Pulmonary rehabilitation improves long-term outcomes in interstitial lung disease: A prospective cohort study - 25/01/14

, Cindy Cayou c, Fiona Topp d, Lana Hilling c, Pat G. Camp b, d, e, Pearce G. Wilcox a, Nasreen Khalil a, Harold R. Collard f, Chris Garvey gSummary |
Background |
Pulmonary rehabilitation improves outcomes in patients with interstitial lung disease (ILD), however it is unclear whether these effects are long lasting and which patients benefit most.
Methods |
Patients with ILD were recruited into this prospective cohort study from three pulmonary rehabilitation programs. Patients completed functional assessments (6-minute walk distance (6MWD), and 4-meter walk time) and surveys (quality of life, dyspnea, depression, and physical activity) before rehabilitation, after rehabilitation, and at six months. Changes from baseline were compared using a paired t-test. Independent predictors of change in 6MWD and quality of life were determined using multivariate analysis.
Results |
Fifty-four patients were recruited (22 with idiopathic pulmonary fibrosis), 50 patients (93%) completed the rehabilitation program, and 39 returned for six-month follow-up. 6MWD improved 57.6 m immediately after rehabilitation (95% confidence interval (CI) 40.2–75.1 m, p < 0.0005), and remained 49.8 m above baseline at six months (95%CI 15.0–84.6 m, p = 0.005). The majority of patients achieved the minimum clinically important difference for quality of life (51%), dyspnea (65%), and depression score (52%) immediately after rehabilitation, and improvements were still significant at 6-month follow-up for quality of life, depression, and physical activity. A low baseline 6MWD was the only independent predictor of improvement in 6MWD during rehabilitation (r = −0.49, p < 0.0005). Change in 6MWD was an independent predictor of change in quality of life (r = −0.36, p = 0.01).
Conclusions |
Pulmonary rehabilitation improved multiple short- and long-term outcomes in patients with ILD. While all patients appear to benefit, ILD patients with a low baseline 6MWD had greater benefit from rehabilitation.
Clinical trials registration number |
NCT01055730 (clinicaltrials.gov).
Le texte complet de cet article est disponible en PDF.Keywords : Pulmonary rehabilitation, Exercise, Interstitial lung disease
Plan
Vol 108 - N° 1
P. 203-210 - janvier 2014 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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