Eficacia de las intervenciones de rehabilitación pulmonar en pacientes con Enfermedad Pulmonar Obstructiva Crónica: Revisión Sistemática

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a global public health problem and the third leading cause of death worldwide. It is characterized by persistent airflow limitation and chronic respiratory symptoms that severely affect quality of life. Pulmonary rehabilitation (PR) has become a key non-pharmacological approach for the comprehensive care of these patients. Objectives: To evaluate the effectiveness of pulmonary rehabilitation interventions in patients with COPD in terms of functional capacity, quality of life, and reduction of exacerbations. Methods: A systematic review was conducted according to the PRISMA 2020 guidelines and the Cochrane Handbook. Twenty-three randomized controlled trials (RCTs) published between 2020 and 2025 in English and Spanish were selected, retrieved from databases such as PubMed, LILACS, and Cochrane CENTRAL. The risk of bias was assessed using the RoB 2 assessment tool. Results: Pulmonary rehabilitation (PR) programs demonstrated significant improvements in functional capacity (6MWT) and symptom reduction (dyspnea). The effectiveness of other modalities was validated, including eccentric training in severely ill patients, telerehabilitation, and home-based programs, which remove access barriers without compromising safety. Eight-week programs were found to be as effective as 12-week programs. Conclusions: Pulmonary rehabilitation is a highly effective treatment that consistently leads to improvements in the clinical stability of patients with COPD. Its success depends on a biopsychosocial approach and, most importantly, on continuity of exercise. Keywords: Chronic obstructive pulmonary disease, pulmonary rehabilitation, respiratory rehabilitation, telerehabilitation, physical therapy