Arizono Shinichi, Taniguchi Hiroyuki, Sakamoto Koji, Kondoh Yasuhiro, Kimura Tomoki, Kataoka Kensuke, Ogawa Tomoya, Watanabe Fumiko, Tabira Kazuyuki, Kozu Ryo
Department of Rehabilitation, Tosei General Hospital, Seto, Aichi, Japan.
School of Rehabilitation Sciences, Seirei Christopher University, Hamamatsu, Shizuoka, Japan.
Sarcoidosis Vasc Diffuse Lung Dis. 2017;34(4):283-289. doi: 10.36141/svdld.v34i4.5549. Epub 2017 Apr 28.
While the efficacy of pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) has been well established, emerging evidence also suggests its benefit in idiopathic pulmonary fibrosis (IPF). However, the differences and similarities between how PR affects diseases with different physiologies remain unknown. This study aimed to compare the efficacy of PR in COPD and IPF patients by performing multifactorial evaluation with various exercise capacity measurements, and dyspnea and health-related quality of life (QoL) assessment. Twenty-two IPF patients (%vital capacity: 72%) and 27 COPD patients (%forced expiratory volume: 43%) were recruited. Subjects who completed a 10-week outpatient PR program were analyzed. We assessed five exercise capacity indicators (6-minute walking distance, incremental shuttle walking distance, endurance time, peak work rate, and peak values for oxygen uptake [peak VO]), dyspnea (Baseline Dyspnea Index: BDI), and health-related QoL (St. George's Respiratory Questionnaire: SGRQ) at baseline and immediately following completion of the PR program. After 10 weeks of PR, all exercise capacity measurements, except VO, as well as BDI and SGRQ score improved significantly (p<0.05) in both disease groups. The magnitude of the observed changes in each outcome, assessed by the effect size, was comparable between IPF and COPD patients. This was also true for endurance time, the measurement most responsive to PR, with a large effect size. PR can result in comparable improvements in exercise capacity, including endurance time, and dyspnea and HRQoL in both IPF and COPD patients after 10 weeks of exercise training. .
虽然肺康复（PR）对慢性阻塞性肺疾病（COPD）的疗效已得到充分证实，但新出现的证据也表明其对特发性肺纤维化（IPF）有益。然而，PR对不同生理疾病的影响之间的异同仍不清楚。本研究旨在通过进行多因素评估，包括各种运动能力测量、呼吸困难评估以及与健康相关的生活质量（QoL）评估，来比较PR对COPD和IPF患者的疗效。招募了22名IPF患者（肺活量百分比：72%）和27名COPD患者（用力呼气量百分比：43%）。对完成10周门诊PR项目的受试者进行分析。我们在基线时以及PR项目完成后立即评估了五项运动能力指标（6分钟步行距离、递增往返步行距离、耐力时间、峰值工作率和摄氧量峰值[VO峰值]）、呼吸困难（基线呼吸困难指数：BDI）以及与健康相关的QoL（圣乔治呼吸问卷：SGRQ）。经过10周的PR后，两个疾病组中除VO外的所有运动能力测量指标以及BDI和SGRQ评分均有显著改善（p<0.05）。通过效应量评估的每个结局观察到的变化幅度在IPF和COPD患者之间具有可比性。耐力时间也是如此，它是对PR反应最敏感的测量指标，效应量较大。经过10周的运动训练后，PR可使IPF和COPD患者在运动能力（包括耐力时间）、呼吸困难和健康相关生活质量方面得到相当程度的改善。
