Respiratory Impairment, Limited Activity, and Pulmonary Rehabilitation in Patients with Interstitial Lung Disease

Objective: Diffuse Interstitial Lung Disease (DILD) is a pathology with a high mortality rate in Colombia as well as around the world. Linking patients to pulmonary rehabilitation programs is essential to improve their quality of life and aerobic capacity; thus, all patients perform the six-minute walk test (6-MWT). This study aimed to describe the changes in physiological and aerobic capacity-related variables in patients with DILD in the 6-MWT at admission to a pulmonary rehabilitation program and determine possible differences between patients with idiopathic pulmonary fibrosis (IPF) and other DILDs. Methods: This is a cross-sectional descriptive study on patients with DILD who performed the 6-MWT between January 2017 and February 2019. Sociodemographic, clinical, physiological, and exercise tolerance variables were taken into account at four different times of the 6-MWT: Rest time, the end, and the first and the fifth minute after the end of the test. The Human Ethics Committee endorsed the study, and all participants signed the informed consent form. Results: There were 64 patients with DILD. The average age was 60.84 years, 53.1% were female, 73.4% required home oxygen, and 53.1% had a diagnosis of IPF. There were no statistically significant differences in the heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), Borg scale, and fatigue in lower limbs at the four evaluated moments of the test for both groups of patients with DILD (p=0.000); moreover, the FEV1/FVC ratio for patients with other DILD was higher (p=0.000). The distance traveled for IPF was 339.26±124.84, while for other DILDs, it was 365.63±113.00 (p=0.382). Conclusions: Patients with other DILDs have better FEV1/FVC and travel longer distances with less dyspnea and fatigue than patients with IPF during the 6-MWT. Both groups' HR, RR, SpO2, Borg, and fatigue variables presented significant changes during the 6-MWT.

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Pulmonary rehabilitation

Oxford Handbook of Respiratory Nursing ◽

10.1093/med/9780198831815.003.0024 ◽

2021 ◽

pp. 515-522

Author(s):

Terry Robinson ◽

Jane Scullion

Keyword(s):

Lung Disease ◽

Social Isolation ◽

Pulmonary Rehabilitation ◽

Social Performance ◽

Depression And Anxiety ◽

Respiratory Impairment ◽

Follow Up Care ◽

Set Up ◽

Programme Of Care

Pulmonary rehabilitation (PR) is an important component in the management, care, and treatment of patients with chronic lung disease, particularly with COPD and increasingly in ILD. Breathlessness is a symptom of the underlying lung disease, and can result in reduced patient activity, which in turn reduces fitness, leads to social isolation, and can exacerbate depression and anxiety. PR is a multidisciplinary programme of care for patients with chronic respiratory impairment that is individually tailored and designed to optimize physical and social performance and autonomy. This chapter describes the rationale for PR, how to set up an effective rehabilitation regime through education and physical exercise, and how to provide follow-up care.

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Respiratory issues in rehabilitation

Oxford Handbook of Rehabilitation Medicine ◽

10.1093/med/9780198785477.003.0017 ◽

2019 ◽

pp. 233-250

Author(s):

Manoj Sivan ◽

Margaret Phillips ◽

Ian Baguley ◽

Melissa Nott

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Cystic Fibrosis ◽

Lung Disease ◽

Pulmonary Rehabilitation ◽

The Other ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Respiratory Impairment ◽

Neurological Conditions ◽

Respiratory Conditions

Respiratory aspects of rehabilitation fall into two broad and overlapping categories. One is that of pulmonary rehabilitation which traditionally has focused on exercise, behaviour change, and educational-based intervention for those with chronic lung disease, predominantly chronic obstructive pulmonary disease, but its efficacy has since been proven in other chronic respiratory conditions (e.g. asthma, interstitial lung disease, cystic fibrosis, bronchiectasis, lung transplantation, and pulmonary hypertension). The other is rehabilitation in the context of neurogenic respiratory impairment, which is relevant to persons with both degenerative and monophasic-onset neurological conditions. These categories are overlapping as techniques from one may have relevance to the other. This chapter describes these aspects, investigations, and interventions.

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