Effect of home-based pulmonary rehabilitation on ventilation dynamics and small airway dysfunction in people with post-tuberculosis lung disease.

BACKGROUND

As the world moves toward eliminating tuberculosis (TB), there is a large population of TB survivors who still face a significant burden of TB complications. However, basic pulmonary rehabilitation program (PRP) packages for this population are currently lacking. This study aimed to evaluate the effect of home-based PRP (HBPRP) on lung mechanics, exercise capacity, and quality of life (QoL) in people with PTLD (pwPTLD).

METHODS

This is a quasi-experimental study in pwPTLD who underwent HBPRP for 3 months. Before and after HBPRP, the following assessments were performed: QoL using the St George's Respiratory Questionnaire (SGRQ), general fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), handgrip strength (HGS), pulmonary function, and functional exercise capacity using the Glittre-ADL test (TGlittre) coupled with measurement of dynamic ventilation.

RESULTS

When comparing pre- and post-HBPRP values, there was a significant increase in TGlittre time [208 (194-249) vs. 184 (153-211) seconds,  = 0.004] and breathing reserve [56 (34-71) vs. 58 (39-73) %,  = 0.032], and a reduction in end-of-test inspiratory capacity [1.4 (0.9-2.3) vs. 1.6 (1.1-2.6) L,  = 0.030]. Although no increase in spirometric parameters was observed, there was an improvement in small airway dysfunction (SAD) as measured by respiratory oscillometry. Improvements were observed in the Activity and Impacts domains of the SGRQ. However, no significant changes were noted in FACIT-F or HGS after HBPRP.

CONCLUSIONS

In pwPTLD, HBPRP improves exercise tolerance, QoL, and SAD, with no effect on general fatigue and HGS. Therefore, TB programs should ensure the availability of PRP for pwPTLD, including HBPRP.