Differences in response to pulmonary rehabilitation in idiopathic pulmonary fibrosis and chronic obstructive...

The benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) are well recognized. However, whether individuals with idiopathic pulmonary fibrosis (IPF) benefit is less clear.

To evaluate the effects of pulmonary rehabilitation in subjects with IPF and compare their responses with a group of COPD subjects who underwent an identical program.

For- ty-five subjects with IPF and 45 age- and Medical Research Council grade-matched COPD subjects were recruited. Subjects completed an 8-week outpatient pulmonary rehabilitation program. Dyspnea, peripheral muscle force, exercise capacity (6-min walk distance, 6MWD), activities of daily living, and health status (36-item short-form survey, SF-36) were assessed at baseline, immediately following and at 6 months following completion of the program.

Adherence to the program was similar in both groups. Significant improvements in dyspnea, muscle force, exercise capacity and ADL were observed in both groups (all p < 0.05); however, the magnitude of improvement in all outcomes was less in the IPF group [mean (95% CI) improvement in 6MWD, IPF 16.2 (7.1-25.4); COPD 53.1 (44.9-61.2)]. All domains of SF-36, with the exception of social function, improved (all p < 0.05) in the COPD group; however, there were no changes in SF-36 scores in the IPF group. The benefits were well maintained in the COPD group at 6 months, but, with the exception of the ADL score, the benefits were no longer present in the IPF group.

Pulmonary rehabilitation in IPF produces only modest short-term gains in dyspnea, exercise capacity and ADL, but does not improve health status.