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Open AccessArticle

Short-Term Effects of Comprehensive Pulmonary Rehabilitation and its Maintenance in Patients with Idiopathic Pulmonary Fibrosis: A Randomized Controlled Trial

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Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Malterhoeh 1, 83471 Schoenau am Koenigssee, Germany
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Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), 35043 Marburg, Germany
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Center for Interstitial and Rare Lung Diseases, Pneumology, Thoraxklinik University of Heidelberg, Germany and German Center for Lung Research, Röntgenstr. 1, 69126 Heidelberg, Germany
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Comprehensive Pneumology Center (CPC), Ludwig-Maximilians University, Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), 81377 Munich, Germany
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Pneumology and Thoracic Oncology, Robert-Bosch Krankenhaus, Klinik Schillerhoehe, 70839 Gerlingen, Germany
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Department of Respiratory Medicine, Hannover Medical School and Biomedical Research in End-Stage and Obstructive Lung Disease Hannover, German Lung Research Center (DZL), 30625 Hannover, Germany
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Department of Internal Medicine V and Asklepios Fachkliniken München-Gauting, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research, University of Munich, LMU, 82131 Munich, Germany
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Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, 5020 Salzburg, Austria
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Research Office (Biostatistics), Paracelsus Medical University (PMU), 5020 Salzburg, Austria
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Department of Ophthalmology and Optometry, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
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Teaching Department of the Paracelsus University Salzburg (PMU), 5020 Salzburg, Austria
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(5), 1567; https://doi.org/10.3390/jcm9051567
Received: 2 April 2020 / Revised: 12 May 2020 / Accepted: 20 May 2020 / Published: 21 May 2020
(This article belongs to the Special Issue The New Perspective in Pulmonary Fibrosis)
The recommendation for pulmonary rehabilitation (PR) in idiopathic pulmonary fibrosis (IPF) is weak with low-quality evidence. Therefore, the aim of this study is to investigate short-term PR effects and their maintenance after a 3-month follow-up. Fifty-four IPF patients were randomized into a group receiving a 3-week comprehensive, inpatient PR (n = 34, FVC: 74 ± 19% pred.) or usual care (UC) (n = 17, FVC: 72 ± 20%pred.). Outcomes were measured at baseline (T1), after intervention (T2), and 3 months after T2 (T3). A 6-min walk distance (6MWD) was used as the primary outcome and chronic respiratory disease questionnaire (CRQ) scores as the secondary outcome. Change in 6MWD from T1 to T2 (Δ = 61 m, 95% CI (18.5–102.4), p = 0.006) but not from T1 to T3 (∆ = 26 m, 95% CI (8.0–61.5), p = 0.16) differed significantly between groups. Higher baseline FVC and higher anxiety symptoms were significant predictors of better short-term 6MWD improvements. For the change in CRQ total score, a significant between-group difference from T1 to T2 (∆ = 3.0 pts, 95% CI (0.7–5.3), p = 0.01) and from T1 to T3 (∆ = 3.5 pts, 95% CI (1.5–5.4), p = 0.001) was found in favour of the PR group. To conclude, in addition to the short-term benefits, inpatient PR is effective at inducing medium-term quality of life improvements in IPF. PR in the early stages of the disease seems to provoke the best benefits. View Full-Text
Keywords: pulmonary rehabilitation; idiopathic pulmonary fibrosis; exercise; quality of life pulmonary rehabilitation; idiopathic pulmonary fibrosis; exercise; quality of life
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Jarosch, I.; Schneeberger, T.; Gloeckl, R.; Kreuter, M.; Frankenberger, M.; Neurohr, C.; Prasse, A.; Freise, J.; Behr, J.; Hitzl, W.; Koczulla, A.R.; Kenn, K. Short-Term Effects of Comprehensive Pulmonary Rehabilitation and its Maintenance in Patients with Idiopathic Pulmonary Fibrosis: A Randomized Controlled Trial. J. Clin. Med. 2020, 9, 1567.

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