Duration of benefit following completion of pulmonary rehabilitation in interstitial lung disease—an observational study

Sharp, Charles; McCabe, Melanie; Hussain, MJ; Dodd, James; Lamb, Heather; Adamali, Huzaifa; Millar, Ann; Smith, Dean

doi:10.1093/qjmed/hcw105

Cited by 27 publications

(13 citation statements)

References 32 publications

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“…First, continued regular exercise appears to be the most crucial aspect of the improvement; thus, all patients in the APA group but only 2 of 8 in the control group reported that they exercised regularly at the local facility and/or at home over the 6 months. These findings are consistent with the recent report by Sharp et al that nearly half of patients with interstitial lung disease who participated in a PR program failed to continue exercising at home, and these subjects were more likely to lose the benefits of PR after 6 months than the group who continued to exercise [3]. [6], the APA group was similarly better able to sustain the benefits of PR compared with the control group [6].…”

supporting

confidence: 90%

“…We previously reported the results of an 8-week home-based pulmonary rehabilitation (PR) program in patients with fibrotic interstitial idiopathic pneumonia (f-IIP), which demonstrated significant long-term (12 month) improvements in exercise capacity, anxiety, and quality of life [1]. However, most studies of f-IIP patients have shown that the benefits are lost within 6 to 9 months after the PR program [2], largely due to a failure to continue with exercise training [3]. Indeed, previous studies did not offer maintenance program after PR [2].…”

mentioning

confidence: 99%

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Exploiting local facilities for post-pulmonary rehabilitation maintenance programs in fibrotic idiopathic interstitial pneumonia patients: A pilot study

Chéhère

Grosbois

Chenivesse

et al. 2019

Respiratory Medicine and Research

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supporting

confidence: 90%

mentioning

confidence: 99%

Exploiting local facilities for post-pulmonary rehabilitation maintenance programs in fibrotic idiopathic interstitial pneumonia patients: A pilot study

Chéhère

Grosbois

Chenivesse

et al. 2019

Respiratory Medicine and Research

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“…Bleeding during cryobiopsy can also be common [13–19, 22–25], but it is generally readily controlled endoscopically by the use of bronchial blockers and/or use of rigid tube [1, 2, 16, 23, 25, 26]. All episodes of severe bleeding reported in the literature were controlled by placement of bronchial blocker or catheter [24] and no bleeding-related deaths have been reported after cryobiopsy; a recently published report highlights the risk of potentially life-threatening complications when this precaution is not taken [27].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic yield and risk/benefit analysis of trans-bronchial lung cryobiopsy in diffuse parenchymal lung diseases: a large cohort of 699 patients

et al. 2019

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BackgroundStandardization of trans-bronchial lung cryobiopsy in diffuse parenchymal lung diseases is imminent; however, the majority of published series on cryobiopsy include a limited number of patients and are characterized by several differences in procedural technical details.MethodsThis is an observational, retrospective cohort study. Aim of the study was to suggest some sampling strategies related to transbronchial cryobiopsy in the diagnostic work-up of patients with diffuse parenchymal lung diseases.ResultsSix hundred ninety-nine patients with suspected diffuse parenchymal lung disease were recruited. A specific pathological diagnosis was achieved in 614/699 cases (87.8%) and a multidisciplinary diagnosis was obtained in 630/699 cases (90.1%). Diagnostic yield was significantly influenced by the number of samples taken (1 vs ≥ 2 biopsies, p < 0.005). In 60.4% of patients, biopsies were taken from one site and in 39.6% from different sites (in the same lobe or in two different lobes), with a significant increase in diagnostic yield, specifically in patients with fibrotic lung diseases (65.5% vs 93.4%, p < 0.0001). The 2.4 mm or 1.9 mm probes were used, with no differences in terms of diagnostic yield. Regarding safety, pneumothorax occurred in 19.2% and was influenced by baseline lung function; in all patients Fogarty balloon has been used and severe haemorrhage occurred in 0.7% of cases. Three patients (0.4% of cases) died within 30 days after the procedure.ConclusionsWe propose some sampling strategies of cryobiopsy which seem to be associated with a higher diagnostic yield and a favorable risk/benefit ratio: sampling at least two samples in different sites, using either the 2.4 mm or the 1.9 mm probe, intubating the patients and using bronchial blockers/catheters.

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“…Exercise may not only therefore represent a valuable tool for disease assessment and monitoring, but also an effective intervention for maintaining wellbeing and managing disease. Exercise training and rehabilitation programmes in patients with chronic respiratory disease have been reported to improve symptoms and exercise capacity, but the extent and duration of the effect in specific settings need to be fully clarified [85,86]. Although the majority of data derive from studies performed in COPD subjects [87], in recent years, pulmonary rehabilitation programmes have been adopted for patients with ILDs and particularly in IPF [88,89].…”

Section: Exercise Training and Pulmonary Rehabilitation In Ildmentioning

confidence: 99%

Exertional dyspnoea in interstitial lung diseases: the clinical utility of cardiopulmonary exercise testing

Bonini

Fiorenzano

2017

Eur Respir Rev

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Interstitial lung diseases (ILDs) represent a heterogeneous group of pathologies characterised by alveolar and interstitial damage, pulmonary inflammation (usually associated with fibrosis), decreased lung function and impaired gas exchange, which can be attributed to either a known or an unknown aetiology. Dyspnoea is one of the most common and disabling symptoms in patients with ILD, significantly impacting quality of life. The mechanisms causing dyspnoea are complex and not yet fully understood. However, it is recognised that dyspnoea occurs when there is an imbalance between the central respiratory efferent drive and the response of the respiratory musculature. The respiratory derangement observed in ILD patients at rest is even more evident during exercise. Pathophysiological mechanisms responsible for exertional dyspnoea and reduced exercise tolerance include altered respiratory mechanics, impaired gas exchange, cardiovascular abnormalities and peripheral muscle dysfunction.This review describes the respiratory physiology of ILD, both at rest and during exercise, and aims to provide comprehensive and updated evidence on the clinical utility of the cardiopulmonary exercise test in the assessment and management of these pathological entities. In addition, the role of exercise training and pulmonary rehabilitation programmes in the ILD population is addressed.

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Duration of benefit following completion of pulmonary rehabilitation in interstitial lung disease—an observational study

Abstract: Standard PR gives initial benefits in participants with ILD who complete the course, however these are not sustained. Tailored approaches to this group would be appreciated by this group and should be explored.

Cited by 27 publications

References 32 publications

Exploiting local facilities for post-pulmonary rehabilitation maintenance programs in fibrotic idiopathic interstitial pneumonia patients: A pilot study

Exploiting local facilities for post-pulmonary rehabilitation maintenance programs in fibrotic idiopathic interstitial pneumonia patients: A pilot study

Diagnostic yield and risk/benefit analysis of trans-bronchial lung cryobiopsy in diffuse parenchymal lung diseases: a large cohort of 699 patients

Exertional dyspnoea in interstitial lung diseases: the clinical utility of cardiopulmonary exercise testing

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