Value of community based Pulmonary Rehabilitation (PR) for patients with Interstitial Lung Disease (ILD): A retrospective review

Abstract

Little is known regarding PR in ILD. We wanted to discover whether PR can improve functional status, QOL and dyspnoea. The aim of the study was to determine if PR should be considered as a standard of care for patients with ILD. Methods: Data from 30 ILD patients who completed PR were included. All individuals included in the study were reviewed by a respiratory team and offered education, exacerbation management and follow up with the MDT 8 weeks post PR. Baseline and post PR variables were recorded. Results: 30 patients (18 males) with mean age 74.9 (+/- 6.8) and mean BMI of 29.6 kg/m2. The 6MWT demonstrated a significant improvement (P =0.04) after attending PR. The improvement ranged from 5m to 140m with the mean 44.4m. This also meets the minimum clinical importance difference for ILD which is 30m. There was an improvement in daily physical activity level and HRQL assessed by SGRQ score after PR. 16 patients achieved a mean change score of 4 units. The present study found an improvement in dyspnoea scale and a significant improvement in mMRC (P=0.013) after PR program. The depression scores (PHQ-9, GAD-7) showed improvement however not statistically significant (P=0.1 and P=0.4 respectively). The improvement in HRQL scores was strongly associated with improvement in 6 MWT and SGRQ demonstrating possibly that patients were coping better with their condition with improvement in their physical activity. Conclusions: The results suggest that a complete PR programme can improve ILD patients’ HRQL and physical activity and PR should be considered as standard care for ILD. The small sample size and lack of control group are limitations in this study.