Download PDF
Dtsch Med Wochenschr 2015; 140(13): 1001-1005
DOI: 10.1055/s-0041-102720
Fachwissen
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Lungensport: Ambulantes Sportprogramm hilft langfristig bei COPD

Lung exercise: outpatient exercise program has long-term benefits on COPD
Marc Spielmanns
1   Remigius-Krankenhaus Leverkusen-Opladen, Medizinische Klinik und ambulante pneumologische Rehabilitation in Leverkusen
5   Faculty of Health, School of Medicine, Witten University
,
Oliver Göhl
2   Deutsche Rentenversicherung Bayern Süd, Donaustauf
,
Konrad Schultz
3   Medizinischer Direktor, Klinik Bad Reichenhall, Zentrum für Rehabilitation, Pneumologie und Orthopädie, Bad Reichenhall
,
Heinrich Worth
4   Pneumologische und Kardiologische Praxisgemeinschaft Fürth
› Author Affiliations
Further Information

Publication History

Publication Date:
26 June 2015 (online)

Also available at
   Permissions and Reprints

Zusammenfassung

Der positive Einfluss eines regelmäßigen körperlichen Trainings auf den Verlauf von vielen chronischen Erkrankungen aus unterschiedlichen Fachgebieten ist gut belegt. Gerade auch bei der Volkskrankheit COPD (Chronisch Obstruktive Lungenkrankheit) ist körperliches Training eine evidenzbasierte Therapieoption. Diese Arbeit gibt einen Überblick über die Effektivität ambulanter Sportprogramme bei COPD. Vor allem bei der COPD ist die Evidenzlage überzeugend. Zahlreiche Studien haben ergeben, dass folgende positive Effekte durch Lungensport signifikant sind: Zunahme der Ausdauerfähigkeit, Abnahme der Dyspnoe und der krankheitsbedingten Symptome sowie Zunahme der Leistungsfähigkeit und der Lebensqualität. Die Heterogenität der Studien mit unterschiedlichen primären Endpunkten macht eine Beurteilung schwierig. Im Vergleich zu anderen Erkrankungsgruppen ist der Bekanntheitsgrad von Lungensport noch völlig unzureichend und der positive Effekt viel zu wenig genutzt. Regelmäßige körperliche Aktivität ist eine wichtige, wirksame und ebenso kostengünstige Komponente der Therapie der COPD und teilweise sogar einer medikamentösen Therapie überlegen. Gründe genug, diese Therapieform unseren Lungenpatienten nicht vorzuenthalten.

Abstract

The positive influence of regular physical training on the course of many chronic diseases in different fields is well documented. Especially for obstructive respiratory diseases the benefit of lung exercise is convincing. An overview will be given in this work how lung exercise can be an effective form of therapy for pulmonary diseases. Actually the evidence of the efficacy of physical activity is particularly overwhelming in obstructive pulmonary diseases. Several clinical trials showed an enhancement in endurance and exercise capacity, quality of life and a decrease of dyspnea and disease-related symptoms. However in comparison to other disease groups, the benefits and awareness and therefore a widespread dissemination is still insufficient. Regular physical activity is an important, effective and also cost-effective component of the therapy of respiratory diseases and is sometimes even superior to a drug therapy. Enough reason to share this kind of therapy with our patients with pulmonary diseases.

Schlüsselwörter

Lungensport - körperliche Aktivität - COPD - pneumologische Rehabilitation - 6-Minuten-Gehtest - Ausdauertraining

Keywords

Lung exercise - physical activity - COPD - pulmonary rehabilitation - 6 minute walk test - endurance training
 

  • Literatur

  • 1 Meyer A, Baumann HJ. Bewegungstherapie bei obstruktiven Atemwegserkrankungen. In: Braumann KM, Stiller N. Bewegungstherapie bei internistischen Erkrankungen. Kapitel 12 Berlin Heidelberg: Springer-Verlag; 2010: 153-166
    CrossrefGoogle Scholar
  • 2 Glaab T, Vogelmeier K, Hellmann A et al. Guideline-based survey of outpatient COPD management by pulmonary specialists in Germany. Int J COPD 2012; 7: 101-108
    PubMedGoogle Scholar
  • 3 Löllgen H. Bedeutung und Evidenz der körperlichen Aktivität zur Prävention und Therapie von Erkrankungen. Dtsch Med Wochenschr 2013; 138: 2253-2259
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Oxford Centre for Evidence-based Medicine. Levels of Evidence. 2009. http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009 downloaded 23.02.2015
    Google Scholar
  • 5 Rost C Hrsg. Lehrbuch der Sportmedizin. 2.. Auflage: Köln: Deutscher Ärzteverlag; 2011: 41-44
    Google Scholar
  • 6 Meyer A, Machnik MA, Behnke W et al. Teilnahme von asthmatischen Kindern am Schulsport. Pneumologie 2002; 56: 486-492
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Garfinkel SK, Kesten S, Chapman KR et al. Physiologic and nonphysiologic determinants of aerobic fitness in mild to moderate asthma. Am Rev Respir Dis 1992; 145: 741-745
    PubMedGoogle Scholar
  • 8 Shim YM, Burnette A, Lucas S et al. Physical Deconditioning as a Cause of Breathlessness among Obese Adolescents with a Diagnosis of Asthma. PLoS ONE 2013; 8: e61022
    CrossrefPubMedGoogle Scholar
  • 9 Vogiatzis I, Trezis S, Nanas S et al. Skeletal muscle adaptation to interval training in COPD. Chest 2005; 128: 3838-3845
    CrossrefPubMedGoogle Scholar
  • 10 Casaburi R, ZuWallack R. Pulmonary Rehabilitation for Management of Chronic Obstructive Pulmonary Disease. N Engl J Med 2009; 360: 1329-1335
    CrossrefPubMedGoogle Scholar
  • 11 Kenn K, Gloeckl R, Soennichsen A et al. Predictors of success for pulmonary rehabilitation in patients awaiting lung transplantation. Transplantation 2015; 99: 1072-1077
    CrossrefPubMedGoogle Scholar
  • 12 Holland HE, Hill C. Physical training for interstitial lung disease. Cochrane Database Syt Rev 2012; CD006322
    PubMedGoogle Scholar
  • 13 Marra A, Egenlauf B, Bossone E et al. Principles of Rehabilitation and Reactivation: Pulmonary Hypertension. Respiration 2015; 89: 265-273
    CrossrefPubMedGoogle Scholar
  • 14 Carson KV, Chandratilleke MG, Picot J et al. Physical training for asthma. Cochrane Database Syst Rev 2013; CD001116
    PubMedGoogle Scholar
  • 15 Rivas-Perez H, Nana-Sinkam P. Integrating pulmonary rehabilitation into the multidisciplinary management of lung cancer: A review. Respir Med 2015; 109: 437-442
    Google Scholar
  • 16 Bjarnason-Wehrens B, Schulz O, Gielen S et al. Leitlinie körperliche Aktivität zur Sekundärprävention und Therapie kardiovaskulärer Erkrankungen. Clin Res Cardiol Suppl 2009; 4: 1-44
    PubMedGoogle Scholar
  • 17 Göhl O, Pleyer K, Biberger G et al. Empfehlungen zur Planung und Durchführung des körperlichen Trainings im Lungensport. Pneumologie 2006; 60: 716-723
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Emtner E. Chronic obstructive pulmonary disease (COPD). In: Swedish National Institute of Public Health. Physical Activity in the Prevention and Treatment of Disease. 14. Landers; 2010. ISBN: 978-91-7257-715-2 271-282
    Google Scholar
  • 19 Pescatello LS, Arena R, Riebe D et al. Chapter 10. Exercise Prescription for other clinical populations: Chronic obtsructive pulmonary disease. In: ACSM’s Guidelines for Exercise testing and Prescription. 9th. Edition, Lippincott Williams & Wilkins; 2014: 334-337
    Google Scholar
  • 20 Löllgen H, Wismach J, Kunstmann W. Das Rezept für Bewegung. Einsatzmöglichkeiten für Arzt und Patient. Klinikarzt 2013; 42: 416-420
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Spruit MA, Singh SJ, Garvey C et al. ATS / ERS Task Force on Pulmonary Rehabilitation. An Official American Thoracic Society / European Respiratory Society Statement: Key Concepts and Advances in Pulmonary Rehabilitation. Am J Respir Crit Care Med 2013; 188: 3-64
    CrossrefPubMedGoogle Scholar
  • 22 Baumann HJ, Kluge S, Rummel K et al. Low intensity, long-term outpatient rehabilitation in COPD: a randomised controlled trial. Resp Res 2012; 13: 86
    CrossrefPubMedGoogle Scholar
  • 23 Göhl O, Linz H, Schönleben T et al. Benefits of a multimodular outpatient training program for patients with COPD. Pneumologie 2006; 60: 529-536
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Spielmanns M, Winkler A, Fuchs-Bergsma C et al. Effects of oxygen supply during a training for more than 3 months in COPD patients who are normoxemic at rest and at exercise: a blinded, randomized controlled trial. Resp Care 2015; 60: 540-548
    PubMedGoogle Scholar
  • 25 Puhan MA, Gimeno-Santos E, Scharplatz M et al. Pulmonary rehabilitation for people who have been in hospital with an exacerbation of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2011; CD005305
    PubMedGoogle Scholar
  • 26 Garcia-Aymerich J, Lange P, Benet M et al. Regular physical activity modifies smoking-related lung function decline and reduces risk of chronic obstructive pulmonary disease: a population-based cohort study. Am J Respir Crit Care Med 2007; 175: 458-463
    CrossrefPubMedGoogle Scholar
  • 27 Ringbaek T, Brondum E, Mertinez G et al. Long-term effects of 1-year maintenance training on physical functioning and health status in patients with COPD. J Cardiovasc Rehabil 2010; 30: 47-52
    PubMedGoogle Scholar
  • 28 Furness T, Joseph C, Naughton G et al. Benefits of a whole-body vibration to people with COPD: a community-based efficiacy trial. BMC Pulmonary Medicine 2014; 14: 38
    CrossrefPubMedGoogle Scholar
  • 29 Revitt O, Sewell L, Morgan MDL et al. Short outpatient pulmonary rehabilitation programme reduces readmission following a hospitalization for an exacerbation of chronic obstructive pulmonary disease. Respirology 2013; 18: 1063-1068
    PubMedGoogle Scholar
  • 30 Greulich T, Kehr K, Nell C et al. A randomized controlled trial to assess the influence of a three months training program (Gym-based individualized vs. Calisthenics-based non-individualized) in COPD-patients. Resp Res 2014; 15: 36
    CrossrefPubMedGoogle Scholar
  • 31 Reis LFF, Guimaräes FS, Fernandes SJ et al. A long-term pulmonary rehabilitation program progressively improves exercise tolerance, quality of life and cardiovascular risk factors in patients with COPD. Eur J Phys Rehabil Med 2013; 49: 491-497
    PubMedGoogle Scholar
  • 32 Jacome C, Marques A. Impact of pulmonary rehabilitation in patient with mild COPD. Resp Care 2014; 59: 1577-1582
    PubMedGoogle Scholar
  • 33 Dias FD, Malosa Sampaio LM, da Silva GA et al. Home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized clinical trial. Int J COPD 2013; 8: 537-544
    PubMedGoogle Scholar
  • 34 Gimeno-Santos E, Rodriguez DA, Barberan-Garcia A et al. Endurance Exercise Training Improves Heart Rate Recovery in Patients with COPD. COPD 2014; 11: 190-196
    CrossrefPubMedGoogle Scholar
  • 35 Cameron-Tucker H, Wood-Baker R, Owen C et al. Chronic disease self-management and exercise in COPD as pulmonary rehabilitation: a randomized controlled trial. Int J COPD 2014; 9: 513-523
    PubMedGoogle Scholar
  • 36 Corhay JL, Nguyen D, Duysinx B et al. Should we exclude elderly patients with chronic obstructive pulmonary disease from a long-term ambulatory pulmonary rehabilitation programme?. J Rehabil Med 2012; 44: 466-472
    CrossrefPubMedGoogle Scholar
  • 37 Amin S, Abrazado M, Quinn M et al. A controlled study of community-based exercise training in patients with moderate COPD. BMC Pulmonary Medicine 2014; 14: 125
    CrossrefPubMedGoogle Scholar
  • 38 Borghi-Silva A, Mendes RG, Trimer R et al. Potential effect of 6 vs 12-weeks of physical training on cardiac autonomic function and exercise capacity in chronic obstructive pulmonary disease. Eur J Phys Med 2014; [Epub ahead of print]
    PubMedGoogle Scholar
  • 39 Pleguezuelos E, Perez MA, Guirao L et al. Effects of whole body vibration training in patients with severe chronic obstructive pulmonary disease. Respirology 2013; 18: 1028-1034
    CrossrefPubMedGoogle Scholar
  • 40 Theander K, Jakobsson P, Jörgensen N et al. Effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease: a randomized controlled trial. Clinical Rehabilitation 2009; 23: 125-136
    CrossrefPubMedGoogle Scholar
  • 41 Lazik MK, Singh S, Lubina S et al. Female and male chronic obstructive pulmonary disease patients with severe dyspnea do not profit less from pulmonary rehabilitation. Polskie Archiwum Medycyny Wewnetrznej 2008; 118: 7-8
    PubMedGoogle Scholar
  • 42 Barakat S, Michele G, George P et al. Outpatient pulmonary rehabilitation in patients with chronic obstructive pulmonary disease. Int J COPD 2008; 3: 155-162
    PubMedGoogle Scholar
  • 43 Von Leupoldt A, Hahn E, Taube K. Effects of 3-week Outpatient Pulmonary Rehabilitation on Exercise Capacity, Dyspnea, and Quality of Life in COPD. Lung 2008; 186: 387-391
    CrossrefPubMedGoogle Scholar
  • 44 Zwick RH, Burghuber OC, Dovjak N et al. Der Effekt von einem Jahr ambulanter pneumologischer Rehabilitation auf Patienten mit COPD. Wien Klin Wochenschr 2009; 121: 189-195
    CrossrefPubMedGoogle Scholar
  • 45 Worth H, Meyer A, Folgering H et al. Empfehlungen der Deutschen Atemwegsliga zum Sport und körperlichem Training bei Patienten mit obstruktiven Atemwegserkrankungen. Pneumologie 2000; 54: 61-67
    Article in Thieme ConnectPubMedGoogle Scholar