Impact of Pulmonary Rehabilitation on Exercise Tolerance and Quality of Life in Patients With Idiopathic Pulmonary Fibrosis

Abstract

Pulmonary rehabilitation is effective in increasing exercise tolerance and improving quality of life in patients with idiopathic pulmonary fibrosis.

Pulmonary rehabilitation in interstitial lung diseases: A review of the literature

“…Significant improvement was found in the 6MWT, along with a significant decrease in the total SGRQ score. 21 In a large study including 402 patients on a widespread ILD spectrum, PR was performed at a specialist center for an average of 30 days with 5 sessions per week. Clinically significant improvements in the patients' quality of life, physical capacity (the mean increase compared to the baseline 6MWT was 46 m) and a slight improvement in FVC (+1%) were observed.…”

Guidelines of the Polish Respiratory Society for Diagnosis and Treatment of Idiopathic Pulmonary Fibrosis

“…A 2014 meta-analysis of 5 randomised studies (86 patients with ILDs, including IPF, undergoing rehabilitation and 82 non-rehabilitated patients comprising the control group) confirmed the beneficial effects of rehabilitation on distance in the 6MWT, peak oxygen uptake, dyspnoea severity and quality of life, with lack of adverse effects [319]. The most recent meta-analyses of 5 randomised trials involving more than 130 IPF patients divided into a group of subjects receiving rehabilitation and a control group demonstrated an improvement in exercise tolerance, reduction of symptoms and quality of life improvement [320]. Another meta-analysis of 4 randomised trials (a total of 142 subjects) confirmed beneficial short-term effects of rehabilitation on exercise capacity and quality of life but failed to confirm any distant effects [321].…”

Comprehensive Care in Pulmonary Fibrosis

“…Physical activity and autonomy are fundamental for the physical and mental health, and also for better dealing with any chronic illness [53][54][55] . Reduced physical activity is associated with poor QoL and survival 14,24,[58][59][60] . Physical activity and respiratory rehabilitation are recommended in the integral care of IPF 2-4 .…”

“…Physical activity and respiratory rehabilitation are recommended in the integral care of IPF 2-4 . Rehabilitation programs include muscular training by combining exercises of strength and resistance and respiratory education for optimising the pattern of breathing, altogether to improve gas exchange and decreasing anxiety 59,60 . The approach to activity and training will likely change throughout the different stages of the disease and also depend on the daily life activities or habits.…”

“…However, the educational and activity content of specified pulmonary fibrosis physiotherapy or respiratory rehabilitation programs have not been designed yet 44 . Furthermore, the beneficial effect of pulmonary rehabilitation in IPF has been proven evaluating the activity performed during some months, but often the effect may wean out at longer term [58][59][60] . Patients with pulmonary fibrosis may have severe hypoxia (oxygen saturation [SaO 2 ] < 88%) during exercise from mild-to-moderate stages of the disease 1-4 , which may be a challenge for exercise programs.…”