Effectiveness of pulmonary rehabilitation in restrictive lung disease.
BACKGROUND
Pulmonary rehabilitation is effective in improving exercise endurance and quality of life in chronic obstructive pulmonary disease (COPD). However, the efficacy of pulmonary rehabilitation in restrictive lung disease has not been extensively studied.


METHODS
Forty-six patients with restrictive lung disease (35 interstitial lung diseases, 11 skeletal abnormalities) were admitted to a pulmonary rehabilitation program; 26 completed the 8-week program and 15 were followed to a 1-year reassessment. Fifteen noncompliant patients were excluded and 1 patient with interstitial lung disease died at 8 weeks. Pulmonary function tests, exercise endurance, quality of life (Chronic Respiratory Disease Questionnaire, St. George's Respiratory Questionnaire, Hospital Anxiety and Depression scale and dyspnea) were measured at baseline, 8 weeks, and 1 year.


RESULTS
Exercise endurance (treadmill) improved at 8 weeks (mean improvement, 10.2 +/- 7.4 minutes) and at 1 year (mean improvement, 8.7 +/- 12.2 minutes). Shuttle test improved at 8 weeks (mean improvement, 27.2 +/- 75.9 m) but not at 1 year. Patients using long-term oxygen therapy (LTOT) had a better improvement in the treadmill test (P < .01) at 8 weeks compared with those not using LTOT. Thirty-three percent of patients failed to complete the program. There was significant improvement in dyspnea and quality of life in Chronic Respiratory Disease Questionnaire, St. George's Respiratory Questionnaire, and Hospital Anxiety and Depression scale for depression at 8 weeks compared with baseline; there was a sustained significant reduction in hospital admission days noted at 1-year postrehabilitation (P < .05).


CONCLUSIONS
Pulmonary rehabilitation is effective in improving exercise endurance and the quality of life and in reducing hospital admissions in this small group of patients with significant restrictive lung disease. The relatively large dropout number suggests that a standard chronic obstructive pulmonary disease program may not be ideal for patients with restrictive lung disease.
Naji
Nizar A
NA
St. Michael's Hospital and St. Vincent's University Hospitals, Dublin 4, Ireland.
Connor
Marian C
MC
Donnelly
Seamas C
SC
McDonnell
Timothy J
TJ
D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D017563:Lung Diseases, Interstitial / Q000401:mortality / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D009139:Musculoskeletal Abnormalities / Q000401:mortality / Q000503:physiopathology / Q000534:rehabilitation*; D010102:Oxygen Inhalation Therapy; D011788:Quality of Life; D012046:Rehabilitation / Q000379:methods; D012129:Respiratory Function Tests; D011795:Surveys and Questionnaires; D016019:Survival Analysis