Impact of pulmonary rehabilitation on quality of life and functional capacity in patients on waiting lists for lung transplantation

Abstract

OBJECTIVE: To investigate the impact of a pulmonary rehabilitation program on the functional capacity and on the quality of life of patients on waiting lists for lung transplantation. METHODS: Patients on lung transplant waiting lists were referred to a pulmonary rehabilitation program consisting of 36 sessions. Before and after the program, participating patients were evaluated with the six-minute walk test and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). The pulmonary rehabilitation program involved muscle strengthening exercises, aerobic training, clinical evaluation, psychiatric evaluation, nutritional counseling, social assistance, and educational lectures. RESULTS: Of the 112 patients initially referred to the program, 58 completed it. The mean age of the participants was 46 ± 14 years, and females accounted for 52%. Of those 58 patients, 37 (47%) had pulmonary fibrosis, 13 (22%) had pulmonary emphysema, and 18 (31%) had other types of advanced lung disease. The six-minute walk distance was significantly greater after the program than before (439 ± 114 m vs. 367 ± 136 m, p = 0.001), the mean increase being 72 m. There were significant point increases in the scores on the following SF-36 domains: physical functioning, up 22 (p = 0.001), role-physical, up 10 (p = 0.045); vitality, up 10 (p < 0.001); social functioning, up 15 (p = 0.001); and mental health, up 8 (p = 0.001). CONCLUSIONS: Pulmonary rehabilitation had a positive impact on exercise capacity and quality of life in patients on lung transplant waiting lists.

Preoperative physiotherapy in subjects with idiopathic pulmonary fibrosis qualified for lung transplantation: implications on hospital length of stay and clinical outcomes

“…In a prospective study conducted in 2013, Florian et al (5) found that the motor and respiratory performance of patients on the active list for LTx improved following a 36-session rehabilitation program (90 min, three times per week). The physiotherapy consisted of respiratory exercises, muscle strengthening, and aerobic exercise on a treadmill.…”

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“…16 In several studies, PR has been found to be helpful in minimizing physical and psychologic losses of patients. 17,18 In the present study, we also examined the effects of preoperative physiotherapy on lung transplant candidates. This study is the first and most comprehensive study conducted in Turkey on PR in lung transplant patients.…”

“…The SF-36 Quality of Life Questionnaire is a multipurpose, short-form health survey that is applied in many populations, both with disease and healthy, and has been used in many transplant studies. 29 Florian and associates 17 showed that PR applied in transplant candidates on wait lists had a positive effect on exercise capacity and quality of life, as assessed by the SF-36. In our study, there were improvements in the physical function and emotional role subparameters of SF-36.…”

Pulmonary rehabilitation

“…Indeed, patients with chronic respiratory disease other than COPD also suffer from daily symptoms, muscle weakness, exercise intolerance, impaired mood status, poor quality of life and physical inactivity, despite optimal medical treatment [100][101][102][103][104][105][106]. Most of the new studies confirm the positive effects of exercise-based pulmonary rehabilitation in patients with nonsmall cell lung cancer (pre-/post-lung resection) [107][108][109][110][111][112][113][114][115][116][117], chronic respiratory failure due to kyphoscoliosis [118], pre-/post-lung transplantation [119][120][121][122], cystic fibrosis [123], bronchiectasis [124], severe respiratory failure receiving extracorporeal membrane oxygenation [125,126], interstitial lung disease [6,[127][128][129], and pulmonary arterial hypertension [130][131][132]. Existing COPD pulmonary rehabilitation programmes can be adapted to the particular needs of patients with chronic respiratory disease other than COPD, in particular the non-exercising parts [30].…”