The efficacy of a walk-bike on quality of life and exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). A pilot study

Author(s):  
Maarten Stessel ◽  
Monique Wapenaar ◽  
Jasmina Huremovic ◽  
Elisabeth Bendstrup ◽  
Maria Molina ◽  
...  
Breathe ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 130-138 ◽  
Author(s):  
Baruch Vainshelboim

Key pointsExercise training has been proven to be a safe and effective behavioural intervention for prevention and rehabilitation of chronic conditions.Despite the complexity of the signs and symptoms presented in IPF, supervised exercise training is a feasible and effective treatment for clinical improvement.Emerging data show significant enhancements in exercise capacity, dyspnoea and quality of life among IPF patients after exercise training interventions.Understanding of the principles of exercise training and the pathophysiology of IPF are essential for effective exercise programme delivery.Educational aimsTo describe the current evidence supporting exercise training for IPF.To highlight the importance of exercise physiology principles in rehabilitation treatment of patients with IPF.To introduce an effective practical exercise programme for IPF.To discuss the possible underlying physiological mechanisms of training effects in IPF.Exercise is a well-documented safe and effective intervention for prevention and rehabilitation of chronic diseases. Idiopathic pulmonary fibrosis (IPF) is a chronic deadly lung disease associated with severe signs and symptoms, exercise intolerance, diminished quality of life and poor prognosis. In the short term, supervised exercise training programmes have demonstrated clinical benefits in improving exercise capacity, dyspnoea and quality of life in patients with IPF. The underlying mechanisms of chronic adaption to a regular exercise regimen in IPF have yet to be well described and require further investigation. The available data underscore the importance of implementing training principles to target the pathophysiological impairments of IPF in order to optimise training adaption and enhance the outcomes. The current exercise training data in IPF provide sufficient evidence of clinical benefit for consideration to be given to recommending exercise-based pulmonary rehabilitation as standard of care for IPF.


2021 ◽  
Author(s):  
Shu-guang Yang ◽  
Xue-qing Yu ◽  
Jiansheng Li ◽  
Yang Xie ◽  
Wei Zhang ◽  
...  

Abstract Background Idiopathic pulmonary fibrosis is a critical disease with poor prognosis. Although different studies have been conducted for the treatment of idiopathic pulmonary fibrosis, limited treatments are available. Jin-shui Huan-xian granule, which is a Chinese medicine herbal compound, has shown a promising efficacy in reducing frequencies of acute exacerbations, improving exercise capacity the quality of life of patients for idiopathic pulmonary fibrosis. Subjects and Methods: This is a multicenter, randomized, double-blind, placebo-controlled clinical trial. A total of 312 idiopathic pulmonary fibrosis patients will be enrolled and randomly allocated to one of the two groups with 1:1. After a 2-week washout period, 52-week treatment will also be performed for all the patients. Patients in experimental group will be given Jin-shui Huan-xian granule with Jin-shui Huan-xian placebo for control group. Outcome measures including acute exacerbations, pulmonary function, dyspnea, exercise capacity, quality of life will be evaluated in this study. Discussion Based on our previous study, it is hypothesized that JHG will reduce the acute exacerbations, improve exercise capacity, pulmonary function, quality of life, delay the disease progression-free. High-level evidence-based support for TCM in IPF will also be obtained in this study. Trial registration: http:www.clinicaltrials.gov : NCT04187690. Register data: December 11, 2019.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Katherine Janssen ◽  
Drew Rosielle ◽  
Qi Wang ◽  
Hyun Joo Kim

Abstract Background Idiopathic pulmonary fibrosis (IPF) is a fatal disease that results in poor quality of life due to progressive respiratory symptoms, anxiety, and depression. Palliative care improves quality of life and survival in other progressive diseases. No randomized controlled trials have investigated the impact of palliative care on quality of life, anxiety, or depression in IPF. Methods We conducted a randomized, controlled, pilot study to assess the feasibility of measuring the effect of a palliative care clinic referral on quality of life, anxiety, and depression in IPF. Patients were randomized to usual care (UC) or usual care + palliative care (UC + PC) with routine pulmonary follow up at 3 and 6 months. The UC + PC group received a minimum of one PC clinic visit. Primary outcome was change from baseline in quality of life, anxiety, and depression as measured by the St. George’s Respiratory Questionnaire (SGRQ), the Hospital Anxiety and Depression Index (HADS), and the Patient Health Questionnaire (PHQ-9) at 6 months. Results Twenty-two patients were randomized between September 2017 through July 2018; 11 to UC and 11 to UC + PC. There was no difference in the change in SGRQ score at 3 months or 6 months, however, the symptom score trended towards a significant worsening for UC + PC at both 3 and 6 months (mean change at 3 months for UC and UC + PC was − 7.8 and + 10.7, respectively, p = 0.066; mean change at 6 months for UC and UC + PC was − 6.0 and + 4.6, respectively, p = 0.055). There was no difference in the change in HADS anxiety or depression scores. There was a significant transient worsening in PHQ-9 scores for UC + PC at 3 months (UC: -1.6, UC + PC: + 0.9, p = 0.008); this effect did not persist at 6 months. Conclusion This pilot study demonstrated that a randomized controlled trial of palliative care in idiopathic pulmonary fibrosis patients is feasible. Receiving palliative care did not lead to improved quality of life, anxiety, or depression compared to usual care after 6 months. Patients in the UC + PC group trended towards worsening symptoms and a small but statistically significant transient worsening in depression. These findings should be interpreted with caution, and need to be evaluated in adequately powered clinical trials. NCT03981406, June 10, 2019, retrospectively registered.


Author(s):  
Jose Cerdán-de-las-Heras ◽  
Fernanda Balbino ◽  
Anders Løkke ◽  
Daniel Catalán-Matamoros ◽  
Ole Hilberg ◽  
...  

We investigated the usefulness and effectiveness of tele-rehabilitation on exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). A randomized study was carried out, including stable patients with IPF for 3 months of tele-rehabilitation: video and chat consultations with a physiotherapist and workout sessions with a virtual physiotherapist agent (VAPA). Moreover, 6-minute walk test distance (6MWTD), forced vital capacity (FVC), diffusion capacity for carbon monoxide (DLCO), 7 days pedometry, Saint George Respiratory Questionnaire for interstitial lung disease, The King's Brief Interstitial Lung Disease Questionnaire, and General Anxiety Disorder 7 Questionnaire were tested before and after 3 months of tele-rehabilitation, as well as after 3 and 6 months follow-up. Patient satisfaction and adherence were also measured for tele-rehabilitation with VAPA. Twenty-nine patients aged 70.9 ± 8.6 years, male 72.4%, FVC% 83.5 ± 17.7, DLCO% 50.6 ± 13.0, 6MWTD 468.4 ± 14.8 were included. Fifteen patients were randomized to tele-rehabilitation with VAPA and 14 to the control group. Differences in 6MWTD between groups were at baseline (+10 m (p = 0.11)) and after 3 (+39.5m (p = 0.03)), 6 (+ 34.3m (p = 0.02)), and 9 months (+ 40.5m (p = 0.15)) follow-up. No difference was observed in pedometry and quality of life. Adherence was above 63%. Patient satisfaction was high. Tele-rehabilitation with VAPA appears to be useful in patients with IPF. Exercise capacity was better at follow up at 3 and 6 months compared with the control group. There was no change in quality of life or pedometry. Adherence and patient satisfaction were all high.


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