**5. References**


use of an accelerometer, the values of respiratory muscle strength and peripheral muscle strength (hand grip, knee- extension); also more sensitive tools for detecting changes in

Agostoni, E., Gurtner, G., Torri, G., & Rahn, H. (1966). Respiratory mechanics during

American college of sports medicine position stand exercise and physical activity for older adults. (1998a). *Medicine and Science in Sports and Exercise, 30*(6), 992-1008. American college of sports medicine position stand. The recommended quantity and quality

American Thoracic Society, & American College of Chest Physicians. (2003). ATS/ACCP

Ancochea Bermúdez J, et al. (2009). *Estrategia en EPOC del sistema nacional de salud* Retrieved

Araujo, Z. T., & Holanda, G. (2010). Does the BODE index correlate with quality of life in

Asanuma Y, Fujita S, Ide H, & Agishi Y. (1971). Improvement of respiratory resistane by hot

Asanuma Y. (1999). Influence of water immersion on lung volumes and pulmonary

ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories.

Baraniak, A., & Sheffield, D. (2011). The efficacy of psychologically based interventions to

Barbera, J. A., Peces-Barba, G., Agustí, A. G., Izquierdo, J. L., Monsó, E., Montemayor, T., et

Bausewein, C., Farquhar, M., Booth, S., Gysels, M., & Higginson, I. J. (2007). Measurement of

pulmonar obstructiva crónica*. Archivos Bronconeumología, 3*7(6), 297-316. Bauldoff, G. S., Hoffman, L. A., Sciurba, F., & Zullo, T. G. (1996). Home-based, upper-arm

http://www.msc.es/organizacion/sns/planCalidadSNS/docs/EstrategiaEPOCS

*Critical Care Medicine, 167*(2), 211-277. doi:10.1164/rccm.167.2.211

*Brasileira De Pneumologia e Tisilogia, 3*6(4), 447-452.

*Respiratory and Critical Care Medicine, 16*6(1), 111-117.

*Lung : The Journal of Critical Care, 2*5(4), 288-294.

*10*1(3), 399-410. doi:10.1016/j.rmed.2006.07.003

submersion and negative-pressure breathing. *Journal of Applied Physiology, 21*(1),

of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults.(1998b). *Medicine and Science in Sports and Exercise,* 

statement on cardiopulmonary exercise testing. *American Journal of Respiratory and* 

patients with COPD*? Jornal Brasileiro De Pneumologia: Publicacao Oficial Da Sociedade* 

water immersing exercise in adult asthmatic patient*. Clinical Rehabilitation,* 1, 211-

diffusing capacity. A comparison of healthy subjects and patients with chronic obstructive pulmonary disease*. Japanese Journal of Clinical Physiology, 2*9(3), 187-192.

(2002). ATS statement: Guidelines for the six-minute walk test*. American Journal of* 

improve anxiety, depression and quality of life in COPD: A systematic review and meta-analysis*. Patient Education and Counseling, 8*3(1), 29-36. doi:10.1016/

al. (2001). Guía clínica para el diagnóstico y el tratamiento de la enfermedad

exercise training for patients with chronic obstructive pulmonary disease*. Heart &* 

breathlessness in advanced disease: A systematic review*. Respiratory Medicine,* 

exercise tolerance should be included.

**5. References** 

251-258.

*30*(6), 975-991.

2011, from

NS.pdf

217.

j.pec.2010.04.010


Types of Physical Exercise Training for COPD Patients 369

Geytenbeek J. (2008). *Aquatic physiotherapy evidence-based practice guide*. Retrieved from http://www.npz-nrz.nl/downloads/files/Plenair%20Marijke%20HopmanRock2.pdf *Global iniciative for chronic obstructive lung disease (GOLD)*. (2010). Retrieved

Gosselink, R., De Vos, J., van den Heuvel, S. P., Segers, J., Decramer, M., & Kwakkel, G.

*Clinical Respiratory Physiology, 37*(2), 416-425. doi:10.1183/09031936.00031810 Green, R. H., Singh, S. J., Williams, J., & Morgan, M. D. (2001). A randomised controlled trial

Greenleaf J E. (1984). Physiological responses to prolonged bed rest and fluid immersion in

Gruffydd-Jones, K., & Loveridge, C. (2011). The 2010 NICE COPD guidelines: How do they

*General Practice Airways Group, 20*(2), 199-204. doi:10.4104/pcrj.2011.00011 Guyatt, G. H., Berman, L. B., Townsend, M., Pugsley, S. O., & Chambers, L. W. (1987). A

Hilberink, S. R., Jacobs, J. E., van Opstal, S., van der Weijden, T., Keegstra, J., Kempers, P. L.,

Jones, P. W., Quirk, F. H., Baveystock, C. M., & Littlejohns, P. (1992). A self-complete

questionnaire. *The American Review of Respiratory Disease, 145*(6), 1321-1327. Jones, P. W. (2001). Health status measurement in chronic obstructive pulmonary disease.

Jones PW. (2002). Interpreting thresholds for a clinically significant change in health status in asthma and COPD. *Eur Respir j., 19*, 398-404. doi:10.1183/09031936.02.00063702 Kurabayashi H, Machida I, Tamura K, Iwai F, Tamura J, & Kubota K. (2000). Breathing out

Lacasse, Y., Goldstein, R., Lasserson, T. J., & Martin, S. (2006). Pulmonary rehabilitation for

Langer, D., Hendriks, E., Burtin, C., Probst, V., van der Schans, C., Paterson, W., et al. (2009).

Laszlo, G. (2006). Standardisation of lung function testing: Helpful guidance from the ATS/ERS task force. *Thorax, 61*(9), 744-746. doi:10.1136/thx.2006.061648

*(Online), (4)*(4), CD003793. doi:10.1002/14651858.CD003793.pub2

*Clinical Rehabilitation, 23*(5), 445-462. doi:10.1177/0269215509103507

(2011). Impact of inspiratory muscle training in patients with COPD: What is the evidence*? The European Respiratory Journal : Official Journal of the European Society for* 

of four weeks versus seven weeks of pulmonary rehabilitation in chronic

compare with the GOLD guidelines? *Primary Care Respiratory Journal: Journal of the* 

measure of quality of life for clinical trials in chronic lung disease. *Thorax, 42*(10),

et al. (2011). Validation of smoking cessation self-reported by patients with chronic obstructive pulmonary disease. *International Journal of General Medicine, 4*, 85-90.

measure of health status for chronic airflow limitation. the st. george's respiratory

into water during subtotal immersion: A therapy for chronic pulmonary emphysema. *American Journal of Physical Medicine & Rehabilitation, 79*, 150-153. Kurabayashi, H., Machida, I., Hnda H., Akiba T., Kubota K., et al. (1998). Comparison of

three protocols for breathing exercises during immersion in 38ºC water for chronic obstructive pulmonary disease. *American Journal of Physical Medicine &* 

chronic obstructive pulmonary disease. *Cochrane Database of Systematic Reviews* 

A clinical practice guideline for physiotherapists treating patients with chronic obstructive pulmonary disease based on a systematic review of available evidence.

Marzo/23, 2011, from http://www.goldcopd.com

obstructive pulmonary disease. *Thorax, 56*(2), 143-145.

humans. *Journal of Applied Physiology, 57*(3), 619-633.

773-778.

doi:10.2147/IJGM.S15231

*Thorax, 56*(11), 880-887.

*Rehabilitation, 77*(2), 145-147.


Couillard A, & Prefaut C. (2005). From muscle disuse to myopathy in COPD: Potencial contribution of oxidative stress*. European Respiratory journal, 2*6(4), 703-719. Dahlback, G. O. (1975). Influence of intrathoracic blood pooling on pulmonary air-trapping

Eaton, T., Young, P., Nicol, K., & Kolbe, J. (2006). The endurance shuttle walking test: A

Epstein, S. K., Celli, B. R., Martinez, F. J., Couser, J. I., Roa, J., Pollock, M., et al. (1997). Arm

Esteban, C. (2009). Role of physical activity in chronic obstructive pulmonary disease.

Esteban, C., Quintana, J. M., Aburto, M., Moraza, J., Egurrola, M., Perez-Izquierdo, J., et al.

Fishman, A. P. (2008). *Pulmonary diseases and disorder*s (4th ed.). New York: McGraw-Hill. Foy, C. G., Rejeski, W. J., Berry, M. J., Zaccaro, D., & Woodard, C. M. (2001). Gender

Frontera W.R., Herring S.A., Micheli L.J., & Silver J.K. (2008). *Medicina deportiva clínica:* 

Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., et al.

Garrod, R., Marshall, J., Barley, E., & Jones, P. W. (2006). Predictors of success and failure in

Garrod, R., & Lasserson, T. (2007). Role of physiotherapy in the management of chronic lung

Geddes, E. L., Reid, W. D., Crowe, J., O'Brien, K., & Brooks, D. (2005). Inspiratory muscle

Geytenbeek, J. (2002). Evidence for effective hydrotherapy*. Physiotherapy, 8*8(9), 514-529.

responsive measure in pulmonary rehabilitation for COPD patients*. Chronic* 

training reduces the VO2 and VE cost of unsupported arm exercise and elevation in chronic obstructive pulmonary disease*. Journal of Cardiopulmonary Rehabilitation,* 

[Impacto de la actividad física en la EPOC] *Archivos de Bronconeumología, 45 Suppl* 5,

(2010). Impact of changes in physical activity on health-related quality of life among patients with COPD*. The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology, 3*6(2), 292-300. doi:10.1183/

moderates the effects of exercise therapy on health-related quality of life among

(2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise*. Medicine and Science in Sports and Exercise,* 

pulmonary rehabilitation. *The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology, 27*(4), 788-794. doi:10.1183/

diseases: An overview of systematic reviews*. Respiratory Medicine, 10*1(12), 2429-

training in adults with chronic obstructive pulmonary disease: A systematic review*. Respiratory Medicine, 9*9(11), 1440-1458. doi:10.1016/j.rmed.2005.03.006 Geddes, E. L., O'Brien, K., Reid, W. D., Brooks, D., & Crowe, J. (2008). Inspiratory muscle

training in adults with chronic obstructive pulmonary disease: An update of a systematic review*. Respiratory Medicine, 10*2(12), 1715-1729. doi:10.1016/

during immersion*. Undersea Biomedical Research,* 2(2), 133-140.

*Respiratory Disease,* 3(1), 3-9.

7-13. doi:10.1016/S0300-2896(09)72949-7

COPD patients*. Chest, 11*9(1), 70-76.

2436. doi:10.1016/j.rmed.2007.06.007

doi:DOI: 10.1016/S0031-9406(05)60134-4

*tratamiento médico y rehabilitació*n Elsevier.

*4*3(7), 1334-1359. doi:10.1249/MSS.0b013e318213fefb

*1*7(3), 171-177.

09031936.00021409

09031936.06.00130605

j.rmed.2008.07.005


Types of Physical Exercise Training for COPD Patients 371

Okubadejo, A. A., Jones, P. W., & Wedzicha, J. A. (1996). Quality of life in patients with

O'Shea, S. D., Taylor, N. F., & Paratz, J. (2004). Peripheral muscle strength training in COPD: A systematic review. *Chest, 126*(3), 903-914. doi:10.1378/chest.126.3.903 O'Shea, S. D., Taylor, N. F., & Paratz, J. (2009). Progressive resistance exercise improves

Pepin, V., Saey, D., Whittom, F., LeBlanc, P., & Maltais, F. (2005). Walking versus cycling:

Pepin, V., Brodeur, J., Lacasse, Y., Milot, J., Leblanc, P., Whittom, F., et al. (2007). Six-minute

Perk J, Perk L, & Bodén C. (1996). Cardiorespiratory adaptation of COPD patients to physical training on land and in water. *European Respiratory Journal, 9*(2), 248-252. Polkey, M. I., Kyroussis, D., Hamnegard, C. H., Mills, G. H., Green, M., & Moxham, J. (1996).

Polkey, M. I., & Moxham, J. (2004). Improvement in volitional tests of muscle function alone

Puente-Maestu, L., Sanz, M. L., Sanz, P., Cubillo, J. M., Mayol, J., & Casaburi, R. (2000).

Puente-Maestu, L., Sanz, M. L., Sanz, P., Ruiz de Ona, J. M., Rodriguez-Hermosa, J. L., &

Puhan MA, Büsching G, Chünemann HJ, vanOort E, Zaugg C, & Frey M. (2006). Interval

Rabe, K. F., Hurd, S., Anzueto, A., Barnes, P. J., Buist, S. A., Calverley, P., et al. (2007). Global

*Critical Care Medicine, 176*(6), 532-555. doi:10.1164/rccm.200703-456SO

disease. A randomized trial. *Annals of Internal Medicine, 145*, 816-825. Puhan, M., Scharplatz, M., Troosters, T., Walters, E. H., & Steurer, J. (2009). Pulmonary

*Respiratory and Critical Care Medicine, 154*(5), 1310-1317.

10.1378/chest.09-0029

doi:10.1164/rccm.200507-1037OC

*Respiratory Physiology, 23*(1), 5-6.

doi:10.1002/14651858.CD005305.pub2

517-525.

1026-1032.

chronic obstructive pulmonary disease and severe hypoxaemia. *Thorax, 51*(1), 44-47.

muscle strength and may improve elements of performance of daily activities for people with COPD: A systematic review. *Chest*, 136, 1269-1283. Doi

Sensitivity to bronchodilation in chronic obstructive pulmonary disease. *American Journal of Respiratory and Critical Care Medicine, 172*(12), 1517-1522.

walking versus shuttle walking: Responsiveness to bronchodilation in chronic obstructive pulmonary disease. *Thorax, 62*(4), 291-298. doi:10.1136/thx.2006.065540

Diaphragm strength in chronic obstructive pulmonary disease. *American Journal of* 

may not be adequate evidence that inspiratory muscle training is effective. *The European Respiratory Journal : Official Journal of the European Society for Clinical* 

Comparison of effects of supervised versus self-monitored training programmes in patients with chronic obstructive pulmonary disease. *The European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology, 15*(3),

Whipp, B. J. (2000). Effects of two types of training on pulmonary and cardiac responses to moderate exercise in patients with COPD. *The European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology, 15*(6),

versus continuous high-intensity exercise in chronic obstructive pulmonary

rehabilitation following exacerbations of chronic obstructive pulmonary disease. *Cochrane Database of Systematic Reviews (Online), (1)*(1), CD005305.

strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. *American Journal of Respiratory and* 


Lotters, F., van Tol, B., Kwakkel, G., & Gosselink, R. (2002). Effects of controlled inspiratory

Mahler, D. A., Mejia-Alfaro, R., Ward, J., & Baird, J. C. (2001). Continuous measurement of

Mahler, D. A. (2006). Mechanisms and measurement of dyspnea in chronic obstructive

Manual para la rehabilitación respiratoria para personas con EPOC. Retrieved from Manual\_de\_Rehabilitacion\_Respiratoria\_para\_personas\_con\_EPOC.pdf Maltais, F., LeBlanc, P., Jobin, J., Berube, C., Bruneau, J., Carrier, L., et al. (1997). Intensity of

May, D. B., & Munt, P. W. (1979). Physiologic effects of chest percussion and postural drainage in patients with stable chronic bronchitis. *Chest, 75*(1), 29-32. National Clinical Guideline Centre. (2010) Chronic obstructive pulmonary disease:

Miller, M. R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A., et al. (2005).

Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C., et al. (2007).

Newton, D. A., & Bevans, H. G. (1978). Physiotherapy and intermittent positive-pressure ventilation of chronic bronchitis. *British Medical Journal, 2*(6151), 1525-1528. Nici, L., Donner, C., Wouters, E., Zuwallack, R., Ambrosino, N., Bourbeau, J., et al. (2006).

Normandin, E. A., McCusker, C., Connors, M., Vale, F., Gerardi, D., & ZuWallack, R. L.

O'Donnell, D. E., Hernandez, P., Kaplan, A., Aaron, S., Bourbeau, J., Marciniuk, D., et al.

http://guidance.nice.org.uk/CG101/Guidance/pdf/English

*116*(9), 1094-1105. doi:10.1161/CIRCULATIONAHA.107.185650

1390-1413. doi:10.1164/rccm.200508-1211ST

rehabilitation. *Chest, 121*(4), 1085-1091.

*Applied Physiology (Bethesda, Md.: 1985), 90*(6), 2188-2196.

doi:10.1513/pats.200509-103SF

crónicos. *Rehabilitación, 44*(2), 158-66.

09031936.05.00034805

570-576.

muscle training in patients with COPD: A meta-analysis. *The European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology, 20*(3),

breathlessness during exercise: Validity, reliability, and responsiveness. *Journal of* 

pulmonary disease. *Proceedings of the American Thoracic Society, 3*(3), 234-238.

training and physiologic adaptation in patients with chronic obstructive pulmonary disease. *American Journal of Respiratory and Critical Care Medicine, 155*(2), 555-561. Martín-Valero R, Cuesta-Vargas AI, & Labajos-Manzanares MT. (2010). Revisión de ensayos

clínicos sobre rehabilitación respiratoria en enfermos pulmonares obstructivos

management of chronic obstructive pulmonary disease in adults in primary and secondary care. London: National Clinical Guideline Centre. Available from:

Standardisation of spirometry. *The European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology, 26*(2), 319-338. doi:10.1183/

Physical activity and public health in older adults: Recommendation from the american college of sports medicine and the american heart association. *Circulation,* 

American thoracic Society/European respiratory society statement on pulmonary rehabilitation. *American Journal of Respiratory and Critical Care Medicine, 173*(12),

(2002). An evaluation of two approaches to exercise conditioning in pulmonary

(2008). Canadian thoracic society recommendations for management of chronic obstructive pulmonary disease - 2008 update - highlights for primary care. *Canadian Respiratory Journal : Journal of the Canadian Thoracic Society, 15 Suppl A*, 1A-8A.


Types of Physical Exercise Training for COPD Patients 373

Troosters, T., Gosselink, R., Langer, D., & Decramer, M. (2007). Pulmonary rehabilitation in

Troosters, T., Sciurba, F., Battaglia, S., Langer, D., Valluri, S. R., Martino, L., et al. (2010).

*Respiratory Medicine, 104*(7), 1005-1011. doi:DOI: 10.1016/j.rmed.2010.01.012 Vale F, Reardon JZ, ZuWallack RL. (1993). The long-term benefits of outpatient pulmonary rehabilitation on exercise tolerance and quality of life. *Chest, 103*, 42-45. Verrill, D., Barton, C., Beasley, W., & Lippard, W. M. (2005). The effects of short-term and

Vilaró, J., Gimeno, E., Sánchez Férez, N., Hernando, C., Díaz, I., Ferrer, M., et al. (2007).

Vu, K., & Mitsunobu, F. (2005a). Five year observation of the effects of spa therapy for

Vu, K., & Mitsunobu, F. (2005b). Spa therapy for chronic obstructive pulmonary disease.

Wadell, K., Sundelin, G., Henriksson-Larsen, K., & Rune Lundgren. (2004). High intensity

Wadell, K., Henriksson-Larsen, K., Lundgren, R., & Sundelin, G. (2005a). Group training in

*Disability and Rehabilitation, 27*(10), 571-581. doi:10.1080/09638280400018627 Wadell, K., Sundelin, F., Lundgren, R., Henriksson-Larsén, K., & Lindström, B. (2005b).

effects of a physical training programme. *Advances in Physiotherapy, 7*, 51-59. Weiner P, Magadle R, Beckerman M, Weiner M, & Berar-Yanay N. (2003). Specific

White, A. J., Gompertz, S., & Stockley, R. A. (2003). Chronic obstructive pulmonary disease .

Wijkstra, P. J., Ten Vergert, E. M., van Altena, R., Otten, V., Kraan, J., Postma, D. S., et al.

expiratory muscle training in COPD*. Chest, 12*4(2), 468-473.

randomized trial. *The American Journal of Medicine, 109*(3), 207-212.

quality of life. *Chest, 128*(2), 673-683. doi:10.1378/chest.128.2.673

http://external.doyma.es/pdf/2/2v129n09a13109543pdf001.pdf

*Alternative and Complementary Therapies, 11*(2), 89-93.

COPD. *Respiratory Medicine, 98*, 428-438.

89-93.

*5*8(1), 73-80.

824-828.

64. doi:DOI: 10.1016/j.rmedu.2007.02.003

cardiology (subcommittee on exercise, rehabilitation, and prevention) and the council on nutrition, physical activity, and metabolism (subcommittee on physical activity). *Circulation, 107*(24), 3109-3116. doi:10.1161/01.CIR.0000075572.40158.77 Troosters, T., Gosselink, R., & Decramer, M. (2000). Short- and long-term effects of

outpatient rehabilitation in patients with chronic obstructive pulmonary disease: A

chronic obstructive pulmonary disease. *Respiratory Medicine: COPD Update, 3*(2), 57-

Physical inactivity in patients with COPD, a controlled multi-center pilot-study.

long-term pulmonary rehabilitation on functional capacity, perceived dyspnea, and

Actividades de la vida diaria en pacientes con enfermedad pulmonar obstructiva crónica: Validación d. *Medicina Clínica, 129*(9), 326-332. Retrieved from

patients with pulmonary emphysema, evaluated by %low attenuation area (%LAA) of the lungs on high-resolution CT, %Dlco and %residual volume (RV).

Studies at the Misasa medical center. *Alternative & Complementary Therapies,* (April),

physical group training in water – an effective training modality for patients with

patients with COPD – long- term effects after decreased training frequency.

Muscle performance in patients with chronic obstructive pulmonary disease –

6: The aetiology of exacerbations of chronic obstructive pulmonary disease*. Thorax,* 

(1995). Long term benefits of rehabilitation at home on quality of life and exercise tolerance in patients with chronic obstructive pulmonary disease*. Thorax, 5*0(8),


Rabinovich, R. A., Ardite, E., Troosters, T., Carbo, N., Alonso, J., Gonzalez de Suso, J. M., et

Rabinovich, R. A., & Vilaro, J. (2010). Structural and functional changes of peripheral

Reda, A. A., Kotz, D., Kocks, J. W., Wesseling, G., & van Schayck, C. P. (2010). Reliability

Ries, A. L., Bauldoff, G. S., Carlin, B. W., Casaburi, R., Emery, C. F., Mahler, D. A., et al.

practice guidelines. *Chest, 131*(5 Suppl), 4S-42S. doi:10.1378/chest.06-2418 Ries, A. L. (2008). Pulmonary rehabilitation: Summary of an evidence-based guideline.

Rodrigues, F. (2010). Role of extra-pulmonary factors - depression, muscle weakness, health-

Rose, C., Wallace, L., Dickson, R., Ayres, J., Lehman, R., Searle, Y., et al. (2002). The most

Schoenhofer, B., Koehler, D., & Polkey, M. I. (2004). Influence of immersion in water on

Schrier, A. C., Dekker, F. W., Kaptein, A. A., & Dijkman, J. H. (1990). Quality of life in

Shoemaker, M. J., Donker, S., & Lapoe, A. (2009). Inspiratory muscle training in patients

Sinclair DJM, I. C. (1980). Controlled trial of supervised exercise training in chronic

Sobradillo, V., Miravitlles, M., Jiménez, C. A., Gabriel, R., Viejo, J. L., Masa, J. F., et al. (1999).

limitación crónica al flujo aéreo. *Archivos Bronconeumologia, 35*(4), 159-166. Storer, T. W. (2001). Exercise in chronic pulmonary disease: Resistance exercise prescription.

Sullivan, S. D., Ramsey, S. D., & Lee, T. A. (2000). The economic burden of COPD. *Chest,* 

Thompson, P. D., Buchner, D., Pina, I. L., Balady, G. J., Williams, M. A., Marcus, B. H., et al.

*Medicine and Science in Sports and Exercise, 33*(7 Suppl), S680-92.

*Pulmonary Medicine, 16*(2), 123-133. doi:10.1097/MCP.0b013e328336438d Ramsey, S. D., & Sullivan, S. D. (2003). The burden of illness and economic evaluation for

COPD. *The European Respiratory Journal.Supplement, 41*, 29s-35s.

*Care Medicine, 164*(7), 1114-1118.

*Respiratory Care, 53*(9), 1203-1207.

*Education and Counseling, 47*(4), 311-318.

*Cardiopulmonary Physical Therapy Journal, 20*(3), 5-15.

weakness. *Chest, 125*(6), 2069-2074.

bronchitis. *BMJ, 1*, 519-521.

*117*(2 Suppl), 5S-9S.

j.rmed.2010.04.023

709-715.

*98*(4), 894-899.

al. (2001). Reduced muscle redox capacity after endurance training in patients with chronic obstructive pulmonary disease. *American Journal of Respiratory and Critical* 

muscles in chronic obstructive pulmonary disease patients. *Current Opinion in* 

and validity of the clinical COPD questionniare and chronic respiratory questionnaire. *Respiratory Medicine, 104*(11), 1675-1682. doi:10.1016/

(2007). Pulmonary rehabilitation: Joint ACCP/AACVPR evidence-based clinical

related quality of life - in COPD evolution. *Revista Portuguesa De Pneumologia, 16*(5),

effective psychologically-based treatments to reduce anxiety and panic in patients with chronic obstructive pulmonary disease (COPD): A systematic review. *Patient* 

muscle function and breathing pattern in patients with severe diaphragm

elderly patients with chronic nonspecific lung disease seen in family practice. *Chest,* 

with chronic obstructive pulmonary disease: The state of the evidence.

Estudio IBERPOC en españa: Prevalencia de sintomas respiratorios habituales y de

(2003). Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: A statement from the council on clinical cardiology (subcommittee on exercise, rehabilitation, and prevention) and the council on nutrition, physical activity, and metabolism (subcommittee on physical activity). *Circulation, 107*(24), 3109-3116. doi:10.1161/01.CIR.0000075572.40158.77


**19** 

*Italy* 

**Hospital at Home for Elderly Patients** 

Demographic, epidemiological, social, and cultural trends in European countries are changing the traditional patterns of care. The next decades will see increasing rates of caredependent older people and non communicable diseases as the leading cause of chronic illness and disability. The break-up of the traditional large family group and urbanization will also lead to gaps in the care of older or disabled family members. These changes in needs and social structure require a different approach to health and social sector policy and services since a disease-oriented approach, alone, is no longer appropriate. An answer to these issues could be home care, a sustainable approach to prevent the need for unnecessary acute or long-term institutionalization and maintain individuals in their home and community as long as possible providing diagnostic, therapeutic and social support

Home is a place of emotional and physical associations, memories and comfort. Although many people can be happy in assisted-living facilities, retirement communities or nursing homes – and for many people these are better options – leaving home can be disruptive and depressing for some people. Recent trends in health care favour alternatives to traditional hospital care for patients with acute or chronic diseases. Home care used appropriately decreases hospitalization and nursing home use without compromising medical outcomes. Moreover, patients generally prefer to remain in familiar surroundings. Physician support

Chronic Obstructive Pulmonary Disease (COPD) has been the focus of several hospital at home studies, however, most models studied have been early-discharge schemes that employed nursing care, without physician care in the home. There have been fewer studies

of home care services honors that preference (Levine et al., 2003).

of substitutive physician-led clinical unit model of hospital at home.

**1. Introduction** 

(Tarricone & Tsouros, 2008).

**with Acute Exacerbation of Chronic** 

**Obstructive Pulmonary Disease** 

Aimonino Ricauda Nicoletta1, Tibaldi Vittoria1,

Bertone Paola1 and Isaia Giovanni Carlo2

*1Hospital at Home Service, San Giovanni* 

*2University of Torino, Department of Medical and Surgical Disciplines – Geriatric Section,* 

*Battista Hospital of Torino* 

*S. Giovanni Battista Hospital* 

Yohannes, A. M., Baldwin, R. C., & Connolly, M. J. (2005). Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease. *Age and Ageing, 34*(5), 491-496. doi:10.1093/ageing/afi163
