Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis: A Chance for a Multidisciplinary Treatment Approach

Abstract

Objectives: Idiopathic pulmonary fibrosis (IPF) is characterized by progressively worsening lung function, ventilation capacity, dyspnea, and finally reduced exercise intolerance. All of these have a significant negative impact on functional capacity and quality of life. In this study, we aim to evaluate the effects of pulmonary rehabilitation (PR) in IPF and assess the predictors of success. Methods: Data from 17 IPF patients who completed the program from the total of 27 patients who applied to PR were used in our study. We evaluated their pulmonary function tests, exercise capacity, peripheral-respiratory muscle strength, body composition, quality of life, and psychological states before and after PR. Results: Following the PR program, improvements over the minimal clinically important differences were observed in almost all parameters compared to the baseline; however, statistically significant improvements were only observed in the medical research council (P=0.020), the St. George respiratory questionnaire (P=0.002), the maximal inspiratory pressure (P=0.024), the anxiety score (P=0.001), the depression score (P=0.002), and the right quadriceps muscle strength (P=0.046). There was only a statistically significant negative correlation between the initial forced vital capacity and the forced expiratory volume in one-second value with the increase in patients’ maximal inspiratory pressure values after PR. Discussion: After a multidisciplinary, comprehensive PR program, dyspnea sensation, exercise capacity, endurance time, quality of life, respiratory and peripheral muscle strengths, and psychological status were improved regardless of age, gender, antifibrotic treatment, and comorbidities. Therefore, patients should be referred to PR units before the deterioration in the quality of life in the early stages of the disease.