Effect of Pulmonary Rehabilitation (PR) Program in Patients with Interstitial Lung Disease (ILD)-Indian scenario

Abstract

Introduction: Interstitial Lung diseases (ILD) are group of disorders wherein due to varied etiologies, interstitium goes into progressive inflammation or fibrosis. Although, the awareness has improved but the therapy is still facing challenges. Pulmonary Rehabilitation (PR) is a worthy modality, which not only supports but also imparts evident benefits in these patients.

Material and methods: The study is a retrospective observational study conducted over a period of 2 years at Pulmonary Rehabilitation center, a private clinic setup on patients with different restrictive lung diseases like interstitial lung diseases, neuromuscular disorders and post-surgical patients. A total of 100 patients were enrolled, out of which 21 patients were lost to follow up. The study population included 34% males and 66 % females with a mean age of 56.3 ± 14.2 years. 24 patients required oxygen support (where SpO2< 90% at baseline). Outcome measures were assessed in these patients at the time of enrollment into the program (0 week) and at the end of the program (8 weeks). Effect of PR programme was then analyzed with appropriate statistical methods.

Results: Overall, statistically significant benefits were noted in 6 Minute walk distance (6MWD), muscle strength, dyspnea and Quality of life with 8 weeks. The mean 6 MWTD was 297.9 meters pre PR, which improved to 359.7 meters at the completion of 8 weeks post PR. Mean difference was 61.8 meters, which was found to be statistically significant (p value<0.001) Improvement in muscle strength of different upper and lower limb muscle groups were noted. Also, significant improvement in comprehensive score of Chronic Respiratory Diseases Questionnaire (CRDQ) scores was documented. Statistically significant improvement was found in the dyspnea, fatigue and emotional components. However, mastery components did not show statistically significant change.

Conclusion: PR has proven to be a very useful modality in the management of restrictive lung diseases, especially with the known limitations of pharmacological options to treat this disabling chronic lung diseases, even with those with evident type I respiratory failure at the beginning.