康复
医学
肺康复
肺病
疾病
疾病管理
梅德林
重症监护医学
慢性病
临床试验
物理疗法
生活质量(医疗保健)
慢性病
医疗保健
护理部
病理
法学
经济
帕金森病
内科学
经济增长
政治学
作者
Caroline R. Richardson,Barry A. Franklin,Marilyn L. Moy,Elizabeth A. Jackson
出处
期刊:BMJ
[BMJ]
日期:2019-06-17
卷期号:: l2191-l2191
被引量:45
摘要
Abstract Much of the burden on healthcare systems is related to the management of chronic conditions such as cardiovascular disease and chronic obstructive pulmonary disease. Although conventional outpatient cardiopulmonary rehabilitation programs significantly decrease morbidity and mortality and improve function and health related quality of life for people with chronic diseases, rehabilitation programs are underused. Barriers to enrollment are multifactorial and include failure to recommend and refer patients to these services; poor communication with patients about potential benefits; and patient factors including logistical and financial barriers, comorbidities, and competing demands that make participation in facility based programs difficult. Recent advances in rehabilitation programs that involve remotely delivered technology could help deliver services to more people who might benefit. Problems with intensity, adherence, and safety of home based programs have been investigated in recent clinical trials, and larger dissemination and implementation trials are under way. This review summarizes the evidence for benefit of in-person cardiac and pulmonary rehabilitation programs. It also reviews the literature on newer developments, such as home based remotely mediated exercise programs developed to decrease cost and improve accessibility, high intensity interval training in cardiac rehabilitation, and alternative therapies such as tai chi and yoga for people with chronic obstructive pulmonary disease.
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