Abstract
Acute exacerbations of chronic obstructive pulmonary disease (COPD) are commonly described as events in the natural course of the disease characterized by a change in the patient's baseline dyspnoea, cough, and/or sputum that is beyond normal day-to-day variations, is acute in onset, and may warrant a change in regular medication [1, 2]. The majority of those are thought to be caused by complex interactions between the host, bacteria, viruses and environmental pollution [3], leading to increased upper and lower airway and systemic inflammation [1]. Due to bronchospasm, mucosal oedema and sputum inspissation, airway resistance is increased [4]. Severe exacerbations oftentimes involve an obvious deterioration of health status leading to hospitalization [5], which are the primary driver of all COPD-related medical care costs, accounting for 50 to 75% of the direct COPD associated health care costs [6, 7].
Although exacerbations are diagnosed based on respiratory symptoms, evidence arises that they also have systemic consequences, including a detrimental influence on skeletal muscle function [8], exercise tolerance [9] and mood status [10].
This review aims at describing the systemic consequences of acute exacerbations of COPD and compiles evidence for the feasibility and effectiveness of different rehabilitation strategies to counteract these consequences during and/or immediately after the acute phase of the exacerbation.
- ERS