Σπυρίδων Ζακυνθινός, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Βογιατζής, Αναπληρωτής Καθηγητής, ΣΕΦΑΑ, ΕΚΠΑ
Ιωάννης Καλομενίδης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
COPD is a global scourge affecting a large proportion of the population and a financial burden for modern societies. Its cause still remains unknown and its treatment is mostly symptomatic. Like a respiratory disease COPD affects firstly the ventilation causing hyperinflation, hypersecretion of mucus and dyspnea. However, a very prominent feature of COPD is the deterioration of strength and endurance of the peripheral skeletal muscles. Many, rather complicated, pathways through which COPD affects the peripheral muscles of the patient have been implicated, but nothing is conclusive yet. The ventilation effects of COPD combined with peripheral muscle weakness, lead to reduced physical activity, and decline of the patients’ quality of life.
Besides the classic pharmaceutical administration, pulmonary rehabilitation comes to complete the COPD treatment. Pulmonary rehabilitation consists of many different specialties like doctors, phycologists, nutritionists, physiotherapists etc. The cornerstone of pulmonary rehabilitation is considered exercise training. Exercise training includes endurance training, which usually takes place on a treadmill or a cycloergometer, and strength training, which comprises of resistance bands, dumbbells etc. The effects of COPD on muscles have been proven to improve after at least 6 – 8 weeks of training exercise but for the results to last more than 6 – 12 months, the continuation of exercise is necessary. Supplementary to exercise, NMES comes to improve muscle condition, and reduce deconditioning to patients that for any number of reasons cannot undertake exercise training. Different types of exercise like yoga and tai chi have been successfully applied on exercise programs but further investigation is required.