Pulmonary rehabilitation improves long-term outcomes in interstitial lung disease: a prospective cohort study

Respir Med. 2014 Jan;108(1):203-10. doi: 10.1016/j.rmed.2013.11.016. Epub 2013 Dec 4.


Background: Pulmonary rehabilitation improves outcomes in patients with interstitial lung disease (ILD), however it is unclear whether these effects are long lasting and which patients benefit most.

Methods: Patients with ILD were recruited into this prospective cohort study from three pulmonary rehabilitation programs. Patients completed functional assessments (6-minute walk distance (6MWD), and 4-meter walk time) and surveys (quality of life, dyspnea, depression, and physical activity) before rehabilitation, after rehabilitation, and at six months. Changes from baseline were compared using a paired t-test. Independent predictors of change in 6MWD and quality of life were determined using multivariate analysis.

Results: Fifty-four patients were recruited (22 with idiopathic pulmonary fibrosis), 50 patients (93%) completed the rehabilitation program, and 39 returned for six-month follow-up. 6MWD improved 57.6 m immediately after rehabilitation (95% confidence interval (CI) 40.2-75.1 m, p < 0.0005), and remained 49.8 m above baseline at six months (95%CI 15.0-84.6 m, p = 0.005). The majority of patients achieved the minimum clinically important difference for quality of life (51%), dyspnea (65%), and depression score (52%) immediately after rehabilitation, and improvements were still significant at 6-month follow-up for quality of life, depression, and physical activity. A low baseline 6MWD was the only independent predictor of improvement in 6MWD during rehabilitation (r = -0.49, p < 0.0005). Change in 6MWD was an independent predictor of change in quality of life (r = -0.36, p = 0.01).

Conclusions: Pulmonary rehabilitation improved multiple short- and long-term outcomes in patients with ILD. While all patients appear to benefit, ILD patients with a low baseline 6MWD had greater benefit from rehabilitation.

Clinical trials registration number: NCT01055730 (clinicaltrials.gov).

Keywords: Exercise; Interstitial lung disease; Pulmonary rehabilitation.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Canada
  • Cohort Studies
  • Depression / rehabilitation
  • Dyspnea / diagnosis
  • Dyspnea / etiology
  • Dyspnea / rehabilitation*
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Diseases, Interstitial / complications
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / rehabilitation*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Quality of Life
  • Sensitivity and Specificity
  • Surveys and Questionnaires
  • Time Factors
  • United States
  • Walking*

Associated data

  • ClinicalTrials.gov/NCT01055730