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

TitlePulmonary rehabilitation improves long-term outcomes in interstitial lung disease: a prospective cohort study.
Publication TypeJournal Article
Year of Publication2014
AuthorsRyerson, CJ, Cayou, C, Topp, F, Hilling, L, Camp, PG, Wilcox, PG, Khalil, N, Collard, HR, Garvey, C
JournalRespir Med
Volume108
Issue1
Pagination203-10
Date Published2014 Jan
ISSN1532-3064
KeywordsAged, Canada, Cohort Studies, Depression, Dyspnea, Female, Follow-Up Studies, Humans, Lung Diseases, Interstitial, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Quality of Life, Questionnaires, Sensitivity and Specificity, Time Factors, United States, Walking
Abstract

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).

DOI10.1016/j.rmed.2013.11.016
Alternate JournalRespir Med
PubMed ID24332409