Early Intervention of Pulmonary Rehabilitation for Fibrotic Interstitial Lung Disease Is a Favorable Factor for Short-Term Improvement in Health-Related Quality of Life

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.

Efecto de un programa de ejercicio físico y educación en pacientes con enfermedades pulmonares intersticiales difusas

“…17 No se presentaron cambios significativos en el IMC en los grupos de comparación; esto podría deberse al tiempo de intervención en el programa de ejercicio físico y educación, ya que no son lo suficientemente prolongados para generar cambios que contribuyan a la disminución del componente graso en este tipo de pacientes. 18,19 Además, en este estudio no se realizó un control y seguimiento nutricional que permitirá ocasionar cambios relevantes relacionados con la intervención.…”

Factors influencing long-term outcomes in fibrotic interstitial lung disease (F-ILD) diagnosed through multidisciplinary discussion (MDD): a prospective cohort study

“…Thus, registries that include both IPF and non-IPF patients are warranted. Identification of prognostic factors across fibrotic lung diseases is critical for early introduction of antifibrotics and rehabilitation [ 29 , 30 ].…”

Cardiac and Pulmonary Rehabilitation: Two Underutilized Approaches with Some Unexpected Benefits

“…However, based on recent meta-analytical data, long-lasting improvements in functional exercise capacity, dyspnea and quality of life are to be expected in this clinical setting after rehabilitation [32]. A recent study of 28 patients with fibrotic interstitial lung disease analysed the clinical features that are able to predict the effectiveness of pulmonary rehabilitation, concluding that it should be offered soon after the disease is diagnosed and before the functional impairment becomes severe [33]. Accordingly, another study on a similar patient population investigated the benefits of add-on pulmonary rehabilitation in patients treated with antifibrotic drugs [34].…”