Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota (Drs Duke, Moua, Maria Benzo, and Roberto Benzo and Ms Hoult); Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota (Dr Ridgeway); and Department of Statistics, Mayo Clinic, Rochester, Minnesota (Ms Roy).
J Cardiopulm Rehabil Prev. 2023 Jul 1;43(4):270-276. doi: 10.1097/HCR.0000000000000766. Epub 2023 Jan 12.
Pulmonary rehabilitation is a behavioral modification intervention shown to improve exercise tolerance and patient-reported quality of life in patients with fibrotic interstitial lung disease. Home-based rehabilitation may provide easier access for those who struggle to complete center-based rehabilitation programs due to increased symptom burden or frailty.
We present the quantitative and qualitative findings of a pilot study of 21 patients with fibrotic interstitial lung disease who participated in a 12-wk home-based pulmonary rehabilitation program with activity monitoring and health coaching.
Pre- and post-intervention patient-reported outcome questionnaires suggested improvements in dyspnea and respiratory-related quality of life but were underpowered to meet statistical significance. Half had increases in mean daily step counts while a quarter declined because of disease progression. Qualitative analysis of semistructured participant interviews suggested a significant baseline disease burden with related secondary impacts, including anxiety regarding disease progression and prognosis. Many who participated had no specific program expectations or self-determined goals but still found the program impactful, particularly on their abilities to adapt and cope with the disease.
Our study suggests feasibility in a diverse set of patients with varying severity and diagnostic subtypes. We also provide quantitative and qualitative aspects of program impact on patient well-being and highlight the complex interaction between measured physical and self-reported outcomes and disease experience.
肺康复是一种行为改变干预措施，已被证明可提高纤维化间质性肺疾病患者的运动耐量和患者报告的生活质量。基于家庭的康复可能为那些由于症状负担加重或虚弱而难以完成中心为基础的康复计划的患者提供更容易的途径。
我们介绍了一项针对 21 名纤维化间质性肺疾病患者的试点研究的定量和定性结果，这些患者参加了为期 12 周的基于家庭的肺康复计划，该计划包括活动监测和健康指导。
干预前后患者报告的结果调查问卷表明呼吸困难和呼吸相关生活质量有所改善，但由于研究样本量较小，未达到统计学意义。一半患者的平均每日步数增加，而四分之一患者因疾病进展而减少。半结构化参与者访谈的定性分析表明，基线疾病负担严重，存在相关的次要影响，包括对疾病进展和预后的焦虑。许多参与者没有特定的项目期望或自我确定的目标，但仍发现该项目具有影响力，特别是在他们适应和应对疾病的能力方面。
我们的研究表明，在不同严重程度和诊断亚型的患者中具有可行性。我们还提供了计划对患者健康的影响的定量和定性方面，并强调了测量的身体和自我报告的结果与疾病经历之间的复杂相互作用。
