Pulmonary rehabilitation improves long-term outcomes in interstitial lung disease: A prospective cohort study

Ryerson, Christopher J.; Cayou, Cindy; Topp, Fiona J.; Hilling, Lana; Camp, Pat G.; Wilcox, Pearce; Khalil, Nasreen; Collard, Harold R.; Garvey, Chris

doi:10.1016/j.rmed.2013.11.016

Cited by 150 publications

(131 citation statements)

References 36 publications

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“…This was previously demonstrated among COPD and ILD patients, suggesting greater improvement in longer pulmonary rehabilitation programs [7,10], and supported by Kozu et al [33], who showed that the dyspnea severity and disability level of IPF patients at baseline has a negative impact on the degree of improvement following pulmonary rehabilitation. In contrast, Huppmann et al [34] and Ryerson et al [35] showed higher improvement rates in 6MWD following pulmonary rehabilitation programs in the most deconditioned ILD patients and those with low baseline values, respectively [34,35]. Our findings are also in concordance with a recent report by Arizono et al [36], who also showed significant improvements of CPET parameters in IPF patients, but not V O 2 peak.…”

Section: Discussionsupporting

confidence: 92%

Exercise Training-Based Pulmonary Rehabilitation Program Is Clinically Beneficial for Idiopathic Pulmonary Fibrosis

Vainshelboim

Oliveira²,

Yehoshua³

et al. 2014

Respiration

140

166

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Background: Idiopathic pulmonary fibrosis (IPF) is a chronic, devastating, interstitial lung disease, with few therapeutic options. IPF is characterized by pulmonary restriction, dyspnea, hypoxemia, exercise intolerance and poor quality of life (QOL). Objectives: We aimed to examine the effect of exercise training (ET) on clinical outcomes in IPF patients. Methods: A randomized controlled study included thirty-two IPF patients (aged 68 ± 8 years) who were allocated either to the ET group (n = 15), participating in a 12-week, twice-weekly 60-min supervised ET-based pulmonary rehabilitation program, or to a control group (n = 17) continuing with regular medical treatment alone. Cardiopulmonary exercise test, 6-min walking distance (6MWD) test, 30-second chair-stand test, pulmonary function tests, dyspnea and QOL were assessed at baseline and at the end of the 12-week intervention. Results: Significant differences were observed between the ET and the control groups in raw mean deltas (Δ = post- - pre-intervention): Δ6MWD, 81 m, p < 0.001; ΔVO₂ peak, 2.6 ml/kg/min, p = 0.002; Δwork rate, 22 W, p < 0.001; Δanaerobic threshold, 3.1 ml/kg/min, p < 0.001, and ΔFVC % predicted, 6%, p = 0.038. Dyspnea, QOL and 30-second chair-stand were also improved significantly following the program. Conclusions: ET improves exercise tolerance, functional capacity, pulmonary function, dyspnea and QOL in patients with IPF, suggesting a short-term treatment efficacy for clinical improvement, and should be considered the standard care for IPF.

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Section: Discussionsupporting

confidence: 92%

Exercise Training-Based Pulmonary Rehabilitation Program Is Clinically Beneficial for Idiopathic Pulmonary Fibrosis

Vainshelboim

Oliveira²,

Yehoshua³

et al. 2014

Respiration

140

166

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“…Such benefit was assessed using the 6MWT, with an average gain of 70 meter before and after PR. This outcome is on a par with the minimal clinically important difference (MCID) in other chronic disease states, such as 54 meter in COPD 20 or 56-57 meter seen in patients with interstitial lung disease 16,21 or 25 meter in patients with coronary artery disease. 22 Our intention was to evaluate and compare the outcomes in pharmacotherapy and PR in PH and also compare it to newer data that supports an MCID of 33 meters for patients with PH.…”

Section: Summary Of Main Findingsmentioning

confidence: 98%

A retrospective study on the effects of pulmonary rehabilitation in patients with pulmonary hypertension

et al. 2014

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A retrospective analysis of 23 patients was undertaken to evaluate the outcome of pulmonary rehabilitation (PR) in patients with pulmonary hypertension (PH) over a preceding 6-year time frame. Chart review and data analyses were undertaken evaluating pulmonary arterial hypertension pharmacotherapy versus the same therapy with the addition of PR. Analysis included 23 patients who had a mean pulmonary artery pressure of 36.6 while on therapy and who had initial six-minute walk tests (6MWTs) ranging between 54 and 396 meters. Outcomes included 6MWTs and Saint George's Respiratory Questionnaire. There was no improvement in 6MWT postpharmacotherapy. Patients with low 6MWT <250 meters had substantial gains in 6MWT postrehabilitation (average of 86 meters). As well, those with initial 6MWT >250 meters had a significant improvement of 52.55 meters, documenting the utility of PR in patients with PH. PH patients are increasingly seen in PR clinics as they share many characteristics present in chronic respiratory disease states. There is increasing literature supporting the utility of PR in this population. We have found that patients with 6MWTs as low as <250 meters are also candidates for PR and can demonstrate substantial benefits as measured using the 6MWTs.

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“…Early referral to physical training should be considered, as less severe physiological limitation may provide greater opportunity to successfully undertake training [52]. But several studies found that patients with very low functional exercise capacity and severe symptoms should be offered the opportunity to undertake a training program and may experience clinically important benefits [1,73].…”

Section: Physical Training In Sarcoidosismentioning

confidence: 99%

Physical activity and training in sarcoidosis: review and experience-based recommendations

Strookappe

Saketkoo

Elfferich

et al. 2016

Expert Review of Respiratory Medicine

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Pulmonary rehabilitation improves long-term outcomes in interstitial lung disease: A prospective cohort study

Abstract: NCT01055730 (clinicaltrials.gov).

Cited by 150 publications

References 36 publications

Exercise Training-Based Pulmonary Rehabilitation Program Is Clinically Beneficial for Idiopathic Pulmonary Fibrosis

Exercise Training-Based Pulmonary Rehabilitation Program Is Clinically Beneficial for Idiopathic Pulmonary Fibrosis

A retrospective study on the effects of pulmonary rehabilitation in patients with pulmonary hypertension

Physical activity and training in sarcoidosis: review and experience-based recommendations

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