In recent years, research has demonstrated that exercise programs can benefit patients with chronic obstructive pulmonary disease (COPD) and patients with congestive heart failure (CHF). Yet many physicians do not refer such patients to any kind of exercise or rehabilitation program. Advances in Cardiopulmonary Rehabilitation examines the history of how pulmonary and cardiac diseases have been treated and shows how that history tends to constrain contemporary thinking in spite of significant advances in treatment.

• Why do only a small percentage of eligible patients enroll in cardiopulmonary rehab programs?
• What percentage of patients can be helped, and in what ways?
• What are the most cost-efficient allocations of scarce financial resources for cardiac and pulmonary patients?

The contributors to this book address these questions and provide answers that are challenging and often quite surprising.

The First Quƒbec International Symposium on Cardiopulmonary Rehabilitation was held in Quƒbec City in May 1999, bringing together experts from around the world to discuss every aspect of cardiopulmonary rehabilitation. Editors Jean Jobin, PhD, Franƒ§ois Maltais, MD, Pierre LeBlanc, MD, and Clermont Simard, PhD, selected the most groundbreaking papers presented at the conference and expanded on several of them for this reference.

The book offers review articles and some original research. The editors' comprehensive introduction and conclusion provide an invaluable synthesis and overview of current understanding and future directions for cardiopulmonary rehabilitation.

Whether you are a clinician, a researcher, an educator, or an administrator, Advances in Cardiopulmonary Rehabilitation will give you

• an understanding of how trends in cardiopulmonary rehabilitation during the past century affect current practices,
• hard data that will help you determine the best practices in cardiopulmonary rehabilitation,
• data that will enhance your ability to treat patients you may have assumed were untreatable, and
• a clear overview of recent research in cardiopulmonary rehabilitation.

Part I explains not only what has happened in the past, but how past and current practices may influence the future. Part II offers thorough scientific reviews of pharmacological treatment for CHF and COPD. Part III, offers the clearest discussion available"accompanied by extensive data"of how to decide who should be referred and who should not. Part IV discusses peripheral muscle limitations and dysfunction. Part V addresses risks and benefits for different kinds of patients, home exercise programs for COPD patients, interactions between exercise and left ventricular remodeling, and effects of temperature extremes on people with cardiovascular disease. Part VI explains how cardiopulmonary illness, as well as various rehab approaches, affect a patient's psychosocial health, and examines economic evaluations of rehab programs. Part VII deals with factors that affect quality of life and how to measure outcomes of treatment in terms of quality of life. Finally, part VIII looks to the future"what is likely to happen in the areas of technology, pharmacology, psychosocial factors, and self-help care.

This well-researched volume (more than 2,200 bibliographical references) is essential for anyone who deals with cardiac or pulmonary patients. This is the only single volume that probes the scientific, clinical, economic, and even psychosocial frontiers of cardiac and pulmonary rehabilitation.

Contents

Introduction

J. Jobin, F. Maltais, C. Simard, and P. LeBlanc, Canada

Part I. Historical Perspectives on the Evolution of Cardiopulmonary Rehabilitation
Chapter 1. Historical Review of Cardiopulmonary Rehabilitation and Implications for the Future

P.K. Wilson and T. Kawamura, United States of America
Chapter 2. Cardiovascular Rehabilitation: A Concept in Search of Its Identity

S. Dumont, Canada

Part II. Pharmacological Treatment of Congestive Heart Failure and Chronic Obstructive Pulmonary Disease: An Update
Chapter 3. Current Pharmacological Therapy for Congestive Heart Failure

M.H. Leblanc, Canada
Chapter 4. Pharmacological Treatment of Patients With Chronic Obstructive Pulmonary Disease: Update and Future Directions

J. Bourbeau, Canada

Part III. Selecting, Recruiting, and Screening Candidates
Chapter 5. Selection of Best Candidates for Cardiopulmonary Rehabilitation in the Future

W.A. Dafoe, Canada
Chapter 6. Evaluation of Cardiac Patients With Standard Exercise ECG Testing: Prognostic Scores and Predictive Equations

V.F. Froelicher, United States of America
Chapter 7. Can Women Benefit From Exercise Cardiac Rehabilitation?

T. Kavanagh, L.F. Hamm, R.J. Shephard, D.J. Mertens, J. Kennedy, and J. Beyenne, Canada

Part IV. Peripheral Components of Exercise Intolerance: Implications for Cardiopulmonary Rehabilitation
Chapter 8. Peripheral Muscle Limitations to Exercise in Patients With Congestive Heart Failure: Implications for Rehabilitation

J. Jobin and J.-F. Doyon, Canada
Chapter 9. Peripheral Muscle Dysfunction in Patients With Chronic Obstructive Pulmonary Disease

F. Maltais, J. Jobin, and P. LeBlanc, Canada
Chapter 10. Treatment of Skeletal Muscle Dysfunction With Anabolic Hormone Supplementation in Patients With Chronic Obstructive Pulmonary Disease

R. Casaburi, United States of America

Part V. Exercise in Cardiopulmonary Rehabilitation: Benefits and Special Considerations
Chapter 11. Putting the Risk of Exercise in Perspective: Implications for Primary and Secondary Prevention

B.A. Franklin, United States of America
Chapter 12. Interaction Between Exercise Training and Remodeling in Patients With Left Ventricular Dysfunction and Chronic Heart Failure

P. Giannuzzi and P.L. Temporelli, Italy
Chapter 13. Effects of Cold, Wind, and Hot Temperature on Patients With Cardiovascular Diseases

M. Juneau, Canada
Chapter 14. Feasibility and Efficacy of a Home-Based Rehabilitation Program in Patients With Chronic Obstructive Pulmonary Disease

P. LeBlanc and R. Debigare, Canada
Chapter 15. Quality of Life in Patients With Chronic Obstructive Pulmonary Disease on Long-Term Oxygen Therapy: Role of Exercise Training

C. Prƒfault, V. Gautier-Dechard, D. Fuchs-Clement, and M. Poulain, France

Part VI. Psychosociological Aspects of Cardiopulmonary Rehabilitation
Chapter 16. Stress and Coronary Artery Disease: Should Stress Management Be Taken Into Consideration in the Rehabilitation of Patients With Coronary Artery Disease?

D.M. Marcadet, France
Chapter 17. Effects of Illness and Adversity on Quality of Life

M. Ojanen, Finland
Chapter 18. Economic Evaluation of Cardiopulmonary Rehabilitation

N. Oldridge, United States of America

Part VII. Quality of Life and Cardiopulmonary Rehabilitation
Chapter 19. Health-Status Measurement Instruments in Patients With Chronic Obstructive Pulmonary Disease

Y. Lacasse, E. Wong, G. Guyatt, and R.S Goldstein, Canada
Chapter 20. Measurement of Quality of Life in Cardiac Rehabilitation

G. Dupuis, M.C. Taillefer, A.M. ƒ‰tienne, O. Fontaine, S. Boivin, and A. Von Turk, Canada

Part VIII. Cardiopulmonary Rehabilitation in the Third Millennium
Chapter 21. Horizons in Pulmonary Rehabilitation

A.L. Ries, United States of America
Chapter 22.Integrating Technology and Self-Care in Cardiology: Challenge for the Future

M.J. Sullivan, United States of America

Conclusion

F. Maltais, J. Jobin, C. Simard, and P. LeBlanc, Canada

Audiences

Reference for cardiac rehabilitation specialists, pulmonary rehabilitation specialists, clinicians, exercise physiologists, occupational therapists, physical therapists, cardiologists, respirologists, rehabilitation nurses, rehabilitation administrators, health/physical educators, nursing administrators, researchers in cardiopulmonary rehabilitation, and researchers in secondary prevention.

Jean Jobin, PhD, was a professor of medicine at Laval University in Québec and director of the Cardiopulmonary Rehabilitation Research Laboratory at the Institut de cardiologie et de pneumologie de l'Université Laval at Laval Hospital.

Dr. Jobin was a certified program director of the American College of Sports Medicine's (ACSM) Certification for Exercise Specialists in French at Laval University; he was a fellow of the ACSM and of the American Association of Cardiovascular and Pulmonary Rehabilitation, a member of the Canadian Association of Cardiac Rehabilitation and the Canadian Cardiovascular Society. He was president of the scientific committee of the First Québec International Symposium on Cardiopulmonary Rehabilitation in May 1999.

Jean Jobin passed away in 2009.

François Maltais, MD, is a respirologist at the Pneumology Center at Laval Hospital in Québec. He is adjunct professor of medicine at Laval University and director of the Pulmonary Rehabilitation Program at Laval Hospital.

A member of the Québec, Canadian, and American Thoracic Societies, Dr. Maltais is certified in internal medicine and in pulmonary medicine. He has been awarded numerous research grants from private and public foundations including the Medical Research Council of Canada (MRC) to investigate such topics as peripheral muscle dysfunction, strength training, and exercise training in COPD among many others.

Dr. Maltais enjoys mountain biking and downhill skiing. He lives with his wife and children in L'Ancienne-Lorette, Québec.

Pierre LeBlanc, MD, is clinical professor in the department of medicine at Laval University, where he is in charge of teaching respiratory physiology. He is a member of the American Thoracic Society and the Canadian Thoracic Society. Dr. LeBlanc has published highly significant and often quoted research concerning mechanisms of breathlessness during exercise in cardiorespiratory patients.

Dr. LeBlanc is an avid cyclist and enjoys cross-country skiing. From 1975 to 1976, he was a member of the Canadian track and field team. He, his wife, and children live in Cap-Rouge, Québec.

Clermont Simard, PhD, is professor of Physical Education and Special Populations at Laval University. He founded the International Federation for Adapted Physical Activity in 1976, for which he was specially honored by Spain's University of Lleida in 1999.

Dr. Simard is a fellow of the ACSM and was president of the First Québec International Symposium on Cardiopulmonary Rehabilitation in May 1999. His many years of research have focused on adapting physical activity to populations with special needs, the impact of disuse on muscular metabolism and function, the aging process and physical activity as they affect quality of life, and on means of helping older adults live more autonomous lives.

Dr. Simard and his wife make their home in St.-Nicolas, Québec.