Home-Based Pulmonary Rehabilitation for Patients With Idiopathic Pulmonary Fibrosis

Abstract

Purpose: To evaluate the adherence and effectiveness of a home-based exergame program for patients with idiopathic pulmonary fibrosis (IPF). Method: Patients with IPF were randomly assigned to a relatively unsupervised Wii Fit exergame intervention group or Wii video game control group (with no active whole-body movement involved). Participants in both groups were instructed to play their respective games 30 min/d, 3 d/wk for 12 wk. In addition, they were asked to perform their usual exercise/physical activities. Outcome measures were 6-min walk distance (6MWD), exercise-related dyspnea, and St George's Respiratory Questionnaire (SGRQ). Results: The 20 participants differed significantly between intervention and control groups in baseline characteristics (forced vital capacity = 2.0 ± 0.5 vs 3.1 ± 0.7 L; forced expiratory volume in 1 sec = 1.7 ± 0.4 vs 2.5 ± 0.6 L, respectively). Participant adherence rate to the exergame program was very low (20%). There was no significant improvement in the outcome measures in either group. In fact, both the intervention and control groups had a deterioration in 6MWD (−22 ± 56 m vs −60 ± 111 m), respectively and SGRQ scores (3 ± 9 vs 1 ± 11), respectively. Conclusions: The home-based exergame intervention for patients with IPF did not show improvement in functional performance, dyspnea, or health-related quality of life at the completion of the 12-wk program in our 2 heterogeneous groups. In addition to the low adherence rate, insufficient frequencies and durations of exergaming may contribute to the lack of improvement. A lack of effectiveness of home-based pulmonary rehabilitation using exergaming for patients with IPF appears consistent with prior observational studies that used more traditional modes of home-based exercise.

Effectiveness of Pulmonary Rehabilitation in Interstitial Lung Disease, Including Coronavirus Diseases: A Systematic Review and Meta-analysis

“…As evaluated by Cochrane Collab ' f R T 18.2 % of the studies showed a high risk of bias, 31,37 72.7 % some concerns 21, 32-36, 38, 39 and 9,1 % a low risk of bias. 30 When studies were analysed by individual domains, 91% of them had shortcomings in the selection of the reported results domain 21,[31][32][33][34][35][36][37][38][39] (Supplementary Figure S1).…”

Effects of Exercise Training on Cardiopulmonary Function and Quality of Life in Elderly Patients with Pulmonary Fibrosis: A Meta-Analysis

“…• 6MWD: The 6MWD was evaluated in eleven studies (nine GQ [16,17,19,24,26,[28][29][30][31], two FQ [32,33]). The effect sizes were calculated according to Cohen's d. The difference of the 6MWD between two conditions supported PF patients in exercise training (Cohen's d = 0.77, MD: 34.04; 95% CI: 26.50 to 41.58; Z = 8.85, p < 0.01) (Figure 2).…”

“…Hence, we concluded that there was no difference between exercise duration subgroups. Four GQ studies [17,29,31,33] evaluated subjects older than 70 (Cohen's d = 0.45, p = 0.14), seven studies (six GQ [16,19,24,26,28,30], one FQ [32]) evaluated those 70 or younger (Cohen's d = 0.86, p < 0.01). The 6MWD differences between the age subgroups (p < 0.01) suggested that the 3 : predicted forced vital capacity (FVC% pred), 4 : predicted diffusing capacity of the lung for carbon monoxide (DLCO% pred), 5 : predicted total lung capacity (TLC% pred), 6 : St. George's Respiratory Questionnaire total score (SGRQ), 7 : modified Medical Research Council score (mMRC).…”

“…Exercise frequency, duration, intensity and type subgroups had no significant difference in DLCO% pred results (p = 0.93, 0.84, 0.86, 0.86) (Table 3). • DLCO% pred: Five studies were included in the meta-analysis to provide DLCO% pred numerical data (four GQ [16,19,26,30], one FQ [32]). The combined DLCO% pred did not support patients with PF engaging in exercise training (Cohen's d = 0.16, MD: 1.86; 95% CI: -0.37 to 4.09; Z = 1.63, p = 0.10) (Figure 5).…”

Long-term effects of home-based pulmonary rehabilitation on idiopathic interstitial pneumonia patients

“…It is hypothesized that PR can also be used as a treatment method in ILD patients and delay the progression of the disease; however, there are currently no detailed guidelines on the use of PR in ILD patients (Igarashi et al 2018). Several studies have shown that the PR program has several benefits tailored to improving the prognosis of ILD patients (Sciriha et al 2019;Wallaert et al 2019;Yuen et al 2019). Few studies focus on the long-term effects of home-based PR programs on patients.…”