**13. Conclusions**

A comprehensive multimodality pulmonary rehabilitation program is becoming an essential part of the management of COPD patients. It is not only cost effective but also scientifically proven to improve patients' symptoms and functionality. With a gradual increase in daily activity, COPD patients are able to achieve higher HRQoL compared to pharmacotherapy alone. Despite these proven benefits, widespread utilization of PR remains poor. Multiple factors, including; physician unfamiliarity of benefits of PR, patient compliance with the exercise regimen and insurance coverage contribute to this gap. With the increasing prevalence of COPD worldwide, a safe and effective option like PR needs to be actively promoted and utilized.

**15**

**Author details**

provided the original work is properly cited.

*Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease*

Apart from standardized exercise regimens and strength training, the emphasis of an effective PR program is on behavioral modification. This result in long lasting, positive changes on the disease course. In addition, empowering the COPD patients by educating them about disease, smoking cessation and nutrition is a crucial step in the right direction. Development of home based or telerehabilitation services may assist in reducing the disparity in access to PR for many more COPD patients.

*DOI: http://dx.doi.org/10.5772/intechopen.81742*

Authors declare no conflicts of interest.

PR pulmonary rehabilitation HRQoL health-related quality of life RCT randomized controlled trial

ADLs activities of daily living

6MWT 6 minute walk test

COPD chronic obstructive pulmonary disease

NMES neuromuscular electrical stimulation

mMRC modified Medical Research Council

FIM functional independence measure AMPS assessment of motor and process skills

Ankur Girdhar\*, Puneet Agarwal and Amita Singh Peninsula Regional Medical Center, Salisbury, MD, USA

\*Address all correspondence to: ankur.girdhar@peninsula.org

FCE functional capacity evaluation DEXA dual energy X-ray absorptiometry

capacity

AECOPD acute exacerbation of chronic obstructive pulmonary disease

BODE index body mass index, airflow obstruction, dyspnea and exercise

**Conflict of interest**

**Appendix**

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

*Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease DOI: http://dx.doi.org/10.5772/intechopen.81742*

Apart from standardized exercise regimens and strength training, the emphasis of an effective PR program is on behavioral modification. This result in long lasting, positive changes on the disease course. In addition, empowering the COPD patients by educating them about disease, smoking cessation and nutrition is a crucial step in the right direction. Development of home based or telerehabilitation services may assist in reducing the disparity in access to PR for many more COPD patients.
