Physiotherapy and rehabilitative interventions in patients with chronic respiratory diseases: exercise and non-exercise treatment.

Aim: The aim of this literature review was to describe and discuss the available evidence about different modalities of physical therapy treatment and pulmonary rehabilitation (PR) involving exercise training in patients with chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis and interstitial lung disease (ILD).
Methods: The search was performed by using the Cochrane Library and PubMed databases. We selected studies published between 2001 and 2012 which involved physiotherapy treatment and included patients with COPD, asthma, bronchiectasis or ILD, aged 18 years or more, in stable or unstable disease condition.
Results and Conclusion: PR involving exercise training was effective in improving exercise capacity, muscle force, quality of life and reducing symptoms in patients with COPD and asthma. Although there are few studies published about exercise training in patients with bronchiectasis, improvement in exercise capacity and quality of life in those patients was also observed. Patients with ILD also respond to exercise training; however, the response is less pronounced than in COPD and they lose the gains more quickly. Non-exercise-based interventions, such as bronchial hygiene techniques and inspiratory muscle training, also present positive results when applied to patients with COPD, asthma and bronchiectasis. In some cases it is recommended that these interventions are combined with exercise training. Studies about non-exercise based interventions applied to patients with ILD are still necessary.