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Background Pulmonary rehabilitation (PR) (primarily composed of an exercise training program (ET) and educational workshops) is an effective intervention for patients with chronic obstructive pulmonary disease. Although factors which influence participation in the full PR program have been reported, specific data on the educational component of PR have not been published. We aimed to identify factors which predict refusal to participate in the educational component of PR. Research design and methods 201 patient charts were retrospectively included in the analysis. Patients were classified according to their acceptance or refusal to participate in the educational workshops. Results The location of ET outside the center was independently related to refusal to participate in the educational workshops (OR =0.01 [95%CI 0.00 to 0.17]). Patients who refused the workshops were less disabled according to the number of prescriptions of non-invasive ventilation, oxygen consumption and workload achieved during cardiopulmonary exercise testing, and use of medical transport. Conclusions The location of exercise sessions during PR influences patients' decisions to refuse or accept center-based educational workshops. When center-based PR programs are limited, and the ET is relocated to the patient's home, the educational workshops should also be relocated. Trial registration The trial is registered at ClinicalTrials.gov (NCT04301245).

The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which is responsible for the current pandemic and results in a large number of hospitalizations. This highly contagious disease causes severe acute respiratory infection; thus, many patients require management in intensive care. At a time when there is a high influx of patients with COVID-19 in Intensive Care Units (ICU) all over the world, there is little literature concerning the physiotherapy management of these patients. This article provides information based on the latest evidence to help physiotherapists optimize care, to protect patients and care providers in the ICU, and for follow-up care.

Riassunto Le patologie respiratorie ostruttive sono un importante campo di intervento del fisioterapista nel campo della pneumologia. La broncopneumopatia cronica ostruttiva (BPCO), la fibrosi cistica, la dilatazione dei bronchi (esclusa la fibrosi cistica) o, ancora, l’asma fanno, cosi, parte delle patologie per le quali il fisioterapista occupa un posto fondamentale nell’implementazione delle diverse terapie accanto agli altri professionisti sanitari che gravitano intorno a questi pazienti. La riabilitazione respiratoria costituisce, attualmente, un trattamento di riferimento per questi disturbi ventilatori ostruttivi ed e suddivisa in diverse aree di intervento: svezzamento dal fumo, riqualificazione allo sforzo (con o senza adiuvanti), promozione dell’attivita fisica, ginnastica ed educazione terapeutica (assunzione di trattamenti, supporto nutrizionale). Il fisioterapista occupa un posto importante in queste diverse modalita e puo anche proporre altre terapie specifiche in funzione della natura del disturbo ostruttivo, come il disingombro bronchiale nella fibrosi cistica o gli esercizi respiratori nell’asma. Attraverso questi interventi, il fisioterapista contribuisce all’aumento delle capacita di sforzo dei pazienti e al miglioramento della loro qualita di vita.