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2

Янина Казисовна Галецкайте

ФГАОУ ВО «Первый МГМУ им. И.М.Сеченова»

врач-терапевт 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2

Список литературы

  1. Tudor-Locke C, Washington T.L, Hart T.L. Expected values for steps/day in special populations. Prev Med 2009; 49 (1): 3-11.
  2. Spruit M.A, Singh S.J, Garvey C et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013; 188: e13-e64.
  3. Федеральные клинические рекомендации по диагностике и лечению хронической обструктивной болезни легких. М.: Российское респираторное общество, 2014. http://www.pulmonology.ru/download/COPD2014may.doc
  4. Lacasse Y, Goldstein R, Lasserson Toby J et al. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2006; 4: CD0037993. doi: 10.1002/14651858.CD003793.pub
  5. Griffiths T.L, Burr M.L, Campbell I.A et al. Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial. Lancet 2000; 355: 362-8.
  6. Singh S.J, Jones P.W, Evans R et al. Minimum clinically important improvement for the incremental shuttle walking test. Thorax 2008; 63: 775-7.
  7. Redelmeier D.A, Bayoumi A.M, Goldstein R.S et al. Interpreting small differences in functional status:the six minute walk test in chronic lung disease patients. Am J Respir Crit Care Med 1997; 155: 1278-82.
  8. Dodd J.W, Hogg L, Nolan J et al. The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study. Thorax 2011; 66: 425-9.
  9. Dodd J.W, Marns P.L, Clark A.L et al. The COPD Assessment Test (CAT): short- and medium-term response to pulmonary rehabilitation. COPD 2012; 9: 390-4.
  10. Ringbaek T, Martinez G, Lange P. A comparison of the assessment of quality of life with CAT, CCQ, and SGRQ in COPD patients participating in pulmonary rehabilitation. COPD 2012; 9: 12-5.
  11. De Blok B.M.J, de Greef M.H.G, ten Hacken N.H.T et al. The effects of a lifestyle physical activity counseling program with feedback of a pedometer during pulmonary rehabilitation in patients with COPD: a pilot study. Patient Educ Couns 2006; 61: 48-55.
  12. Pitta F, Troosters T, Probst V.S et al. Are patients with COPD more active after pulmonary rehabilitation? Chest 2008; 134: 273-80.
  13. Sewell L, Singh S.J, Williams J.E.A et al. Can individualized rehabilitation improve functional independence in elderly patients with COPD? Chest 2005; 128: 1194-200.
  14. Garrod R, Paul E.A, Wedzicha J.A. An evaluation of the reliability and sensitivity of the London Chest Activity of Daily Living Scale (LCADL). Respir Med 2002; 96: 725-30.
  15. Garrod R, Marshall J, Jones F. Self efficacy measurement and goal attainment after pulmonary rehabilitation. Int J COPD 2008; 3: 791-6.
  16. Kovelis D, Zabatiero J, Oldemberg N et al. Responsiveness of three instruments to assess self-reported functional status in patients with COPD. COPD 2011; 8: 334-9.
  17. Lareau S.C, Carrieri-Kohlman V, Janson-Bjerklie S et al. Development and testing of the Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ). Heart Lung 1994; 23: 242-50.
  18. Law M, Baptiste S, McColl M et al. The Canadian occupational performance measure: an outcome measure for occupational therapy. Can J Occup Ther 1990; 57: 82-7.
  19. Sewell L, Singh S.J, Williams J.E.A et al. Can individualized rehabilitation improve functional independence in elderly patients with COPD? Chest 2005; 128: 1194-200.
  20. Yohannes A.M, Roomi J, Winn S et al. The Manchester Respiratory Activities of Daily Living questionnaire: development, reliability, validity, and responsiveness to pulmonary rehabilitation. J Am Geriatr Soc 2000; 48: 1496-500.
  21. Troosters T, Gosselink R, Decramer M. Short- and long-term effects of outpatient rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Am J Med 2000; 109: 207-12.
  22. Simpson K, Killian K, McCartney N et al. Randomised controlled trial of weightlifting exercise in patients with chronic airflow limitation. Thorax 1992; 47: 70-5.
  23. O’Shea S.D, Taylor N.F, Paratz J.D. A predominantly home-based progressive resistance exercise program increases knee extensor strength in the short-term in people with chronic obstructive pulmonary disease: a randomised controlled trial. Aust J Physiother 2007; 53: 229-37.
  24. Kongsgaard M, Backer V, Jorgensen K et al. Heavy resistance training increases muscle size, strength and physical function in elderly male COPD-patients - a pilot study. Respir Med 2004; 98: 1000-7.
  25. Hoff J, Tjonna A.E, Steinshamn S et al. Maximal strength training of the legs in COPD: a therapy for mechanical inefficiency. Med Sci Sports Exerc 2007; 39: 220-6.
  26. Clark C.J, Cochrane L, Mackay E. Low intensity peripheral muscle conditioning improves exercise tolerance and breathlessness in COPD. Eur Respir J 1996; 9: 2590-6.
  27. Clark C.J, Cochrane L.M, Mackay E et al. Skeletal muscle strength and endurance in patients with mild COPD and the effects of weight training. Eur Respir J 2000; 15: 92-7.
  28. Casaburi R, Bhasin S, Cosentino L et al. Effects of testosterone and resistance training in men with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2004; 170: 870-8.
  29. Arnold R, Ranchor A.V, Koeter G.H et al. Changes in personal control as a predictor of quality of life after pulmonary rehabilitation. Patient Educ Couns 2006; 61: 99-108.
  30. Ries A.L, Kaplan R.M, Limberg T.M et al. Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease. Ann Intern Med 1995; 122: 823-32.
  31. Vincent E, Sewell L, Wagg K et al. Measuring a change in self-efficacy following pulmonary rehabilitation: an evaluation of the PRAISE tool. Chest 2011; 140: 1534-9.
  32. Harrison S.L, Greening N.J, Williams J.E et al. Have we underestimated the efficacy of pulmonary rehabilitation in improving mood? Respir Med 2012; 106: 838-44.
  33. Griffiths T.L, Burr M.L, Campbell I.A et al. Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial. Lancet 2000; 355: 362-8.
  34. Coventry P.A, Hind D. Comprehensive pulmonary rehabilitation for anxiety and depression in adults with chronic obstructive pulmonary disease: systematic review and meta-analysis. J Psychosom Res 2007: 551-65.
  35. Bratäs O, Espenes G, Rannestad T et al. Pulmonary rehabilitation reduces depression and enhances health-related quality of life in COPD patients - especially in patients with mild or moderate disease. Chron Respir Dis 2010; 7: 229-37.
  36. Ries A.L, Bauldoff G.S, Carlin B.W et al. Pulmonary rehabilitation: Joint ACCP/AACVPR evidence-based clinical practice guidelines. Chest 2007; 131 (5): 4S-42S.
  37. Bolton C.E et al. British Thoracic Society guideline on pulmonary rehabilitation in adults. Thorax 2013; 68: ii1-ii30.
  38. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2018. https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf
  39. Beauchamp M.K, Janaudis-Ferreira T, Goldstein R.S, Brooks D. Optimal duration of pulmonary rehabilitation for individuals with chronic obstructive pulmonary disease - a systematic review. Chron Respir Dis 2011; 8: 129-40.
  40. Pitta F, Troosters T, Probst V.S et al. Are patients with COPD more active after pulmonary rehabilitation? Chest 2008; 134: 273-80.
  41. Rossi G, Florini F, Romagnoli M et al. Length and clinical effectiveness of pulmonary rehabilitation in outpatients with chronic airway obstruction. Chest 2005; 127: 105-9.
  42. Albores J, Marolda C, Haggerty M et al. The use of a home exercise program based on a computer system in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev 2013; 33: 47-52.
  43. Fernández A.M, Pascual J, Ferrando C et al. Home-based pulmonary rehabilitation in very severe COPD: is it safe and useful? J Cardiopulm Rehabil Prev 2009; 29: 325-31.
  44. Guell M.R, De Lucas P, Galdiz J.B et al. Home vs hospital-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: a Spanish multicenter trial. Arch Broncopneumol 2008; 44: 512-18.
  45. Maltais F, Bourbeau J, Shapiro S et al. Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Ann Intern Med 2008; 149: 869-78.
  46. Mendes De Oliveira J.C, Studart Leitao Filho F.S, Malosa Sampaio L.M et al. Outpatient vs. home-based pulmonary rehabilitation in COPD: a randomized controlled trial. Multidiscip Respir Med 2010; 5: 401-9.
  47. Puente-Maestu L, Sanz M.L, Sanz P et al. Comparison of effects of supervised versus self-monitored training programmes in patients with chronic obstructive pulmonary disease. Eur Respir J 2000; 15: 517-25.
  48. White R.J, Rudkin S.T, Harrison S.T et al. Pulmonary rehabilitation compared with brief advice given for severe chronic obstructive pulmonary disease. J Cardpulm Rehabil 2002; 22: 338-44.
  49. Falvo D.R. Effective patients education. A guide to increased compliance. Third edition. UK. Jones and Bartlett Publishers, 2004.
  50. Toshima M.T, Kaplan R.M, Riae A.L. Experimental evaluation of rehabilitation in chronic obstructive pulmonary disease: short-term effects on exercise endurance and health status. Health Psychol 1990; 9 (3): 237-52.
  51. Van Manen J.G, Bindels P.J.E, Dekker F.W et al. The influence of COPD on health-related quality of life independent of the influence of comorbidity. J Clin Epid 2003; 56: 1177-84.
  52. Белевский А.С. Организация и проведение обучения больных хронической обструктивной болезнью легких: Методические рекомендации. М.: Атмосфера, 2003.
  53. Клинические рекомендации. Пульмонология. Под ред. А.Г.Чучалина. М.: ГЭОТАР-Медиа, 2005.
  54. Клинические рекомендации. Хроническая обструктивная болезнь легких. Под ред. А.Г.Чучалина М.: Атмосфера, 2003.
  55. Семенюк С.А. Влияние обучения больных ХОБЛ на течение заболевания и качество жизни. Дис. … канд. мед. наук. М., 2007.
  56. Hoogendoorn M, van Wetering C.R, Schols A.M, Rutten-van Mölken M.P. Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective? Eur Respir J 2010; 35: 79-87.
  57. Hopp J.W, Neish C.M. Patients and family education. In: Hodgkin JE, Connors GL, Bell CW, eds. Pulmonary rehabilitation. Guidelines to success. Philadelphia: JB Lippincolt, 1993.
  58. Lorig K, Stewart A, Ritter P, Gonzalez V. Outcome measures for health education and other health care interventios. Sage Publications, 1996; p. 10-34.
  59. Griffiths T.L, Phillips C.J, Davies S et al. Cost effectiveness of an outpatient multidisciplinary pulmonary rehabilitation programme. Thorax 2001; 56: 779-84.
  60. Waterhouse J.C, Walters S.J, Oluboyede Y, Lawson R.A. A randomized trial of community versus hospital pulmonary rehabilitation, followed by telephone or conventional follow-up. Health Technol Assess 2010; 14: i-v, vii-xi, 1-140.
  61. Thorpe O, Johnston K, Kumar S. Barriers and enablers to physical activity participation in patients with COPD: a systematic review. J Cardiopulm Rehabil Prev 2012; 32: 359-69.
  62. Hogg L, Grant A, Garrod R et al. People with COPD perceive ongoing, structured and socially supportive exercise opportunities to be important for maintaining an active lifestyle following pulmonary rehabilitation: a qualitative study. J Physiother 2012; 58: 189-95.
  63. Jenkins S, Hill K, Cecins N.M. State of the art: how to set up a pulmonary rehabilitation program. Respirology 2010; 15: 1157-73.
  64. Lotters F, van Tol B, Kwakkel G, Gosselink R. Effects of controlled inspiratory muscle training in patients with COPD: a meta-analysis. Eur Respir J 2002; 20: 570-6.
  65. Magadle R, McConnell A.K, Beckerman M, Weiner P. Inspiratory muscle training in pulmonary rehabilitation program in COPD patients. Respir Med 2007; 101: 1500-5.
  66. O’Brien K, Geddes E.L, Reid W.D et al. Inspiratory muscle training compared with other rehabilitation interventions in chronic obstructive pulmonary disease: a systematic review update. J Cardiopulm Rehabil Prev 2008; 28: 128-41.
  67. Revill S.M, Singh S.J, Morgan M.D. Randomized controlled trial of ambulatory oxygen and an ambulatory ventilator on endurance exercise in COPD. Respir Med 2000; 94: 778-83.
  68. Emtner M, Porszasz J, Burns M et al. Benefits of supplemental oxygen in exercise training in nonhypoxemic chronic obstructive pulmonary disease patients. Am J Respir Crit Care Med 2003; 168: 1034-42.
  69. Dyer F, Callaghan J, Cheema K et al. Ambulatory oxygen improves the effectiveness of pulmonary rehabilitation in selected patients with chronic obstructive pulmonary disease. Chron Respir Dis 2012; 9: 83-91.
  70. Garrod R, Mikelsons C, Paul E.A et al. Randomized controlled trial of domiciliary noninvasive positive pressure ventilation and physical training in severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000; 162 (41): 1335-41.
  71. Duiverman M.L, Wempe J.B, Bladder G et al. Nocturnal non-invasive ventilation in addition to rehabilitation in hypercapnic patients with COPD. Thorax 2008; 63: 1052-7.
  72. Kohnlein T, Schonheit-Kenn U, Winterkamp S et al. Noninvasive ventilation in pulmonary rehabilitation of COPD patients. Respir Med 2009; 103: 1329-36.
  73. Van’t Hul A, Kwakkel G, Gosselink R. The acute effects of noninvasive ventilator support during exercise on exercise endurance and dyspnea in patients with chronic obstructive pulmonary disease: a systematic review. J Cardpulm Rehabil 2002; 22: 290-7.
  74. Costes F, Agresti A, Court-Fortune I et al. Noninvasive ventilation during exercise training improves exercise tolerance in patients with chronic obstructive pulmonary disease. J Cardpulm Rehabil 2003; 23: 307-13.
  75. Reuveny R, Ben-Dov I, Gaides M et al. Ventilatory support during training improves training benefit in severe chronic airway obstruction. Isr Med Assoc J 2005; 7: 151-5.
  76. Van’t Hul A, Gosselink R, Hollander P et al. Training with inspiratory pressure support in patients with severe COPD. Eur Respir J 2006; 27: 65-72.
  77. Toledo A, Borghi-Silva A, Sampaio L.M.M et al. The impact of noninvasive ventilation during the physical training in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). Clinics 2007; 62: 113-20.
  78. Hawkins P, Johnson L.C, Nikoletou D et al. Proportional assist ventilation as an aid to exercise training in severe chronic obstructive pulmonary disease. Thorax 2002; 57: 853-9.
  79. Rooyackers J.M, Dekhuijzen P.N, van Herwaarden C.L et al. Training with supplemental oxygen in patients with COPD and hypoxaemia at peak exercise. Eur Respir J 1997; 10: 1278-84.
  80. Garrod R, Paul E.A, Wedzicha J.A. Supplemental oxygen during pulmonary rehabilitation in patients with COPD with exercise hypoxaemia. Thorax 2000; 55: 539-43.
  81. Arnardóttir R., Boman G, Larsson K et al. Interval training compared with continuous training in patients with COPD. Respir Med 2007; 101: 1196-204.
  82. Mador M.J, Krawza M, Alhajhusian A et al. Interval training versus continuous training in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev 2009; 29: 126-32.
  83. Nasis I.G, Vogiatzis I, Stratakos G et al. Effects of interval-load versus constant-load training on the BODE Index in COPD patients. Respir Med 2009; 103: 1392-8.
  84. Puhan M.A, Büsching G, Schünemann H.J et al. Interval versus continuous high-intensity exercise in chronic obstructive pulmonary disease:a randomized trial. Ann Intern Med 2006; 145: 816-25.
  85. Varga J, Porszasz J, Boda K et al. Supervised high intensity continuous and interval training vs. self-paced training in COPD. Respir Med 2007; 101: 2297-304.
  86. Vogiatzis I, Terzis G, Nanas S et al. Skeletal muscle adaptations to interval training in patients with advanced COPD. Chest 2005; 128: 3838-45.
  87. Vogiatzis I, Terzis G, Stratakos G et al. Effect of pulmonary rehabilitation on peripheral muscle fiber remodeling in patients with COPD in GOLD stages II to IV. Chest 2011; 140: 744-52.
  88. Beauchamp M.K, Nonoyama M, Goldstein R.S et al. Interval versus continuous training in individuals with chronic obstructive pulmonary disease-a systematic review. Thorax 2010; 65: 157-64.
  89. Hawkins P, Johnson L.C, Nikoletou D et al. Proportional assist ventilation as an aid to exercise training in severe chronic obstructive pulmonary disease. Thorax 2002; 57: 853-9.
  90. Rodrigo G, Pollack C, Rodrigo C et al. Heliox for treatment of exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2002; 2: CD003571.
  91. Ho A.M, Lee A, Karmakar M.K et al. Heliox vs air-oxygen mixtures for the treatment of patients with acute asthma: a systematic overview. Chest 2003; 123: 882-90.
  92. Johnson J.E, Gavin D.J, Adams-Dramiga S. Effects of training with heliox and noninvasive positive pressure ventilation on exercise ability in patients with severe COPD. Chest 2002; 122: 464-72.
  93. Vivodtzev I, Pepin J.L, Vottero G et al. Improvement in quadriceps strength and dyspnea in daily tasks after 1 month of electrical stimulation in severely deconditioned and malnourished COPD. Chest 2006; 129: 1540-8.
  94. Zanotti E, Felicetti G, Maini M et al. Peripheral muscle strength training in bed-bound patients with COPD receiving mechanical ventilation: effect of electrical stimulation. Chest 2003; 124: 292-6.
  95. Vivodtzev I, Debigare R, Gagnon P et al. Functional and muscular effects of neuromuscular electrical stimulation in patients with severe COPD: a randomized clinical trial. Chest 2012; 141: 716-25.
  96. Bourjeily-Habr G, Rochester C.L, Palermo F et al. Randomised controlled trial of transcutaneous electrical muscle stimulation of the lower extremities in patients with chronic obstructive pulmonary disease. Thorax 2002; 57: 1045-9.
  97. Schols A.M, Ferreira I.M, Franssen F.M et al. Nutritional assessment and therapy in COPD: a European Respiratory Society statement. Eur Respir J 2014; 44: 1504-20.
  98. Ferreira I.M, Brooks D, White J et al. Nutritional supplementation for stable chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2012; 12: CD000998.
  99. Wilson D.O, Rogers R.M, Wright E.C, Anthonisen N.R. Body weight in chronic obstructive pulmonary disease. The national Institutes of Health Intermittent Positive-Pressure Breathing Trial. Am Rev Respir Dis 1989; 139: 1435-8.
  100. Creutzberg E.C, Wouters E.F.M, Mostert R et al. A role for anabolic steroids in the rehabilitation of patients with COPD? A double-blind, placebo-controlled, randomized trial. Chest 2003; 124: 1733-42.
  101. Pison C.M, Cano N.J, Cherion C et al. Multimodal nutritional rehabilitation improves clinical outcomes of malnourished patients with chronic respiratory failure: a randomised controlled trial. Thorax 2011; 66: 953-60.
  102. Broekhuizen R, Creutzberg E.C, Weling-Scheepers C.A.P.M et al. Optimizing oral nutritional drink supplementation in patients with chronic obstructive pulmonary disease. Br J Nutr 2005; 93: 965-71.
  103. Borghi-Silva A, Baldissera V, Sampaio L.M.M et al. L-carnitine as an ergogenic aid for patients with chronic obstructive pulmonary disease submitted to whole-body and respiratory muscle training programs. Braz J Med Biol Res 2006; 39: 465-74.
  104. Baldi S, Aquilani R, Pinna G.D et al. Fat-free mass change after nutritional rehabilitation in weight losing COPD: role of insulin, C-reactive protein and tissue hypoxia. Int J COPD 2010; 5: 29-39.
  105. Kubo H, Honda N, Tsuji F et al. Effects of dietary supplements on the Fischer ratio before and after pulmonary rehabilitation. Asia Pac J Clin Nutr 2006; 15: 551-5.
  106. Broekhuizen R, Wouters E.F.M, Creutzberg E.C et al. Polyunsaturated fatty acids improve exercise capacity in chronic obstructive pulmonary disease. Thorax 2005; 60: 376-82.
  107. Carreiro A, Santos J, Rodrigues F. Impact of comorbidities in pulmonary rehabilitation outcomes in patients with chronic obstructive pulmonary disease. Rev Port Pneumol 2013; 19: 106-13.
  108. Von Leupoldt A, Taube K, Lehmann K et al. The impact of anxiety and depression on outcomes of pulmonary rehabilitation in patients with COPD. Chest 2011; 140: 730-6.
  109. Garrod R, Marshall I, Barley E et al. Predictors of success and failure in pulmonary rehabilitation. Eur Respir J 2006; 27: 788-94.
  110. Овчаренко С.И., Галецкайте Я.К., Волель Б.А. и др. Типы реагирования на хроническое заболевание у пациентов с хронической обструктивной болезнью легких и ревматоидным артритом. Клиницист. 2013; 1: 21-9.
  111. Овчаренко С.И., Галецкайте Я.К., Волель Б.А. Легочная реабилитация больных хронической обструктивной болезнью легких с учетом типа реагирования на заболевание. Сибирское мед. обозрение. 2017; 5 (107): 28-35.
  112. Foglio K, Bianchi L, Bruletti G et al. Seven-year time course of lung function, symptoms, health-related quality of life, and exercise tolerance in COPD patients undergoing pulmonary rehabilitation programs. Respir Med 2007; 101: 1961-70.
  113. Griffiths T.L, Burr M.L, Campbell I.A. et al. Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial. Lancet 2000; 355: 362-8.
  114. Spruit M.A, Troosters T, Trappenburg J.C et al. Exercise training during rehabilitation of patients with COPD: a current perspective. Patient Educ Couns 2004; 52: 243-8.
  115. Carr S.J, Goldstein R.S, Brooks D. Acute exacerbations of COPD in subjects completing pulmonary rehabilitation. Chest 2007; 132: 127-34.
  116. Hill K, Bansal V, Brooks D, Goldstein R.S. Repeat pulmonary rehabilitation programs confer similar increases in functional exercise capacity to initial programs. J Cardiopulm Rehabil Prev 2008; 28: 410-4.
  117. Romagnoli M, Dell’Orso D, Lorenzi C et al. Repeated pulmonary rehabilitation in severe and disabled COPD patients. Respiration 2006; 73: 769-76.
  118. Carr S.J, Hill K, Brooks D, Goldstein R.S. Pulmonary rehabilitation after acute exacerbation of chronic obstructive pulmonary disease in patients who previously completed a pulmonary rehabilitation program. J Cardiopulm Rehabil Prev 2009; 29: 318-24.
  119. Галецкайте Я.К. Хроническая обструктивная болезнь легких: клинико-психосоматические соотношения и реабилитационные подходы. Дис. … канд. мед. наук. М., 2014.

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