Abstract
Patients with fibrosing interstitial lung disease (FILD) have poor health-related quality of life (HRQOL). We analyzed predictors of short-term improvement of HRQOL after starting pulmonary rehabilitation (PR) in moderate to severe FILD patients. This study involved 28 consecutive patients with FILD (20 males, median age of 77.5 years), who participated in PR program of our hospital for >6 weeks. The St. George’s Respiratory Questionnaire (SGRQ) score and the 6-min walk distance (6MWD) were evaluated before and after PR, and the predictors of efficacy of PR were analyzed. The duration from diagnosis of FILD to start of PR showed a positive correlation with the increase in the SGRQ score, and the baseline SGRQ score showed a negative correlation with increase in the 6MWD. The FILD subtype, modified Medical Research Council score, and treatment history were not associated with the endpoints. According to the receiver operating characteristic curve (ROC) analyses, starting PR within 514 days after diagnosis of FILD was a significant favorable predictor of improvement in the SGRQ total score more than a minimal clinically important difference of 4. In this study, early intervention of PR and lower SGRQ score were associated with the favorable response to PR. PR for FILD should be initiated early before the disease becomes severe.
Highlights
We found that a shorter duration from diagnosis of fibrosing interstitial lung disease (FILD) to and the median 6-min walk distance (6MWD) at baseline was 308 to 526 m; these values were higher than those start of pulmonary rehabilitation (PR) was associated with improvement in the St. George’s Respiratory Questionnaire (SGRQ) total score, and the lower SGRQ
We found that a shorter duration from diagnosis of FILD to start of total score at baseline was associated with improvement in 6MWD
Genstudies of PR for patients with FILD suggested that a higher forced vital capacity (FVC), a milder exercise-induced der was not associated with the change in 6MWD and SGRQ total score
Summary
Saint George’s Respiratory Questionnaire (SGRQ), the degree of dyspnea, and exercise tolerance are associated with one another and survival in patients with FILD [13,14,15,16,17]. A milder degree of dyspnea and higher pulmonary function, exercise tolerance, and HRQOL at baseline were associated with higher efficacy of PR in some previous studies of PR [21,23,24,26,29]. We analyzed the predictors of the short-term efficacy of PR in patients with FILD, including the PR intervention timing. Our study focuses on the efficacy of PR for patients with more severe FILD in the previous studies
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