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Targeting symptoms works in COPD and heart-failure rehab

Heart failure patients could benefit from the same kind of rehab as those with lung conditions, said CSP member Sally Singh.

Professor Singh and colleagues found both groups did well on an exercise-based programme focusing on the common disabling symptoms rather than the organ disease (Evans RA et al. Respiratory Medicine 2010: 104; 1473-1481)

‘The evidence for cardiac rehabilitation in heart failure is well established, although provision in the UK is very poor,’ said Professor Singh, head of cardiac and pulmonary rehabilitation at Glenfield Hospital in Leicester.

Rehabilitation programmes for patients recovering from heart attacks or heart surgery are well established. But those patients have better exercise tolerance than people with heart failure, said Professor Singh.

However, both chronic heart failure and chronic obstructive pulmonary disease (COPD) cause fatigue and breathlessness on exertion. This can make it hard for patients to take the exercise that has been shown to reverse some of their muscle dysfunction.

Pulmonary rehabilitation is integral to COPD management, backed by plentiful evidence of improved exercise performance and health. But although guidelines for chronic heart failure also recommend exercise, rehab programmes for this condition haven’t developed in the same way.

‘Exercise capacity is remarkably similar in patients with heart failure and COPD,’ said Professor Singh. ‘It would therefore seem reasonable to develop a generic approach to rehabilitation combining COPD and heart failure in one programme.

‘Our research shows that it is entirely possible to achieve a successful and comparable outcome for both heart failure and COPD.’

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