Effects of limb training in symptomatic patients with interstitial lung disease of different severity and etiology: A pilot study

Usefulness of comprehensive rehabilitation including exercise is still a matter of debate in patients with interstitial lung disease (ILD). We therefore investigated whether (and to what extent) an exercise program impacts on dyspnea and other usual measures, and if lung derangement predicts the effect of exercise on outcomes in these patients. Twenty patients (age 66±12 yr, 16 M) with ILD of different etiology (diffusive lung capacity-DLCO 45±22 % pr, IPF 65%) completed a course including arm and leg training. Measurements of chronic (MRC questionnaire, baseline dyspnea index and transitional dyspnea index, BDI/TDI) and acute (by Borg scale) dyspnea, 6-minute walking test (6MWD), and quality of life (St. George's Respiratory Questionnaire-SGRQ) were taken pre-post rehabilitation. Patients were grouped by the median value of both DLCO (>45 or <45% pr.) or tidal volume to inspiratory capacity-VT/IC ratio (>44 or <44% pr.), and by the different etiology (idiopathic or non-idiopathic) of the lung fibrosis. Training relieved acute dyspnea (p<0.05) and chronic breathlessness (MRC -0.5±0.5 score, BDI 5.2±3.0 to TDI 1.9±1.5 p), while improving 6MWD (by 29±42 m) and SGRQ total score (-10.2±11.9 p) in the whole group. However, outcome responses were similar in the identified subgroups. In this preliminary study we were able to confirm that rehabilitation including limb training is a feasible and effective therapy in patients with ILD, although lung derangement seems not to predict the outcome responses to rehabilitation. The results warrant further investigation on a larger population to assess the predictive role of lung derangement on outcomes.