1. Stress and self-management of COPD patients (collaborative care)
New strategy of respiratory rehabilitation:
Stress and self-management of COPD patients
(collaborative care)
Toneyama National Hospital (Japan)
R.Maekura M.D.

2. 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.

3. Sympathetic nervous stress during exercise is a
good prognostic predictor in patients with COPD

4. 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 also
a 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.

5. Stress management; Appropriate pulmonary rehabilitation including OT
(stress management ) according to the pathophysiology
of individual patients with COPD
improves his or her prognosis.