[Physical therapy in COPD--Evidence based medicine?]

Several therapeutical options of physical therapy in COPD show significant effects on the organism. Some of those effects are verified, but there is still an uncertainty about the exact influences on the disease and the beneficial outcome, especially because different trials describe contradictory results. Existing studies observed an improved respiratory mechanism with a more economical ventilatory work and a better gas exchange by use of physical therapy. Therefore the right indication for certain options of physical therapy should be defined, so that the outcome can be controlled and a benefit can be drawn from the effects. Sufficient data of existing trials for the whole physical therapy in COPD is still deficient. Due to an inappropriate study design and/or the number of observed patients a lot of clinical studies are not qualified to lead to significant results and recommendations. For the future it is necessary to investigate the exact effects of physical therapy with controlled, randomised, clinical trials further on. Hereby an improvement of the care of patients with COPD can be achieved and the beneficial effects and the outcome with physical therapy can better be estimated.