ZuWallack - Figure 23
Bronchodilator Therapy and Exercise Training
FIG. 23: Another important concept of pulmonary rehabilitation is that it is very effective when combined with other forms of therapy, particularly bronchodilators. This Figure shows data a multicenter study, also from Casaburi’s group, looking at a long-acting bronchodilator versus placebo in addition to pulmonary rehabilitation.[19] Patients with COPD were randomized to treatment with either a long-acting bronchodilator or placebo; patients were allowed use of a short-acting bronchodilator as needed. After 4 weeks, both groups were given a course of exercise training pulmonary rehabilitation, and then after the pulmonary rehabilitation was stopped they were followed for a further 10 weeks Looking at exercise endurance (y-axis), both groups benefited from the exercise training, but the group receiving the bronchodilator plus the pulmonary rehabilitation improved more. This supports the concept that maximally bronchodilating patients ensures that they can exercise train at higher intensities and get more benefit from the pulmonary rehabilitation.
References
Casaburi R, Kukafka D, Cooper CB, et al. Improvement in exercise tolerance with the combination of tiotropium and pulmonary rehabilitation in patients with COPD. Chest. 2005;127:809–817.
