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A rethink on rehabilitation could reverse frailty

16 June 2016


According to a new study, one in four patients with chronic obstructive pulmonary disease (COPD) respond favourably to exercise rehabilitation, despite being frail.


Chronic obstructive pulmonary disease (COPD) is a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. It is a major cause of ill health in the UK, affecting at least 900,000 people. 


Led by Royal Brompton & Harefield NHS Foundation Trust and King’s College London, the study has implications for the treatment of frailty, which affects one in ten people over 65 and is associated with a greater risk of falls, disability, hospitalisation and death.


Pulmonary rehabilitation targets many components of frailty, including slowness, fatigue, weakness and physical inactivity.


The study found that frail patients recruited from Harefield Hospital’s pulmonary rehabilitation programme who completed the eight week programme scored consistently better in measures of breathlessness, exercise performance, physical activity and health status compared to non-frail participants. After rehabilitation, 61 per cent of previously frail patients no longer met the criteria for frailty.


Rehabilitation of older people typically focuses on fall prevention through balance training and education, but the outcomes of this study provide strong grounds for exploring the use of pulmonary rehabilitation, potentially adapted to support a wider group of frail people beyond those with respiratory conditions.


Dr William Man, consultant chest physician, said: “Although COPD is primarily a lung disease, many organ systems can be affected, contributing to the syndrome of frailty.


“This stresses the importance of a holistic approach to care and shows how interventions such as exercise training can bring great benefits to people with lung disease, without necessarily treating the lungs.”


Researchers plan to follow up outcomes over several years.


Read the publication, funded by the National Institute for Health Research and the Medical Research Council.


Find out more about the COPD service at the Trust.


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