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Diffuse Lung Disease |

Short Term Outcomes of Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis

Nirmal Sharma; Surya Bhatt; Tracy Luckhardt; Joao de Aandrade
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University of Alabama at Birmingham, Birmingham, AL


Chest. 2014;146(4_MeetingAbstracts):371A. doi:10.1378/chest.1991557
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Abstract

SESSION TITLE: Interstitial Lung Disease Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Pulmonary rehabilitation (PR) improves exercise capacity, dyspnea, and quality of life (QOL) of COPD patients. PR is recommended to patients with idiopathic pulmonary fibrosis (IPF) but only few studies have explored its role in IPF. PR programs have not been developed specifically for IPF patients and it is unknown if IPF patients have outcomes comparable to their COPD counterparts. We hypothesize that IPF patients have PR compliance rates and short-term outcomes comparable to those with COPD.

METHODS: We analyzed a database of subjects with IPF and COPD who attended a PR program at the University of Alabama at Birmingham between 1996 and 2012. Patients with other types of restrictive lung diseases and those with both IPF and COPD were excluded. Baseline data included demographics, pulmonary function, 6 minute walk distance (6MWD), San Diego shortness of breath questionnaire (SOBQ), Short Form 36 Health Survey (SF-36) and Beck Depression Inventory (BDI) scores. Changes in baseline parameters before and after PR were compared between COPD and IPF using Fisher’s test, unpaired t-test, or Mann-Whitney test. Data are reported as means and standard deviation.

RESULTS: 54 IPF and 456 COPD patients were included. Mean age was 66.3 (10.7) for IPF and 66 (9.1) for COPD (p=0.56). There were no differences in gender and race. More IPF patients were “never smokers” (26% vs 4.9%, p <0.001). IPF patients had lower FVC and DLCO. Baseline 6MWD, MET, SOBQ, BDI, and SF-36 were similar in both groups. Completion rates were comparable: 54% in IPF vs 43% in COPD (p=0.30). Change in 6MWD for IPF was 47.2m (71) vs 52.2m (72) in COPD (p=0.36). Change in SOBQ was similar in both groups: -10.3 (17) and -10.3 (15) (p=0.49). BDI improved in both groups: -4 (6.1) in IPF vs -3.5 (6.9) in COPD (p=0.32). All mental and physical domains of SF-36 improved, but intergroup differences were not significant.

CONCLUSIONS: Rates of completion of the PR program were low for IPF and COPD. PR improved dyspnea, QOL, and exercise capacity in IPF. The magnitude of the improvement was comparable to that of COPD.

CLINICAL IMPLICATIONS: A PR program that contains all the components recommended by the 2006 ATS consensus statement seems to confer similar short-term benefit to patients with IPF and COPD. Studies are needed to further our understanding of the causes of the elevated dropouts and whether the benefits of PR in IPF are sustained over time.

DISCLOSURE: The following authors have nothing to disclose: Nirmal Sharma, Surya Bhatt, Tracy Luckhardt, Joao de Aandrade

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