PT  - JOURNAL ARTICLE
AU  - Maureen M. Peasey
AU  - Claire M. Nolan
AU  - Samantha S.C. Kon
AU  - Jane L. Canavan
AU  - Sarah E. Jones
AU  - Amy L. Clark
AU  - William D.-C. Man
TI  - Pulmonary rehabilitation in idiopathic pulmonary fibrosis: Predictors of adherence and exercise improvement
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P3566
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P3566.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P3566.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - BackgroundAlthough there is evidence to support short term benefits of pulmonary rehabilitation (PR) in idiopathic pulmonary fibrosis (IPF), there are concerns about adherence and heterogeneity in response, particularly in patients with more severe disease.AimTo determine whether baseline parameters (age, sex, BMI, MRC dyspnoea score (MRC), oxygen saturations on room air (SpO2), FVC %pred, incremental shuttle walk (ISW) and Hospital Anxiety and Depression scale (HAD)) predict PR completion and exercise response to PR in IPF.MethodWe analysed data from 82 consecutive IPF patients referred for outpatient PR. Completion was defined as attendance to ≥50% sessions. Exercise response was determined by change in incremental shuttle walk (ISW) pre and post PR. Correlations between baseline variables and completion or exercise improvement were determined by Spearman’s rank. Multiple logistic regression and multiple linear regression were used to identify baseline variables independently associated with completion and exercise improvement.Results40 IPF patients completed PR (49%). Completion was more likely with lower MRC, higher SpO2 and ISW (r=-0.28,0.27,0.35; all p<0.01), whilst exercise improvement correlated with lower age and higher SpO2 (r=-0.40,0.34; p=0.02,0.03). Baseline FVC% did not correlate with completion or exercise response. A multiple logistic regression model had a completion predictor success of 63% with a Nagelkerke’s R2 of 0.218. A multiple linear regression model comprising age and SpO2 explained only 11% of variance in ISW change.ConclusionIn IPF patients, simple baseline parameters of disease severity cannot predict completion of or exercise response to PR.