呼吸リハビリテーション

Pulmonary Rehabilitation

はじめに

　我が国では呼吸リハビリテーション（以下，リハ）は，「呼吸器の病気によって生じた障害を持つ患者に対して，可能な限り機能を回復，維持させ，これにより，患者自身が自立できることを継続的に支援してゆくための医療である」と定義されている^1）．

　呼吸リハの概念は，従来の身体機能の維持・改善を目的としたものから，生活の質（quality of life：QOL）の向上，疾病の自己管理や急性増悪の予防へと拡大し，最近では生命予後の延長という新たな局面にも対応する幅広い概念で捉えられ，心理面のサポートや生活・環境面の工夫や改善も取り入れて行うべき，全人的な取組みとなっている．

　呼吸リハでは，慢性呼吸器疾患患者にとどまらず，呼吸症状を有する全ての患者がその対象となる．代表的疾患を挙げて概説する．

Abstract : Pulmonary rehabilitation is an extremely effective treatment with many cases providing evidence of its efficacy. When treating chronic obstructive pulmonary disease (COPD), the updated ACCP/AACVPR and GOLD guidelines designate pulmonary rehabilitation reduces dyspnea on effort, improves patient health-related QOL and decreases anxiety and depression, additionally, walking related exercises as the most effective. While the BODE index has a relation to longevity, “E”: the activity of daily life score is the most effective metric of all. Exercise therapy is recognized as the only method that can break the vicious circle of the dyspnea spiral, and what's more, comprehensive pulmonary rehabilitation is even more efficacious as a treatment modality. In addition, perioperative respiratory rehabilitation and conditioning with ARDS for deglutition pneumonia are also effective. However, few doctors or medical personnel are fully aware of the benefits of pulmonary rehabilitation. So to address this shortcoming, we must make greater efforts to popularize pulmonary rehabilitation.