Pulmonary Rehabilitation in Patients With Post-Tuberculosis Lung Disease: A Prospective Multicentre Study

Abstract

Introduction: The majority of the studies on pulmonary rehabilitation (PR) in post-tuberculosis lung disease (PTLD) were from a single center, had a low sample size and/or did not allow a complete functional evaluation before and after PR program (PRP). The objective of this study was to evaluate if PTLD patients had benefits from PR in a large collaborating multicentre study conducted in reference centers in Brazil, Italy and France.

Methods: PTLD patients underwent a comprehensive 5-week PRP (Group 1), and were compared with non-rehabilitated patients (Group 2). Pulmonary function tests, 6-minute walk test (6MWT), and arterial blood gas analysis were measured two times: before and at the end of the PRP (Group 1), and at the beginning of the follow-up and after 3 months (Group 2).

Results: Eighty-five patients were included in Group 1 and 96 patients in Group 2. Several functional parameters improved after rehabilitation, such as forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), diffusing capacity of the lung for carbon monoxide (DLCO), distance walked in 6MWT, the initial and final SaO₂ at 6MWT. In Group 2, several functional parameters decreased after 3 months.

Conclusions: We demonstrated the benefits from PRP in patients with PTLD, including improvements in lung function and in exercise capacity. National TB programs should ensure the availability of accessible and quality post-treatment PRP for PTLD patients.

Keywords: Mycobacterium tuberculosis; Post-tuberculosis lung disease; Pulmonary rehabilitation; Tuberculosis.