Vainshelboim Baruch, Oliveira Jose, Yehoshua Liora, Weiss Israela, Fox Benjamin Daniel, Fruchter Oren, Kramer Mordechai Reuven
Pulmonary Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
Respiration. 2014;88(5):378-88. doi: 10.1159/000367899. Epub 2014 Oct 23.
Idiopathic pulmonary fibrosis (IPF) is a chronic, devastating, interstitial lung disease, with few therapeutic options. IPF is characterized by pulmonary restriction, dyspnea, hypoxemia, exercise intolerance and poor quality of life (QOL).
We aimed to examine the effect of exercise training (ET) on clinical outcomes in IPF patients.
A randomized controlled study included thirty-two IPF patients (aged 68 ± 8 years) who were allocated either to the ET group (n = 15), participating in a 12-week, twice-weekly 60-min supervised ET-based pulmonary rehabilitation program, or to a control group (n = 17) continuing with regular medical treatment alone. Cardiopulmonary exercise test, 6-min walking distance (6MWD) test, 30-second chair-stand test, pulmonary function tests, dyspnea and QOL were assessed at baseline and at the end of the 12-week intervention.
Significant differences were observed between the ET and the control groups in raw mean deltas (Δ = post- - pre-intervention): Δ6MWD, 81 m, p < 0.001; ΔVO2 peak, 2.6 ml/kg/min, p = 0.002; Δwork rate, 22 W, p < 0.001; Δanaerobic threshold, 3.1 ml/kg/min, p < 0.001, and ΔFVC % predicted, 6%, p = 0.038. Dyspnea, QOL and 30-second chair-stand were also improved significantly following the program.
ET improves exercise tolerance, functional capacity, pulmonary function, dyspnea and QOL in patients with IPF, suggesting a short-term treatment efficacy for clinical improvement, and should be considered the standard care for IPF.
特发性肺纤维化（IPF）是一种慢性、严重的间质性肺病，治疗选择有限。IPF的特征为肺功能受限、呼吸困难、低氧血症、运动不耐受和生活质量（QOL）差。
我们旨在研究运动训练（ET）对IPF患者临床结局的影响。
一项随机对照研究纳入了32例IPF患者（年龄68±8岁），这些患者被分为ET组（n = 15），参加为期12周、每周两次、每次60分钟的基于ET的有监督的肺康复计划，或对照组（n = 17），仅继续接受常规药物治疗。在基线和12周干预结束时评估心肺运动试验、6分钟步行距离（6MWD）试验、30秒坐立试验、肺功能试验、呼吸困难和生活质量。
ET组和对照组在原始平均变化值（Δ=干预后-干预前）方面存在显著差异：Δ6MWD，81米，p<0.001；Δ最大摄氧量峰值，2.6毫升/千克/分钟，p = 0.002；Δ工作率，22瓦，p<0.001；Δ无氧阈值，3.1毫升/千克/分钟，p<0.001，以及Δ预测用力肺活量百分比，6%，p = 0.038。该计划实施后，呼吸困难、生活质量和30秒坐立试验也有显著改善。
ET可改善IPF患者的运动耐量、功能能力、肺功能、呼吸困难和生活质量，提示其对临床改善具有短期治疗效果，应被视为IPF的标准治疗方法。
