Pulmonary rehabilitation in patients with pulmonary sarcoidosis: impact on exercise capacity and fatigue

Abstract

Background: There is limited evidence regarding the impact of interdisciplinary pulmonary rehabilitation (PR) on exercise capacity and fatigue in patients with pulmonary sarcoidosis. Objective: The aim of this study was to evaluate the impact on exercise capacity and fatigue following PR, and to examine whether baseline fatigue was related to change in exercise capacity (∆VO2peak). Methods: Forty-one patients with pulmonary sarcoidosis attending a 4-week inpatient PR program were recruited to this pre-post study. Both maximal exercise capacity, defined as peak oxygen uptake (VO2peak) and measured with a cardiopulmonary exercise test, and fatigue, assessed with the Fatigue Assessment Scale (score 10–50 points), were measured before and after PR. Results: There was a statistically significant improvement in VO2peak (1.2 ± 2.3 mL/kg/min, p = 0.002) and fatigue decreased significantly (-1.7 ± 3.9 points, p = 0.009) following PR. The unadjusted linear regression analyses demonstrated that age (B = -0.076, p = 0.017) and baseline fatigue (B = 0.196, p = 0.001) were predictors for change in VO2peak, while in the adjusted analyses (age, sex, baseline VO2peak, baseline fatigue and diffusion capacity of the lung for carbon monoxide), only baseline fatigue predicted change in VO2peak following PR (B = 0.165, p = 0.026). Conclusion: A 4-week inpatient interdisciplinary PR is safe and beneficial in improving exercise capacity and reducing fatigue in patients with pulmonary sarcoidosis. Baseline fatigue was partly related to change in VO2peak following PR, where a higher level of baseline fatigue was associated with a larger improvement in VO2peak following PR.