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Pulmonary rehabilitation
P45 Outcomes following pulmonary rehabilitation for patients with restrictive lung diseases with or without oxygen therapy
  1. V L Warrington,
  2. J Scullion,
  3. L Sewell,
  4. J Williams,
  5. S Singh.
  1. University Hospitals of Leicester NHS Trust, Leicester, UK

Abstract

Introduction To review the outcome of pulmonary rehabilitation (PR) for patients with restrictive lung diseases who do or not have oxygen therapy.

Methods 10 years of PR data were searched for patients with Interstitial Lung Disease (ILD), Pulmonary Fibrosis (PF) or Cryptogenic Fibrosing Alveolitis (CFA) who had completed PR. PR classes were twice weekly for 7 weeks which consisted of training based on a walking programme, static bike and strength exercises. Exercise capacity measured by Incremental Shuttle Walk Test (ISWT) and Endurance Shuttle Walk Test (ESWT), health status measured by Hospital Anxiety and Depression Scale (HADS) and Chronic Respiratory Questionnaire – self-reported (CRQ) results were analysed.

Results 25/81 patients who had completed PR were oxygen users: 16 male, mean(SD) age 69.8 (7.7) years; FEV1 1.95(0.63) l; FVC 2.52 (0.8) l; FEV1/FVC 81.83 (8.43)%; BMI 28.6 (5.97). 10 had ambulatory, 5 had long term and 10 used short-burst oxygen therapy with a median flow rate of 4 l/min. Patients without oxygen were 72.3 (9.5) years with a FEV1 1.84(0.61) l; FVC 2.41 (0.68) l; FEV1/FVC 78.58 (7.3)%; BMI 27.65(5.05); 33 male. Independent T-Tests revealed the only significant baseline difference between the groups was resting oxygen saturation (SaO2) with oxygen users having a mean SaO2 of 90.5% compared to non-oxygen users′ SaO2 being 94.8% (p=0.001). Paired T-Tests were performed between baseline and discharge scores for both groups (Abstract P45 Table 1). Those not using oxygen improved their mean change in ISWT (p=0.026) and ESWT (p=0.039) scores between baseline and discharge significantly more than those using oxygen. Oxygen users had significantly (p<0.001) lower SaO2 levels after performing ISWT (78% compared to 89%) and ESWT (78% compared to 87%) than those not using oxygen.

Abstract P45 Table 1

Baseline and mean change in PR outcome measures for patients using or not using oxygen

Conclusion PR produces positive outcomes for patients with ILD, CFA or PF. Improvements in exercise capacity and health status for non-oxygen users were statistically and clinically significant, more so than for oxygen users. Those using oxygen de-saturated more than those not using oxygen after performing the SWTs. As both groups of patients benefited, PR should be offered to all patients with restrictive lung diseases irrespective of oxygen use, although the typical PR programme may need some adjustment for oxygen users to gain more benefit.

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