Impact of pulmonary rehabilitation on quality of life and functional capacity in patients on waiting lists for lung transplantation

J Bras Pneumol. May-Jun 2013;39(3):349-56. doi: 10.1590/S1806-37132013000300012.
[Article in En, Portuguese]

Abstract
in En , Portuguese

Objective: To investigate the impact of a pulmonary rehabilitation program on the functional capacity and on the quality of life of patients on waiting lists for lung transplantation.

Methods: Patients on lung transplant waiting lists were referred to a pulmonary rehabilitation program consisting of 36 sessions. Before and after the program, participating patients were evaluated with the six-minute walk test and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). The pulmonary rehabilitation program involved muscle strengthening exercises, aerobic training, clinical evaluation, psychiatric evaluation, nutritional counseling, social assistance, and educational lectures.

Results: Of the 112 patients initially referred to the program, 58 completed it. The mean age of the participants was 46 ± 14 years, and females accounted for 52%. Of those 58 patients, 37 (47%) had pulmonary fibrosis, 13 (22%) had pulmonary emphysema, and 18 (31%) had other types of advanced lung disease. The six-minute walk distance was significantly greater after the program than before (439 ± 114 m vs. 367 ± 136 m, p = 0.001), the mean increase being 72 m. There were significant point increases in the scores on the following SF-36 domains: physical functioning, up 22 (p = 0.001), role-physical, up 10 (p = 0.045); vitality, up 10 (p < 0.001); social functioning, up 15 (p = 0.001); and mental health, up 8 (p = 0.001).

Conclusions: Pulmonary rehabilitation had a positive impact on exercise capacity and quality of life in patients on lung transplant waiting lists.

OBJETIVO:: Avaliar o impacto de um programa de reabilitação pulmonar na capacidade funcional e na qualidade de vida de pacientes em lista de espera para transplante pulmonar.

MÉTODOS:: Pacientes em lista de espera para transplante pulmonar encaminhados a um programa de reabilitação pulmonar de 36 sessões. Os participantes foram avaliados no início e no final desse com o teste de caminhada de seis minutos (TC6) e com o questionário de qualidade de vida Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). O programa de reabilitação pulmonar foi composto por exercícios de fortalecimento muscular, treinamento aeróbico, acompanhamento clínico e psiquiátrico, acompanhamento nutricional, assistência social e palestras educacionais.

RESULTADOS:: Dos 112 pacientes encaminhados, 58 completaram o programa. A média de idade dos participantes foi de 46 ± 14 anos; sendo 52% do sexo feminino. Entre esses pacientes, 37 (47%) eram portadores de fibrose pulmonar, 13 (22%) tinham enfisema pulmonar, e 18 (31%), tinham outras doenças pulmonares em fase avançada. Houve uma melhora significativa na distância percorrida no TC6 ao final do programa (367 ± 136 m vs. 439 ± 114 m; p = 0,001), com um aumento médio de 72 m. Houve aumentos significativos nas pontuações dos seguintes domínios do SF-36: capacidade funcional, 22 pontos (p = 0,001); aspectos físicos, 10 (p = 0,045); vitalidade, 10 (p < 0,001); aspectos sociais, 15 (p = 0,001); e saúde mental, 8 (p = 0,001).

CONCLUSÕES:: O programa de reabilitação pulmonar teve um impacto positivo na capacidade de exercício e na qualidade de vida nos pacientes em lista de espera para transplante pulmonar.

MeSH terms

  • Adult
  • Breathing Exercises
  • Exercise Therapy / methods
  • Exercise Tolerance
  • Female
  • Humans
  • Idiopathic Pulmonary Fibrosis / physiopathology
  • Idiopathic Pulmonary Fibrosis / rehabilitation
  • Lung Diseases / physiopathology
  • Lung Diseases / rehabilitation*
  • Lung Transplantation*
  • Male
  • Middle Aged
  • Prospective Studies
  • Pulmonary Emphysema / physiopathology
  • Pulmonary Emphysema / rehabilitation
  • Quality of Life*
  • Respiratory Function Tests
  • Statistics, Nonparametric
  • Waiting Lists*