title: Pulmonary rehabilitation in lymphangioleiomyomatosis: a controlled clinical trial.
abstract: Lymphangioleiomyomatosis (LAM) is a cystic lung disease frequently associated with reduced exercise capacity. The aim of this study was to assess safety and efficacy of pulmonary rehabilitation in LAM.This controlled clinical trial included 40 patients with LAM and a low physical activity level. The pulmonary rehabilitation programme comprised 24 aerobic and muscle strength training sessions and education. The primary outcome was exercise capacity (endurance time during a constant work rate exercise test). Secondary outcomes included health-related quality of life (St George's Respiratory Questionnaire (SGRQ)), 6-min walking distance (6MWD), dyspnoea, peak oxygen consumption (V'O2 ), daily physical activity (pedometer), symptoms of anxiety and depression, lung function and peripheral muscle strength (one-repetition maximum).The baseline characteristics were well balanced between the groups. The pulmonary rehabilitation group exhibited improvements in the following outcomes versus controls: endurance time (median (interquartile range) 169 (2-303) s versus -33 (-129-39) s; p=0.001), SGRQ (median (interquartile range) -8 (-16-2) versus 2 (-4-5); p=0.002) and 6MWD (median (interquartile range) 59 (13-81) m versus 20 (-12-30) m; p=0.002). Dyspnoea, peak V'O2 , daily physical activity and muscle strength also improved significantly. No serious adverse events were observed.Pulmonary rehabilitation is a safe intervention and improves exercise capacity, dyspnoea, daily physical activity, quality of life and muscle strength in LAM.
authors.affiliation: Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Mariana S
authors.initials: MS
authors.lastname: Araujo
authors.affiliation: Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Bruno G
authors.initials: BG
authors.lastname: Baldi
authors.affiliation: Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Carolina S G
authors.initials: CS
authors.lastname: Freitas
authors.affiliation: Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: André L P
authors.initials: AL
authors.lastname: Albuquerque
authors.affiliation: Physical Therapy, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Cibele C B
authors.initials: CC
authors.lastname: Marques da Silva
authors.affiliation: Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Ronaldo A
authors.initials: RA
authors.lastname: Kairalla
authors.affiliation: Physical Therapy, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Celso R F
authors.initials: CR
authors.lastname: Carvalho
authors.affiliation: Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil crrcarvalho@uol.com.br.
authors.forename: Carlos R R
authors.initials: CR
authors.lastname: Carvalho
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis; D001938:Brazil; D003863:Depression / Q000150:complications / Q000175:diagnosis; D004417:Dyspnea / Q000150:complications / Q000175:diagnosis; D015444:Exercise; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D018192:Lymphangioleiomyomatosis / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D010101:Oxygen Consumption; D061214:Patient Safety; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking