All rehabilitation programmes include education as an important component. Important topics normally addressed in educational programmes are: the anatomy and physiology of the lung, breathing strategies, medication, self-management skills, psychological factors (coping, anxiety, panic control), and smoking cessation . Education may improve patients' active participation in a programme, improve understanding of the disease, and help patients and their family members to cope with the disabilities and handicaps due to the pulmonary disease . However, no clear evidence has so far been found for the effects of education alone. Two studies, mentioned above, did not show any change in exercise tolerance or symptoms with education alone [43,45]. However, in these studies the education groups served mostly as control group in a trial of more comprehensive rehabilitation. At present, there has only been one randomized and controlled study comparing education sessions with written material only . The authors found that the education sessions significantly improved the domains of social disability and knowledge of COPD. However, neither exercise parameters nor health-related quality of life were measured in this study.
Thus, although it is widely assumed that education is beneficial in rehabilitation, the influence of education as a sole component has not clearly been demonstrated. A possible explanation for these disappointing results is that sensitive tools are not available for measuring the effects of pure education adequately. It might be interesting to investigate whether education is effective as an adjunct to exercise training when such tools have been developed.
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