Abstract
BackgroundFew data are available on the long-term effect of pulmonary rehabilitation (PR) and on long PR programs in interstitial lung diseases (ILD).We aimed to evaluate the effects of PR on exercise capacity (6-Minute Walking Distance, 6MWD; Peak Work Rate, Wmax), quality of life (St George’s Respiratory Questionnaire, SGRQ), quadriceps force (QF) and objectively measured physical activity in ILD after the 6-month PR-program and after 1 year.Methods60 patients (64 ± 11 years; 62% males; 23% with IPF) were randomly assigned to receive a 6 month-PR program or usual medical care.ResultsExercise capacity, quality of life and muscle force increased significantly after the program as compared to control (mean,95%CI[ll to ul]; 6MWD + 72,[36 to 108] m; Wmax 19, [8 to 29]%pred; SGRQ − 12,[− 19 to − 6] points; QF 10, [1 to 18] %pred). The gain was sustained after 1 year (6MWD 73,[28 to 118] m; Wmax 23, [10 to 35]%pred; SGRQ − 11,[− 18 to − 4] points; QF 9.5, [1 to 18] %pred). Physical activity did not change.ConclusionsPR improves exercise tolerance, health status and muscle force in ILD. The benefits are maintained at 1-year follow-up. The intervention did not change physical activity.Trial registrationClinicaltrials.gov NCT00882817.
Highlights
Few data are available on the long-term effect of pulmonary rehabilitation (PR) and on long PR programs in interstitial lung diseases (ILD)
It has been shown that quadriceps weakness [4] and physical inactivity [5] are present in idiopathic pulmonary fibrosis (IPF) and poor exercise capacity, physical inactivity
Study subjects Patients with chronic ILD referred to the ILD clinic in the University Hospital of Leuven were considered for enrolment
Summary
Few data are available on the long-term effect of pulmonary rehabilitation (PR) and on long PR programs in interstitial lung diseases (ILD). We aimed to evaluate the effects of PR on exercise capacity (6-Minute Walking Distance, 6MWD; Peak Work Rate, Wmax), quality of life (St George’s Respiratory Questionnaire, SGRQ), quadriceps force (QF) and objectively measured physical activity in ILD after the 6-month PR-program and after 1 year. Treatment typically involves corticosteroids or cytotoxic drugs and, in some cases, antifibrotic agents [3] While these therapies tackle the respiratory problems to some degree, strategies that further reduce complaints, improve health status and delay extra-pulmonary disease progression are needed. A recent large Australian trial reported somewhat smaller effects [9]. None of these studies propose long programs and only one small trial showed limited long-term effects (beyond 6 months) [15]
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