ABSTRACT
INTRODUCTION: In addition to dyspnoea and cough in interstitial lung diseases (ILD), the main symptom is decreased effort capacity. Pulmonary rehabilitation (PR)is recommended besides medical treatment approaches in chronic respiratory diseases. PR programs include approaches such as exercise training, patient and family training, nutritional assessment and support, psychosocial assessment and support. COPD patients more often directed to PR programs, besides that PR is also recommended for ILD. In this study, we aimed to evaluate the PR-related gains in patinets with IPF and non-IPF ILD. METHODS: This retrospective study that we evaluated the PR data, demographic features of the patients with ILD who completed PR program between 2017 and 2020. PR was an 8-week (2days) outpatient PR program including aerobic and strengthening exercises. The 6-minute walking test (6MWT) results, quality of life scores that were recorded at the beginning and end of the PR program were evaluated.The patients were evaluated in two groups, patinets with IPF and non-IPF ILD. RESULTS: A total of 56 patients (30 IPF, 26 non-IPF) with mean age 62±10 were included in the study. Among IPF patients 23 (77%) of them were receiving antifibrotic drugs. Non -IPF patients were: Unclassified ILD 9(16%), nonspecific interstitial pneumonia (NSIP) 8 (14%), sarcoidosis 3(%5), fibrotic hypersensitivity pneumonitis (fHP) 3 (5%), sjogren 2 (4%), scleroderma 1(2%). Both in IPF and non-IPF groups improvement in 6MWT, SGRQ total score after PR were statistically significantly improved (p= 0.001, p=0.002), (p= 0.001, p=0.018). Inspiratory muscle evaluation, MIP statistically increased after PR both in IPF and non-IPF patients (p= 0.015, p=0.028). There no significant differences in gains after PR program in walking capacity, quality of life, maximum inspiratory pressure between IPF and non-IPF patients. CONCLUSION: PR programs provide significant gains both in patints with IPF and non-IPF ILD. It is important that patients should be directed to PR programs in the early stages of ILD.
ABSTRACT
OBJECTIVES: Chronic respiratory diseases exert a global health burden with high health care costs, morbidity, and mortality. The aim of the present study was to investigate the effect of pulmonary rehabilitation (PR) on emergency admission and hospitalization rates of patients with chronic respiratory disease. MATERIALS AND METHODS: In this retrospective cohort study, hospitalization rates and emergency admissions of patients before (December 2014-December 2015) and after PR (January 2015-December 2016) were investigated. Patients with chronic respiratory diseases were included. Chronic obstructive pulmonary disease (COPD) patients were classified based on the Global Initiative Chronic Obstructive Pulmonary Disease assessment scheme. PR was applied by three physiotherapists over 8 weeks (2 days/week). Data on patient demographics, clinical and anthropometric data, spirometry, exercise capacity, and quality of life before and after PR were acquired. RESULTS: This study evaluated 51 patients, of whom 76% were men. A total of 37 (73%) COPD patients and 14 (27%) non-COPD patients (7 bronchiectasis, 4 interstitial lung disease, and 3 kyphoscoliosis) were included. The patients exhibited significantly improved incremental shuttle walk test (ISWT) and endurance test scores (p<0.05) after PR. Similar to exercise capacity, the patients exhibited significantly improved Modified Medical Research Council (mMRC) score, St. George's Respiratory Questionnaire (SGRQ), anxiety and depression scores (p<0.05) after PR. In COPD patients, differences in pre- and post-PR ISWT, COPD assessment test, mMRC, and SGRQ scores were statistically significant (p=0.001). The number of emergency admissions and hospitalizations significantly decreased after PR (p=0.001; p=0.001). The post-PR FEV1% of COPD significantly increased (p=0.029). CONCLUSION: Pulmonary rehabilitation leads to an increase in exercise capacity as well as improved quality of life, resulting in a decrease in emergency admissions and hospitalization rates. Considering the cost of hospitalization, it is important to add PR to the management of patients with chronic respiratory diseases, in addition to medical therapy.