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Rehabilitation and the National Emphysema Treatment Trial

Roger S. Goldstein, FRCP, FCCP
Author and Funding Information

Affiliations: Toronto, ON, Canada
 ,  Dr. Goldstein is Professor of Medicine and Physical Therapy, University of Toronto, and Director, Program in Respiratory Rehabilitation, West Park Healthcare Centre.

Correspondence to: Roger S. Goldstein, FRCP, FCCP, Professor of Medicine and Physical Therapy, University of Toronto, and Director, Program in Respiratory Rehabilitation, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON, M6M 2J5, Canada; e-mail: rgoldstein@westpark.org



Chest. 2005;128(6):3783-3784. doi:10.1378/chest.128.6.3783
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Although pulmonary rehabilitation is accepted by many professional societies as the prevailing standard of care for patients with chronic lung disease,13 large observational studies that examine key outcomes such as survival, functional exercise capacity, or health-related quality of life have been slow in coming. Trials of lung volume reduction surgery, the largest of which has been the National Emphysema Treatment Trial (NETT),4 although not originally designed for this purpose, have enabled us to observe the influence of rehabilitation on a large population of patients with COPD. The NETT design required patients to agree to undergo 6 to 10 weeks of rehabilitation prior to randomization as a prerequisite to enrollment. This requirement was probably a consequence of the positive experiences among the surgical community when their patients received pulmonary rehabilitation in association with major thoracic surgery, as well as the key roles in the NETT played by many of the pulmonary rehabilitation leaders in the United States.

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