Abstract
Background
Aim of this study was to investigate whether pulmonary rehabilitation (PR) is also effective in the management of patients awaiting lung transplantation (LTx) and whether there are any predictors of success.
Methods
In an observational clinical pre-post-trial we investigated the effects of an inpatient PR (mean: 34 ±15 days) in 811 LTx candidates. We compared baseline and follow up data of patients with COPD, Alpha-1-Antitrypsin deficiency (AATD), interstitial lung disease (ILD) or cystic fibrosis (CF) with regard to exercise capacity (6MWD) and health related quality of life (HRQL; SF36). Multivariate stepwise regression analysis was performed to detect predictors of PR outcome.
Results
811 data sets from consecutive patients who were referred to our rehabilitation center prior to LTx could be analyzed (COPD: 360; AATD: 127; ILD: 195; CF: 69; other: 60). Overall, 6MWD increased by 56±58m (p<0.001) at the end of PR. The physical summary component of SF36 improved by 1.9±8.5 points (0-100) (p<0.001), the mental summary component of SF36 by 8.7±13.5 points (p<0.001). Stepwise regression analysis yielded no relevant predictor of success or non-success of PR with regard to age, gender, disease, BMI, 6MWD and HRQL on admission.
Conclusions
We could show that specialized PR in patients with end-stage lung disease awaiting LTx may lead to significant and clinically relevant improvements in exercise capacity and HRQL regardless of the underlying disease or any of the above mentioned parameters. Further studies should evaluate the relevance of such PR effects on the clinical course of patients with end stage lung disease and their outcome after LTx.
- © 2014 ERS