Effect of Pulmonary Rehabilitation on Systemic Inflammation Muscle Mass and Functional Status in Interstitial Lung Diseases

BACKGROUND AND OBJECTIVE Cytokines play an important role in the pathogenesis of Interstitial lung diseases (ILDs) and several inflammatory mediators have been shown to be increased in ILDs. Pulmonary rehabilitation (PR) programme is a well-established and widely accepted therapeutic tool used in patients with chronic lung diseases like COPD. However, very little is known about the effect of PR over systemic inflammation, muscle mass and exercise capacity in patients of ILDs. MATERIAL AND METHODS Thirty eight patients of ILD were randomised to two groups after enrolment and 4 weeks of standard pharmacotherapy. Group 1 received standard pharmacotherapy and pulmonary rehabilitation for eight weeks while group 2 received standard therapy alone. High sensitivity C-reactive protein (Hs-CRP), mid thigh cross-sectional area CT scan (MTCSACT), pulmonary function test (PFT), six minute walk distance (6MWD), , arterial blood gases (ABG) and lactate levels were measured at the time of enrolment, at 4 weeks and at the end of 12 weeks. RESULTS 18 subjects were randomly allocated to group 1 and 20 subjects to group 2. MTCSACT showed statistically significant increase at the end of 12 weeks compared to baseline level and 4 weeks in group 1 (p1 = 0.0043, p2= 0.0089). Hs-CRP levels showed more reduction in group 1 although not statistically significant ( p1 = 0.1008, p2= 0.083).6mwd showed statistically more improvement in group 1 (p1 less than0.0001, p2less than 0.0001). Blood lactate, PFT and blood gases parameters showed no significant changes. CONCLUSION PR in addition to pharmacotherapy has an important role in improving muscle mass, exercise capacity and functional status and reducing systemic inflammation in the patients of ILDs and should be considered actively in theses group of patients. Short Title Effect of Pulmonary rehab in ILDs