Pulmonary rehabilitation in patients with COPD.

The available evidence indicates that pulmonary rehabilitation benefits patients with symptomatic COPD. The effect of pulmonary rehabilitation programs on health care utilization is promising but requires further investigation. In contrast, aerobic lower extremity training is of benefit in several areas of importance to patients with COPD. These areas include exercise endurance, perception of dyspnea, quality of life, and self-efficacy. The exact role of upper extremity exercise and ventilatory muscle training in the exercise training programs requires further studies. Education and psychological support improve the awareness of the patient and increase their understanding of the disease, but when used alone they are of limited value. Pulmonary rehabilitation, when coupled with smoking cessation, optimization of blood gases, and medications, offers the best treatment option for patients with symptomatic airflow obstruction.