Ferreira A, Garvey C, Connors GL, Hilling L, Rigler J, Farrell S, Cayou C, Shariat C, Collard HR Chest. Published online first October 10, 2008; doi:10.1378/chest.08-1458.
Background: Data examining the role of pulmonary rehabilitation in interstitial lung disease are limited. This study investigated the effects of pulmonary rehabilitation on functional status and dyspnea in a large group of patients with interstitial lung disease, and which baseline patient variables could predict improvement in outcomes.
Methods: Data from patients referred to pulmonary rehabilitation with a diagnosis of interstitial lung disease were included. Baseline and post-pulmonary rehabilitation variables were recorded and changes in 6 min walk distance and Borg score for dyspnea were evaluated. The impact of baseline variables on change in 6 min walk distance and dyspnea were analyzed.
Results: A statistically significant difference was seen in both the change in Borg score for dyspnea and 6 min walk distance after pulmonary rehabilitation (p < 0.0001). These changes were consistent with previously established clinically significant differences. Baseline 6 min walk distance was a significant predictor of change in 6 min walk distance (p < 0.0001), with increasing baseline 6 min walk distance predicting a smaller improvement after pulmonary rehabilitation.
Conclusions: There were significant improvements noted in both functional capacity and dyspnea reduction for patients with interstitial lung disease who underwent pulmonary rehabilitation.
Editor's Comment. The benefits of pulmonary rehabilitation for patients with COPD are well founded. There are less data for patients with other types of chronic lung disease (eg, interstitial pulmonary fibrosis) however. Although the underlying pathophysiology is different for IPF compared to COPD, significant debilitation exists for most patients with IPF. Improvements in exercise capacity, dyspnea reduction, and health-related quality of life were shown in these 2 studies for patients with IPF. Pulmonary rehabilitation is an effective means to treat patients with IPF and should be included as part of the overall management process. Further research into the mechanisms behind the improvement as well as the effects on healthcare utilization are the next research questions to be addressed and answered for this patient population.
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