The roles of bronchodilators, supplemental oxygen, and ventilatory assistance in the pulmonary rehabilitation of patients with chronic obstructive pulmonary disease.

In patients with chronic obstructive pulmonary disease, pulmonary rehabilitation significantly improves dyspnea, exercise capacity, quality of life, and health-resource utilization. These benefits result from a combination of education (especially in the promotion of collaborative self-management strategies and physical activity), exercise training, and psychosocial support. Exercise training increases exercise capacity and reduces dyspnea. Positive outcomes from exercise training may be enhanced by 3 interventions that permit the patient to exercise train at a higher intensity: bronchodilators, supplemental oxygen (even for the nonhypoxemic patient), and noninvasive ventilatory support.