New strategy of respiratory rehabilitation:

Stress and self-management of COPD patients(collaborative care)

Toneyama National Hospital (Japan)R.Maekura M.D.

These results reveal that the level of breathlessness during CPET might be objectively evaluated by the measurement of NE ( indicated the sympathetic nervous stress)in patients with COPD.

Sympathetic nervous stress during exercise is a

good prognostic predictor in patients with COPD

The sympathetic nervous stress which was estimated by ΔNA/ΔVO2 during exercise, was significantly associated with the survival time in patients with COPD.

In multiple regression analysis, the ΔNA/ΔVO2 was alsoa new independent prognostic predictor from other predictors such as Age, BMI, %FEV1 and rest PaO2, and PaO2-slope, Peak VO2, and Peak VE on CPET.

These results reveal that measurement of ΔNA/ΔVO2 using CPET is a useful to accurately assess the prognosis of patients with COPD.

Appropriate pulmonary rehabilitation including OT

(stress management ) according to the pathophysiology

of individual patients with COPD

improves his or her prognosis.

Stress management;