Effects of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis

Abstract

Effects of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosisNISHIYAMA O, KONDOH Y, KIMURA T, KATO K, KATAOKA K, OGAWA T, WATANABE F, ARIZONO S, NISHIMURA K, TANIGUCHI H. Respirology 2008; 13: 394-399 Background and objective: Although pulmonary rehabilitation is effective for patients with COPD, its efficacy in patients with IPF is unknown. The purpose of this study was to evaluate the effects of pulmonary rehabilitation in IPF. Methods: Thirty patients diagnosed with IPF, according to the consensus statement, were randomly assigned to the rehabilitation group or the control group. The pulmonary rehabilitation mainly consisted of a 10-week programme of exercise training. Pulmonary function, blood gas analysis, 6MWD, dyspnoea rating with the baseline dyspnoea index and health-related quality of life score on the St George's Respiratory Questionnaire were evaluated at baseline and after the programme. Results: Assessment of efficacy was carried out on 13 patients who completed the programme and 15 patients in the control group. There were no significant effects of the programme on measures of pulmonary function, values of arterial blood gas analysis or dyspnoea rating. Although there were some differences in the baseline 6MWD and total health-related quality of life score which were not statistically significant, marked improvements were observed in the 6MWD (mean difference 46.3 m (95% CI: 8.3-84.4), P < 0.05) and the total health-related quality of life score (-6.1 (95% CI: -11.7 to -0.5), P < 0.05). Conclusions: Pulmonary rehabilitation improves both exercise capacity and health-related quality of life in patients with IPF.

Effects of inpatient pulmonary rehabilitation in patients with interstitial lung disease

“…Therefore, our data show a significant and clinically important improvement in all sub-and summary-scores of SF-36. Our observation is in concordance with some published studies [8,23,31,33], while others did not detect any influence of PR in HRQL [10,24,25]. NAJI et al [31] demonstrated in their group of ILD patients a significant reduction in anxiety and depression after completing PR.…”

“…We observed a small, statistically significant improvement of blood gas analysis and lung function parameters, which is in line with other published studies [10,23]. Although these improvements are statistically significant, their clinical relevance is probably negligible.…”

“…Only a few studies have investigated the effect of PR on the 6MWD in ILD patients so far; in all of them PR was performed as an outpatient programme. NISHIYAMA et al [23] observed a PR effect of 46 m in 6MWD, whilst, HOLLAND et al [24] reported a mean increase in the 6MWD of 35 m in ILD patients and of 25 m in a subgroup analysis of 34 patients with IPF. FERREIRA et al [22] measured an average increase of 56 m in their study with 113 ILD patients and SWIGRIS et al [25] documented an improvement of 61 m in 6MWD in their study of 21 IPF patients.…”

“…We speculate that ILD patients walking at their highest possible capacities achieve their dyspnoea maximum more rapidly, in contrast to COPD patients, independent of the distance walked. However, due to conflicting data from different studies, dyspnoea rating is still under debate in IPF patients [10,[22][23][24][25].…”

Effects of Pulmonary Rehabilitation in Patients with Diffuse Interstitial Lung Disease

“…During eight weeks of exercise was performed: continuous exercise on treadmill for 30 minutes starting at 80% speed increase achieved in 6MWT at 4 weeks at 90% [7,8]; O 2 was administered to patients who present in 6MWT desaturation ≥ 4% or during exercise O 2 saturation [SpO 2 ] was <90%; upper limb muscle strengthening 4 sets of 12 reps with 1 minute rest at 30% of maximum resistance [RM], increasing to four weeks at 40% of the RM; breathing techniques and mobility of the chest.…”