Effects of pulmonary rehabilitation in patients with restrictive lung diseases

Abstract

Background: Pulmonary rehabilitation programs improve exercise tolerance, muscle strength, and dyspnea in patients with COPD. The aim of the study was to assess prospectively the effectiveness and feasibility of pulmonary rehabilitation in patients with restrictive lung diseases.

Methods: In a prospective, nonrandomized, noncontrolled study, patients with an established diagnosis of restrictive lung disease (RLD) participated in a 24-week outpatient multidisciplinary rehabilitation program. Pulmonary function, exercise capacity, muscle force, and dyspnea were measured at inclusion, after 12 and 24 weeks of rehabilitation. Primary outcome was the change in 6-min walk distance (6MWD) after 12 weeks of rehabilitation.

Results: Twenty-nine patients out of 31 patients (57 +/- 17 years of age; 21 men; FEV(1): 1.4 +/- 0.7 L) completed the 12-week rehabilitation program and 26 patients the 24-week rehabilitation program. At inclusion, exercise tolerance (maximal oxygen consumption [V(O(2))max]: 63% +/- 27% predicted; 6MWD: 390 +/- 140 m) and quadriceps force ([QF] 61% +/- 21% predicted) were reduced, and dyspnea, assessed using the Chronic Respiratory Disease Questionnaire (CRDQ), was increased (CRDQ item dyspnea [CRDQd]: 16 +/- 6 points). Exercise capacity, muscle force, and CRDQd improved significantly after 12 weeks (6MWD: 445 +/- 142 m; V(O(2))max: 69% +/- 30% predicted; QF: 73% +/- 25% predicted; CRDQd: 20 +/- 6 points) (P < .05). Further improvements were noted after 24 weeks (6MWD: 463 +/- 146 m; CRDQd: 22 +/- 6 points).

Conclusions: Patients with RLD respond well after 12 weeks of pulmonary rehabilitation, and even better results were seen after 24 weeks. Clinically significant improvements were obtained in the majority of the patients after 24 weeks.