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Pulmonary rehabilitation: history, promise and problems
Published on July 31, 2022 25 min
A selection of talks on Clinical Practice
Behavioral medicine: what it is and what it does
- Dr. Gina Touch Mercer
- University of Arizona College of Medicine - Phoenix, USA
The history and foundations of medical research ethics
- Prof. Dr. Christian Lenk
- Ulm University, Germany
Hello. This is Richard Casaburi. I'm a research scientist at the Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center in the Los Angeles area of California. I'm here today to give you a lecture on pulmonary rehabilitation: history, promise and problems.
You'll see here my disclosures, none of which are relevant to this talk.
First, there is the history. The image you'll see here is of Dr. Alvan Barach, who, as you'll see, lived from 1895-1977. I'd like to think of him as the grandfather of pulmonary rehabilitation.
Dr. Barach had a really interesting career. Starting in 1922, he perfected the oxygen tent. In 1934, he used heliox in asthma and emphysema. I was completely unaware that this was done any time in that era. He investigated oral penicillin for pneumonia in 1945. In the early 1950s, he developed portable oxygen supplies and used them in his patients. He had 164 PubMed citations. Remember, PubMed didn't start until the 1990s. These were all collected in retrospect. 91 of them were as the sole author and 6 of them were published in the year of his death. He published several books.
I'd like to draw your attention to this quote. You have to realize that in 1952, the advice to COPD patients was if you get shortness of breath doing something, well, stop doing it. Here's what Dr. Barach said, "In two patients with pulmonary emphysema... an exercise program was instituted with subsequent marked improvement of capacity to exercise... The progressive improvement in ability to walk without dyspnea suggested that a physiological response similar to a training program in athletes may have been produced." Again, a physiologic response. This is what he was positing.