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Pulmonary Rehabilitation |

Effects of Pulmonary Rehabilitation on Quality of Life and Functional Status in Patients With Posttubercular Sequelae

Seema Kumari, MBBS; Balakrishnan Menon, MD; Vishal Bansal, MD
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Vallabhbhai Patel Chest Institute, New Delhi, India


Chest. 2013;144(4_MeetingAbstracts):835A. doi:10.1378/chest.1703664
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Abstract

SESSION TITLE: Physiology/PFTs/Rehabilitation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: To evaluate the effect of pulmonary rehabilitation on muscle mass, functional status and quality of life in patients with post-tubercular sequelae.

METHODS: Patients who had previously completed a course of ATT for diagnosed pulmonary TB and presenting with dyspnea (at rest/exertion) without evidence of active TB were enrolled into a thrice weekly, eight weeks comprehensive pulmonary rehabilitation program along with their usual medical therapy. Post- tubercular sequelae was diagnosed on clinical and radiological basis. Muscle mass, dyspnea, quality of life, blood lactate, pulmonary function, and six minute walk distance (6MWD) were measured prior to and subsequently to the rehabilitation program to assess the improvements.

RESULTS: 29 out of 31 patients (age 42 ±9 years, 57% females, BMI 22 ±5 kg/m2) completed the study. At baseline, muscle mass as assessed by Mid-thigh cross sectional area (MTCSACT) was 9081± 1327 mm2, which significantly increased to 9687± 1734mm2 (p=0.0009). Pre-rehabilitation quality of life as assessed by Chronic Respiratory Disease Questionnaire (CRDQ) was 16.97±3.08 points that significantly improved to 18.96±2.91 points post-rehabilitation (p<0.0001). Maximum improvement was observed in Mastery component of CRDQ (p<0.0001, 28% change). There was a significant improvement in 6MWD (from 463± 87m to 501±81m) at the end of rehabilitation program (p<0.0001). Significant improvement was observed in FEV1 (from 1.04±0.3 L to 1.06±0.3L) after 8 weeks (p= 0.003), however, no significant difference was observed in FEV1 % (from 41.0±14.23% to 41.76±13.75%, p=0.31) at the end of rehabilitation program. Blood lactate decreased significantly (from 0.6±0.2 mmol/L to 0.3±0.1 mmol/L) with pulmonary rehabilitation (p=0.0001).

CONCLUSIONS: Significant improvements in muscle mass, quality of life and functional status are observed after eight weeks of comprehensive pulmonary rehabilitation program.

CLINICAL IMPLICATIONS: Multi-disciplinary pulmonary rehabilitation should be included as an integral part of the long-term management in patients with post-tubercular sequelae.

DISCLOSURE: The following authors have nothing to disclose: Seema Kumari, Balakrishnan Menon, Vishal Bansal

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