Strookappe Bert, Elfferich Marjon, Swigris Jeff, Verschoof Ad, Veschakelen Johny, Knevel Ton, Drent Marjolein
Dept. of Physical Therapy Hospital Gelderse Vallei (ZGV) Ede; ild care expertise team, Dept. of Respiratory Medicine, ZGV, Ede.
Sarcoidosis Vasc Diffuse Lung Dis. 2015 Jun 22;32(1):43-52.
The natural history of disease in patients with stage IV (fibrotic) sarcoidosis may mirror that of patients with idiopathic pulmonary fibrosis (IPF). Both are bothered by progressive dyspnea, exercise limitation and fatigue.
To establish whether patients suffering from pulmonary fibrosis might benefit from a physical training program.
Twenty-four eligible patients referred to the out-patient clinic of the ild care expertise team of Hospital Gelderse Vallei, Ede, The Netherlands between November 2012 and November 2013 were included in this observational pilot study of a 12-week physical training program. Outcomes, including exercise capacity, skeletal muscle strength, lung function and fatigue were assessed at two time points: 1) baseline; and 2) after completion of a 12-week physical training program.
At baseline, the percentage predicted DLCO, FVC, FEV1 and exercise capacity (assessed by six-minute walking distance (6MWD) or maximal oxygen uptake) was reduced in both groups. After program completion, exercise capacity improved (>10% improvement 6MWD) in 13 subjects (54.2%): 7 with IPF and 6 with sarcoidosis subjects. Other secondary endpoints, including pulmonary function tests and patient-reported outcome measures improved in some subjects.
A 12-week physical training program improved or maintained exercise capacity in patients with IPF (despite disease progression) or fibrotic sarcoidosis. The results from this pilot study could be used to design prospective studies aimed at answering lingering questions about exercise training in patients with these progressive, incurable conditions.
IV期（纤维化）结节病患者的疾病自然史可能与特发性肺纤维化（IPF）患者相似。两者均受进行性呼吸困难、运动受限和疲劳困扰。
确定患有肺纤维化的患者是否能从体育训练计划中获益。
2012年11月至2013年11月间，24名符合条件的患者被转介至荷兰埃尔德市盖尔德斯山谷医院间质性肺病护理专家团队的门诊，纳入这项为期12周体育训练计划的观察性试点研究。在两个时间点评估包括运动能力、骨骼肌力量、肺功能和疲劳等结果：1）基线；2）12周体育训练计划完成后。
基线时，两组患者的预计DLCO、FVC、FEV1百分比和运动能力（通过六分钟步行距离（6MWD）或最大摄氧量评估）均降低。计划完成后，13名受试者（54.2%）的运动能力有所改善（6MWD改善>10%）：7名IPF患者和6名结节病患者。其他次要终点，包括肺功能测试和患者报告的结局指标在部分受试者中有所改善。
一项为期12周的体育训练计划改善或维持了IPF（尽管疾病进展）或纤维化结节病患者的运动能力。这项试点研究的结果可用于设计前瞻性研究，以回答有关这些进行性、无法治愈疾病患者运动训练的遗留问题。
