Effect of pulmonary rehabilitation on exercise tolerance in patients with interstitial lung disease

Abstract

<bold>Background:</bold> Pulmonary rehabilitation (PR) is an evidence-based approach to benefit functional capacity, dyspnea, and quality of life in patients with chronic respiratory disease. <bold>Aim:</bold> Assess the effect of a PR program on sub-maximal exercise tolerance using the six-minute walk test (6MWT) in patients followed for ILD. <bold>Methods:</bold> Prospective study focusing on 9 patients treated for ILD,in the respiratory department of the Mongi Slim Hospital,conducted from February 1st to April 30th 2024.A functional respiratory assessment including spirometry and 6MWT was carried out at the starting of the study.A PR protocol was then proposed, starting with nutritional assessment.This protocol was carried out over 6 weeks with a final evaluation of respiratory function 8 weeks after the initial assessment according to ATS/ERS recommendations. <bold>Results:</bold> The mean age of the patients was 62 years(6 men and 3 women).Four patients had quit smoking, with a mean consumption of 19.05 pack-years.Patients followed for IPF were receiving (Nintedanib) and the others were on systemic corticosteroids and immunosuppressants. On spirometry, mean FEV1 increased from 2.05 liters to 2.17 liters after the protocol (p=0.263) and mean FVC increased from 2.37 liters to 2.52 liters (p=0.179).The mean distance walked at 6MWT increased significantly after the protocol (333m (50%) on day 1 vs. 448.1 m (64%) on day 60; p=0.001). Furthermore, all patients were able to complete the 6-minute test without stopping at Day 60 (at day 1, 3 patients had stopped walking after 3 minutes). <bold>Conclusion:</bold> PR is an important component of total care for patients with ILD,delivering clinically important improvements in exercise capacity and symptoms.