title: Combined pulmonary fibrosis and emphysema: effect of pulmonary rehabilitation in comparison with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  To evaluate the effectiveness of short-term comprehensive inpatient pulmonary rehabilitation for patients with combined pulmonary fibrosis and emphysema (CPFE), and to compare responses with those of patients with chronic obstructive pulmonary disease (COPD) who underwent an identical programme.
  
  
  METHODS
  Retrospective analysis of several outcome measures.
  
  
  METHODS
  Pulmonary ward at a 358-bed community teaching hospital.
  
  
  METHODS
  3-week inpatient pulmonary rehabilitation programme assessed by pulmonary function tests, 6 min walk test and health-related quality of life (HRQL) using the Short Form-36 (SF-36).
  
  
  RESULTS
  17 patients with CPFE and 49 patients with COPD were referred to and completed the programme between March 2007 and February 2015. Age, sex, smoking status, body mass index and the Medical Research Council dyspnoea grade were comparable between groups. In the CPFE group, improvement from the start of the programme to the programme end was observed in forced expiratory volume in 1 s (FEV1) (from 1.7±0.4 to 1.8±0.4, p=0.034); however, there was no significant improvement in the 6 min walk test (distance, SpO2 nadir and Borg scale on exercise). With regard to HRQL, improvement was observed in physical function (p=0.015) whereas deterioration was observed in social functioning (p=0.044). In the COPD group, significant improvement was observed after the programme in the FEV1, 6 min walk test and 4 of the 8 SF-36 subscales. There was a significant difference in changes in the 6 min walk distance: -16.6±58.4 in CPFE versus 30.2±55.6 in COPD (p=0.009). In 2 domains, there was a significant difference in SF-36 scores between groups: Δvitality, -6.3±22.4 in CPFE versus 11.3±21.1 in COPD, p=0.009; and Δsocial functioning, -18.8±34.2 in CPFE versus 5.3±35.9 in COPD, p=0.027.
  
  
  CONCLUSIONS
  Patients with COPD derived greater benefits than those with CPFE, from the relatively short periods of inpatient pulmonary rehabilitation.
authors.affiliation: Department of Respiratory Medicine , Kobe City Medical Center West Hospital , Kobe, Hyogo , Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tomioka
authors.affiliation: Department of Respiratory Medicine , Kobe City Medical Center West Hospital , Kobe, Hyogo , Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Mamesaya
authors.affiliation: Department of Respiratory Medicine , Kobe City Medical Center West Hospital , Kobe, Hyogo , Japan.
authors.forename: Shyuji
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: Department of Respiratory Medicine , Kobe City Medical Center West Hospital , Kobe, Hyogo , Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kida
authors.affiliation: Department of Respiratory Medicine , Kobe City Medical Center West Hospital , Kobe, Hyogo , Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kaneko
authors.affiliation: Department of Rehabilitation , Kobe City Medical Center West Hospital , Kobe, Hyogo , Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Sakai
keywords: Emphysema; Interstitial Fibrosis; Pulmonary Rehabilitation