Use of research methods in the process of pulmonary rehabilitation and physical therapy of persons with chronic obstructive pulmonary disease (review of clinical guidelines)


  • Kateryna Tymruk-Skoropad


chronic obstructive pulmonary disease, COPD, pulmonary rehabilitation, physical therapy, clinical setting


To date, the analysis of research methods and indicators on the basis of which the assessment of important areas of the physical, functional and psychoemotional state of patients with chronic obstructive pulmonary disease (COPD) at different stages of physical therapy is relevant.

Purpose: to analyze and systematize recommendations on the use of research methods in the process of pulmonary rehabilitation and physical therapy in chronic obstructive pulmonary disease.

Material & Methods: the available clinical guidelines for the diagnosis, treatment and pulmonary rehabilitation of patients with COPD are available. 13 clinical guidelines were analyzed.

Results: selected research guidelines and categories were evaluated in selected clinical guidelines: diagnostic criteria, criteria for participation of patients in the pulmonary rehabilitation program, prognostic criteria, and selection criteria for pulmonary rehabilitation and physical therapy strategies, effectiveness markers. In clinical guidelines, the methods of research that recommend the evaluation of patients with COPD in the treatment and recovery process are grouped as follows: research methods and indicators of the functional state of the respiratory and cardiovascular system, estimates of the level of dyspnea, quality of life and the manifestation of COPD symptoms, the level of physical performance and integrated performance.

Conclusion: most recommendations on the use of methods for studying patients with COPD are justified for diagnosis, prediction and selection of the strategy of drug treatment and oxygen therapy. Most of the recommendations are not sufficiently focused on using research methods and indicators as prognostic criteria and markers of the current and long-term effectiveness of physical therapy. Groups of research methods and indicators have been identified, with the help of which it is recommended to evaluate patients with COPD at the stages of diagnosis, patient selection, predicting the course of the disease, choosing a strategy of the pulmonary rehabilitation program and evaluating its effectiveness.


Expert Committee on the Selection and Use of Essential Medicines (2017), List of Priority Diseases, Diseases and Conditions in Ukraine for 2017–2018, available at: http: / / / articles / 3876 (in Ukr.)

Feshchenko, Yu.I. (2013), "Chronic Obstructive Pulmonary Disease: An Adapted Clinical Invention Based on Evidence", Order of the Ministry of Health of June 27, 2013 No. 555. (in Ukr.)

Anderson, B., Brown, H., Bruhl, E., Bryant, K., Burres, H., Conner, K., Kaderabek, D., Kerestes, G., Kuehn, M., Lim, K., Mrosak, K., Raikar, S., Rickbeil, T. & Westman, K. (2016), «Health Care Guideline: Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD)», Institute for Clinical Systems Improvement, available at: https: // / guidelines / cd / copd / (accessed by 23.06.2018).

Bolton, C.E., Bevan-Smith, E.F., Blakey, J.D., Crowe, P., Elkin, S.L., Garrod, R., Greening, N.J., Heslop, K., Hull, J.H., Man, W.D., Morgan, M.D., Proud, D., Roberts, C.M., Sewell, L., Singh, S.J., Walker, P.P. & Walmsley, S. (2013), «British Thoracic Society Pulmonary Rehabilitation Guideline Development Group; British Thoracic Society Standards of Care Committee. British Thoracic Society guideline on pulmonary rehabilitation in adults», Thorax, 68 Suppl 2:ii1-30.

Charlson, M.E., Pompei, P., Ales, K.L. et al. (1987), «A new method of classifying prognostic comorbidity in longitudinal studies: development and validation», J Chronic Dis, Vol. 40 5, pp. 373-383.

Chick, D.A. (2010), «Chronic Obstructive Pulmonary Disease. UMHS COPD Guideline».

National Clinical Guideline Centre (2010), «Chronic obstructive pulmonary disease: management of chronic obstructive pulmonary disease in adults in primary and secondary care», London, available at: http: // / CG101 / Guidance / pdf / English (accessed 23.06.2018).

Global Initiative for Chronic Obstructive Lung Disease (GOLD) (2017), «Global Strategy for the Diagnosis, Management and Prevention of COPD», available at: http: // / gold-2017-global-strategy-diagnosis-management-prevention-copd / (accessed 23.06.2018).

Güell Rous, M.R., Díaz Lobato, S., Rodríguez Trigo, G., Morante Vélez, F., San Miguel, M., Cejudo, P., Ortega Ruiz, F., Muñoz, A., Galdiz Iturri, J.B., García, A. & Servera, E. (2014), «Sociedad Española de Neumología y Cirugía Torácica (SEPAR)», Pulmonary rehabilitation. Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Arch Bronconeumol, No.50(8), pp. 332-44.

Han, M.K., Muellerova, H., Curran-Everett, D. (2013), «GOLD 2011 disease severity classification in COPDGene: a prospective cohort study», The Lancet Respiratory medicine, No. 1(1), pp. 43-50.

Jones, P.W. (2009), «Health status and the spiral of decline», COPD, No. 6(1), pp. 59-63.

Kankaanranta, H., Harju, T., Kilpeläinen, M., Mazur, W., Lehto, J.T., Katajisto, M., Peisa, T., Meinander, T. & Lehtimäki, L. (2015), «Diagnosis and pharmacotherapy of stable chronic obstructive pulmonary disease: the finnish guidelines», Basic Clin Pharmacol Toxicol, No. 116(4), pp. 291-307.

Management of Chronic Obstructive Pulmonary Disease (COPD). VA / DoD clinical practice guideline, December 2014, 94 р.

Qaseem, A., Wilt, T.J., Weinberger, S.E., Hanania, N.A., Criner, G., Molen, T., Marciniuk, D.D., Denberg, T., Schunemann, H., Wedzicha, W., MacDonald, R. & Shekelle, P. (2011), «Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society», Annals of Internal Medicine, August, Vol. 155, No. 3, pp. 179-192.

Ries, A.L., Bauldoff, G.S., Carlin, B.W., Casaburi, R., Emery, C.F., Mahler, D.A., Make, B., Rochester, C.L., ZuWallack, R. & Herrerias, C. (2007), «Pulmonary Rehabilitation: Joint ACCP / AACVPR Evidence-Based Clinical Practice Guidelines», Chest, No. 131, pp. 4S-42S.

Roffman, C.E., Buchanan, J. & Allison, G.T. (2016), «Charlson Comorbidities Index», Journal of Physiotherapy, July, Vol. 62, Iss. 3, pp. 171.

Russi, E.W., Karrer, W., Brutsche, M., Eich, C., Fitting, J.W., Frey, M., Geiser, T., Kuhn, M., Nicod, L., Quadri, F., Rochat, T., Steurer-Stey, C. & Stolz, D., (2013), «Swiss Respiratory Society. Diagnosis and management of chronic obstructive pulmonary disease: the Swiss guidelines. Official guidelines of the Swiss Respiratory Society», Respiration, No. 85(2), pp. 160-74.

Tymruk-Skoropad, K., Tsizh, L., Vynogradskyi, B. & Pavlova, I. (2018), «Physical therapy in chronic obstructive pulmonary disease (analysis of the evidence-based medicine)», Physiotherapy Quarterly, No. 26(2), pp. 1-8, doi: 10.5114/pq.2018.75993.

Wedzicha, J.A., Miravitlles, M., Hurst, J.R., Calverley, P.M., Albert, R.K., Anzueto, A., Criner, G.J., Papi, A., Rabe, K.F., Rigau, D., Sliwinski, P., Tonia, T., Vestbo, J., Wilson, K.C. & Krishnan, J.A. (2017), «Management of COPD exacerbations: a European Respiratory Society / American Thoracic Society guideline», Eur Respir J., Mar 15, No. 49(3), pii: 1600791.

Withers, N.J., Rudkin, S.T. & White, R.J. (1999), «Anxiety and depression in severe chronic obstructive pulmonary disease: the effects of pulmonary rehabilitation», J Cardpulm Rehabil, No. 19, pp. 362-5.

Yang, I.A., Dabscheck, E.J., George, J., Jenkins, S.C., McDonald, C.F., McDonald, V. & Smith, B. (2017), «Zwar N on behalf of Lung Foundation Australia and the Thoracic Society of Australia and New Zealand. The COPD-X Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease», Version 2.51.

Yoon, H.K., Park, Y.B., Rhee, C.K., Lee, J.H. & Oh, Y.M. (2014), «Committee of the Korean COPD Guideline 2014. Summary of the Chronic Obstructive Pulmonary Disease Clinical Practice Guideline Revised in 2014 by the Korean Academy of Tuberculosis and Respiratory Disease», Tuberc Respir Dis (Seoul), No. 80(3), pp. 230-240.