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. 2020 May 21;9(5):1567.
doi: 10.3390/jcm9051567.

Short-Term Effects of Comprehensive Pulmonary Rehabilitation and its Maintenance in Patients with Idiopathic Pulmonary Fibrosis: A Randomized Controlled Trial

Inga Jarosch  1   2 , Tessa Schneeberger  1   2 , Rainer Gloeckl  1   2 , Michael Kreuter  3 , Marion Frankenberger  4 , Claus Neurohr  5 , Antje Prasse  6 , Julia Freise  6 , Juergen Behr  7 , Wolfgang Hitzl  8   9   10 , Andreas R Koczulla  1   2   11 , Klaus Kenn  1   2
Affiliations

Short-Term Effects of Comprehensive Pulmonary Rehabilitation and its Maintenance in Patients with Idiopathic Pulmonary Fibrosis: A Randomized Controlled Trial

Inga Jarosch et al. J Clin Med. .

Abstract

The recommendation for pulmonary rehabilitation (PR) in idiopathic pulmonary fibrosis (IPF) is weak with low-quality evidence. Therefore, the aim of this study is to investigate short-term PR effects and their maintenance after a 3-month follow-up. Fifty-four IPF patients were randomized into a group receiving a 3-week comprehensive, inpatient PR (n = 34, FVC: 74 ± 19% pred.) or usual care (UC) (n = 17, FVC: 72 ± 20%pred.). Outcomes were measured at baseline (T1), after intervention (T2), and 3 months after T2 (T3). A 6-min walk distance (6MWD) was used as the primary outcome and chronic respiratory disease questionnaire (CRQ) scores as the secondary outcome. Change in 6MWD from T1 to T2 (Δ = 61 m, 95% CI (18.5-102.4), p = 0.006) but not from T1 to T3 (∆ = 26 m, 95% CI (8.0-61.5), p = 0.16) differed significantly between groups. Higher baseline FVC and higher anxiety symptoms were significant predictors of better short-term 6MWD improvements. For the change in CRQ total score, a significant between-group difference from T1 to T2 (∆ = 3.0 pts, 95% CI (0.7-5.3), p = 0.01) and from T1 to T3 (∆ = 3.5 pts, 95% CI (1.5-5.4), p = 0.001) was found in favour of the PR group. To conclude, in addition to the short-term benefits, inpatient PR is effective at inducing medium-term quality of life improvements in IPF. PR in the early stages of the disease seems to provoke the best benefits.

Keywords: exercise; idiopathic pulmonary fibrosis; pulmonary rehabilitation; quality of life.

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Conflict of interest statement

I.J., R.G., T.S., M.K., M.F., A.P., J.F., W.H., A.K., and K.K. declare no conflict of interest. C.N. and J.B. report personal fees from Boehringer Ingelheim and Roche, outside the submitted work.

Figures

Figure 1
Figure 1
Flow diagram.
Figure 2
Figure 2
Effects of pulmonary rehabilitation (closed circles) vs. usual care (open circles) on (A) 6-min walk distance (6MWD), (B) total score in chronic respiratory disease questionnaire (CRQ), (C) Hospital Anxiety and Depression Scale (HADS) anxiety score and (D) HADS depression score. The grey bar in A and B illustrates the PR or control period of 3 weeks. Patients with HADS scores of 8–10 pts. are assumed to be borderline abnormal (dashed). Data are presented as mean (SE). * p < 0.05, ** p < 0.01.
See this image and copyright information in PMC

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