Portuguese Physiotherapists Association reaffirms the importance of increasing accessibility to Respiratory Rehabilitation programmes in Portugal

Today, 21 April, is National Respiratory Rehabilitation Day. The date was implemented in 2016, on the initiative of the Portuguese Lung Foundation and signed by 12 other entities (medical societies and associations of health professionals and respiratory patients).

The aim of this initiative is to raise awareness among health policy-makers, health funders, health professionals, respiratory patients and their relatives and society in general that Respiratory Rehabilitation (RR) is an intervention with proven benefits for health in its physical, psychological and social dimensions, being the most cost-effective intervention in the treatment of people with chronic obstructive pulmonary disease (COPD).

Despite the proven benefits and cost reduction, the accessibility and referral to RR, incomprehensibly, remains extremely low, estimating that only around 2-3% of patients who need it, have access. The Portuguese Society of Physiotherapists appeals for an increase in accessibility to RR, particularly in the community context, and one of the priorities of the NHS should be to increase the number of specialised human resources in Primary Health Care, namely the number of physiotherapists, which is clearly insufficient.

Respiratory physiotherapy and the professional who carries it out, the physiotherapist, are fundamental elements that contribute to the improvement of the health condition of the respiratory patient (acute or chronic), whether integrated in multi-interdisciplinary RR teams or in a more direct practice context not framed within the concept of Respiratory Rehabilitation.

Physiotherapists integrated in the RR teams have an important role in the specific assessment to determine individual rehabilitation needs, in the exercise training component (prescription, implementation and supervision), in education, in health promoting behavioural changes (e.g. regular physical activity), among others (e.g. secretion removal techniques, inspiratory muscle training, respiratory control techniques and dyspnoea relief).

The Portuguese Order of Physiotherapists also underlines the enormous contribution that physiotherapists, at a national and international level, have given to the increase of knowledge, evidence and implementation of Respiratory Rehabilitation, including new models of practice (telerestherapy, low cost home and web-based).

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Pedro Maciel Barbosa

Specialist physiotherapist at the Matosinhos Local Health Unit Sub-coordinator for Primary Health Care, Matosinhos Local Health Unit Visiting Assistant Professor at the Porto School of Health Member of the Board of Directors of the Foundation for Health - SNS Member of the General Council of the Order of Physiotherapists

Carlos Sand

Carlos Areia has been a physiotherapist since 2013, and has worked in various hospitals, clinics and clubs in both Portugal and the UK. He began his academic career at Oxford University in 2016, where he led a clinical trial comparing physiotherapy vs surgery in anterior cruciate injuries in 32 hospitals in England. In 2018 she moved to the neurosciences department, where she developed her own studies on remote monitoring of vital signs, which were implemented during the pandemic. Here he discovered his passion for data, and in 2022, he joined Digital Science as a Data Scientist. He completed his PhD earlier this year, and has more than 60 publications in journals such as The Lancet, BMJ, Cochrane, among others. He is also an honorary lecturer at Oxford Brookes University and a consultant in clinical research.

Eduardo José Brazete Carvalho Cruz

PhD in Physiotherapy from the University of Brighton, UK. Post-Doctorate in Epidemiology from the National School of Public Health at the New University of Lisbon.
Coordinator of the Studies and Planning Office of the Order of Physiotherapists. Coordinating Professor of the Physiotherapy Department of the School of Health of the Polytechnic Institute of Setúbal (ESS-IPS). President of the ESS-IPS Technical-Scientific Council. Coordinator of the Physiotherapy Department at ESS-IPS. Integrated Researcher at the Comprehensive Health Research Centre (CHRC) (a partnership between FCM-UNL, the National School of Public Health, the University of Évora, the Lisbon Institute of Global Mental Health and Santo Espírito Hospital, Terceira Island, Azores).

Sara Souto Miranda

Sara Souto Miranda has a bachelor's and master's degree in physiotherapy from the University of Aveiro, and a postgraduate qualification in adult respiratory physiotherapy from the same institution. In 2023 she completed her double doctorate in Rehabilitation Sciences/Health, Medicine and Life Sciences at the Universities of Aveiro and Maastricht (Netherlands) and is currently working as a technical-scientific advisor to the Studies and Planning Office (GEP) of the Order of Physiotherapists, and as a guest lecturer at the Piaget Institute in Vila Nova de Gaia. As a member of the Respiratory Research and Rehabilitation Laboratory at the University of Aveiro (Lab3R), she has carried out applied research in which she has assessed and treated patients with respiratory pathology, having taken part in 6 research projects. Throughout her career she has published 19 scientific articles in international peer-reviewed journals with an impact factor, 1 book chapter and more than 50 abstracts in conference proceedings. She was a research volunteer at the Ciro rehabilitation centre (Centre for expertise in chronic organ failure) in the Netherlands, and is currently a member of the Guideline Methodology Network of European Respiratory Society. She was honoured by European Lung Foundation e European Respiratory Society for carrying out patient-centred research, by the Directorate General for Higher Education with a merit grant for his master's degree, and by the Ciro Centre with a grant to support research abroad.

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