Abstract
BackgroundRecent evidences show that Pulmonary Rehabilitation (PR) is effective in patients with Interstitial Lung Disease (ILD). It is still unclear whether disease severity and/or etiology might impact on the reported benefits. We designed this prospective study 1) to confirm the efficacy of rehabilitation in a population of patients with ILDs and 2) to investigate whether baseline exercise capacity, disease severity or ILD etiology might affect outcomes.MethodsForty-one patients (IPF 63%, age 66.9 ± 11 ys) were enrolled in a standard PR course in two centers. Lung function, incremental and endurance cyclo-ergometry, Six Minutes Walking Distance (6MWD), chronic dyspnea (Medical Research Council scale-MRC) and quality of life (St. George Respiratory Questionnaire-SGRQ) were recorded before and at the end of PR to measure any pre-to-post change. Correlation coefficients between the baseline level of Diffuse Lung Capacity for Carbon monoxide (DLCO), Forced Vital Capacity (FVC), 6MWD, power developed during incremental endurance test, GAP index (in IPF patients only) and etiology (IPF or non-IPF) with the functional improvement at the 6MWDT (meters), at the incremental and endurance cyclo-ergometry (endurance time) and the HRQoL were assessed.ResultsOut of the 41 patients, 97% (n = 40) completed the PR course. Exercise performance (both at peak load and submaximal effort), symptoms (iso-time dyspnea and leg fatigue), SGRQ and MRC significantly improved after PR (p < .001). Patients with lower baseline 6MWD showed greater improvement in 6MWD (Spearman r score = − .359, p = .034) and symptoms relief at SGRQ (r = −.315, p = .025) regardless of underlying disease.ConclusionPresent study confirms that comprehensive rehabilitation is feasible and effective in patients with ILD of different severity and etiology. The baseline submaximal exercise capacity inversely correlates with both functional and symptom gains in this heterogeneous population.
Highlights
Recent evidences show that Pulmonary Rehabilitation (PR) is effective in patients with Interstitial Lung Disease (ILD)
The overall mean distance covered at the 6MWDT was 376.8 m ± 94.6 m and the overall mean endurance power developed during incremental exercise test was 57.5 w ± 23.7 w, which revealed a substantial reduction of exercise capacity both at submaximal and maximal performance test
In this study we evaluated the impact of a standard comprehensive Pulmonary rehabilitation (PR) program conducted in the real life in patients with Interstitial lung disease (ILD) of different etiology, functional performance and lung impairment
Summary
Recent evidences show that Pulmonary Rehabilitation (PR) is effective in patients with Interstitial Lung Disease (ILD). It is still unclear whether disease severity and/or etiology might impact on the reported benefits. The development of irreversible and progressive parenchymal fibrosis leads to ventilatory constraint and abnormal lung mechanics with limited exercise capacity and dyspnea on exertion [1]. As ILD progresses, the patient’s daily activities decline early following symptoms (shortness of breath, tiredness, muscle fatigue). This reduction in everyday performance begins even before that ventilatory limitation with functional impairment occurs [3]. Due to the progressive exercise limitation, individual’s healthrelated quality of life (HRQoL) is markedly affected [4]
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