Short and long-term effects of pulmonary rehabilitation in interstitial lung diseases: a randomised controlled trial

Silvia Perez-Bogerd, Wim Wuyts, Veronica Barbier, Heleen Demeyer, Alain Van Muylem, Wim Janssens, Thierry Troosters, Silvia Perez-Bogerd, Wim Wuyts, Veronica Barbier, Heleen Demeyer, Alain Van Muylem, Wim Janssens, Thierry Troosters

Abstract

Background: Few data are available on the long-term effect of pulmonary rehabilitation (PR) and on long PR programs in interstitial lung diseases (ILD). We aimed to evaluate the effects of PR on exercise capacity (6-Minute Walking Distance, 6MWD; Peak Work Rate, Wmax), quality of life (St George's Respiratory Questionnaire, SGRQ), quadriceps force (QF) and objectively measured physical activity in ILD after the 6-month PR-program and after 1 year.

Methods: 60 patients (64 ± 11 years; 62% males; 23% with IPF) were randomly assigned to receive a 6 month-PR program or usual medical care.

Results: Exercise capacity, quality of life and muscle force increased significantly after the program as compared to control (mean,95%CI[ll to ul]; 6MWD + 72,[36 to 108] m; Wmax 19, [8 to 29]%pred; SGRQ - 12,[- 19 to - 6] points; QF 10, [1 to 18] %pred). The gain was sustained after 1 year (6MWD 73,[28 to 118] m; Wmax 23, [10 to 35]%pred; SGRQ - 11,[- 18 to - 4] points; QF 9.5, [1 to 18] %pred). Physical activity did not change.

Conclusions: PR improves exercise tolerance, health status and muscle force in ILD. The benefits are maintained at 1-year follow-up. The intervention did not change physical activity.

Trial registration: Clinicaltrials.gov NCT00882817 .

Conflict of interest statement

Ethics approval and consent to participate

The local ethics committee of the university hospital of Leuven approved the study on 22-01-2009 with the committee’s reference number B32220095560.

Consent for publication

Not applicable.

Competing interests

SPB, VB, HD and TT have nothing to disclose. WW reports grants from Roche and Boehringer Ingelheim, outside the submitted work. WJ reports grants from Chiesi, Astra Zeneca, Boehringer Ingelheim, GSK, Novartis, outside the submitted work.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Consort Flow Diagram
Fig. 2
Fig. 2
Effects of PR and at 1-year on exercise capacity, muscle force, health status, physical activity. 6-min walking distance (6MWD) (Panel a), quadriceps force (Panel b), St-Georges respiratory questionnaire (SGRQ) (Panel c) and steps per day (Steps) (Panel d) expressed as percentage (%) of the baseline value as a function of time. Closed circles (solid lines) and open circles (dashed lines) are the mean values and SEM at each time points of rehabilitation and control groups, respectively. Rehabilitation and control groups were compared for rehabilitation effects at each time points: *** p < 0.001; ** p < 0.01; * p ≤ 0.05; ns p > 0.05
Fig. 3
Fig. 3
Feasability of the training. Training intensity at the Start and the End of the 6 month PR program, expressed as mean (SD). Aerobic training: patients started the Cycling at 60% of the initial maximal workload on the cycle ergometer and the Walking at 75% of their maximal walking speed during the initial 6-min walking test. Based on subjective Borg scale scores, the intensity was progressively increased up to 85% of the maximal workload and up to 110% of the maximal walking speed (Dashed lines, Panel a). Resistance training: patients started the program on a multi-gym device in 3 series of 8 repetitions at 70% of the initial 1-Repetition Maximum (1RM) load for each muscle group (chest press, vertical traction, leg press) and this load was progressively incremented (Panel b)

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