Efficacy of aerobic physical retraining in a case of combined pulmonary fibrosis and emphysema syndrome: a case report.
BACKGROUND
Combined pulmonary fibrosis and emphysema has recently been recognized as a syndrome but remains under-diagnosed. Neither clinical management nor therapeutic approaches have been clearly defined. Pulmonary rehabilitation has not been considered within the therapeutic options for combined pulmonary fibrosis and emphysema. In this case we explored the potential benefits of a specific aerobic physical retraining program in the management of combined pulmonary fibrosis and emphysema.


METHODS
We describe the case of a 65-year-old Caucasian man with combined pulmonary fibrosis and emphysema and respiratory failure who was receiving long-term oxygen therapy. Our patient underwent physical retraining with moderate intensity aerobic and breathing exercises for four weeks. Clinical and motor tests, as well as questionnaires assessing quality of life and depression levels, were performed prior to and following the retraining. At the end of the retraining program a relevant reduction of long-term oxygen therapy requirement was registered; improvements in terms of physical performance, quality of life, and mood were observed in our patient but no change in respiratory parameters.


CONCLUSIONS
A program of aerobic physical retraining appears to be beneficial to patients with combined pulmonary fibrosis and emphysema and may be considered as an additional therapeutic option.
Institute of Rehabilitation "Villa Margherita Benevento", Unit of Cardiology and Pneumology, Benevento, Italy. sparcs@libero.it.
Giuseppe
G
De Simone
Department of Medicine and Health Sciences, "V Tiberio" University of Molise, Campobasso, Italy. giovanna.aquino@unimol.it.
Giovanna
G
Aquino
Institute of Rehabilitation "Villa Margherita Benevento", Unit of Cardiology and Pneumology, Benevento, Italy. claudio.digioia@casadicuravillamargherita.it.
Claudio
C
Di Gioia
Department of Cardio-Thoracic and Respiratory Sciences, Second University of Napoli, Napoli, Italy. gennaro.mazzarella@unina2.it.
Gennaro
G
Mazzarella
Department of Medicine and Health Sciences, "V Tiberio" University of Molise, Campobasso, Italy. andrea.bianco@unimol.it.
Andrea
A
Bianco
Department of Medicine and Health Sciences, "V Tiberio" University of Molise, Campobasso, Italy. giuseppe.calcagno@unimol.it.
Giuseppe
G
Calcagno
D000368:Aged; D001945:Breathing Exercises / Q000379:methods; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy; D006801:Humans; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000379:methods; D011656:Pulmonary Emphysema / Q000209:etiology / Q000534:rehabilitation*; D011658:Pulmonary Fibrosis / Q000209:etiology / Q000534:rehabilitation*; D013577:Syndrome; D014026:Nicotiana / Q000009:adverse effects