Effect of pulmonary rehabilitation in patients with post-tuberculosis sequelae with functional limitation

Aqeel Hussain; Alkesh Kumar Khurana; Abhishek Goyal; S Y Kothari; Raj Krishnan Soman; Sai Tej; Abhijit Pakhare

doi:10.1016/j.ijtb.2023.04.012

Effect of pulmonary rehabilitation in patients with post-tuberculosis sequelae with functional limitation

Indian J Tuberc. 2024 Apr;71(2):123-129. doi: 10.1016/j.ijtb.2023.04.012. Epub 2023 Apr 11.

Authors

Aqeel Hussain¹, Alkesh Kumar Khurana², Abhishek Goyal³, S Y Kothari⁴, Raj Krishnan Soman⁵, Sai Tej⁶, Abhijit Pakhare⁷

Affiliations

¹ Pulmonary, Critical Care & Sleep Medicine, AIIMS Bhopal, India. Electronic address: aqeelturabi09@gmail.com.
² Pulmonary, Critical Care & Sleep Medicine, AIIMS Bhopal, India. Electronic address: alkesh.pulmed@aiimsbhopal.edu.in.
³ Pulmonary, Critical Care & Sleep Medicine, AIIMS Bhopal, India. Electronic address: abhishek.pulmed@aiimsbhopal.edu.ins.
⁴ Physical Medicine & Rehabilitation, AIIMS Bhopal, India. Electronic address: shashank.pmr@aiimsbhopal.edu.in.
⁵ Pulmonary, Critical Care & Sleep Medicine, AIIMS Bhopal, India. Electronic address: rksut1688@gmail.com.
⁶ Pulmonary, Critical Care & Sleep Medicine, AIIMS Bhopal, India. Electronic address: psaitej@gmail.com.
⁷ Community and Family Medicine, AIIMS Bhopal, India. Electronic address: Abhijit.cfm@aiimsbhopal.edu.in.

PMID: 38589115
DOI: 10.1016/j.ijtb.2023.04.012

Abstract

Background: Pulmonary rehabilitation improves dyspnea, functional limitation and quality of life in patients with chronic respiratory disease especially Chronic obstructive pulmonary disease (COPD). Whether Pulmonary rehabilitation (PR) will have similar effect in patients with post-tuberculosis sequelae or not and whether the two morphological variants will respond similarly or not was the purpose of our study.

Methods: Adult patients fulfilling the inclusion criteria of a diagnosis of post-tuberculosis sequelae with functional limitation (modified medical research council [mMRC] grade 1 or more) were recruited over a period of two years. A baseline health assessment in the different domains of health was done at the beginning and repeated just after the completion of the rehabilitation program at 6 weeks.

Results: 26 patients completed the PR protocol of our study. Dyspnea improved from an mMRC grade of 1.5 to 0.7 post-PR (p < 0.001). 6MWD increased by 34 meters from a baseline value of 408.6 meters to 442.7 meters post-PR. (p-value 0.3) St. George's Respiratory Questionnaire (SGRQ) symptom score decreased by 13 points, SGRQ activity score decreased by 18 points, SGRQ impact score decreased by 18 and SGRQ total score decreased by 17 points with p-values of 0.037, 0.002, 0.004 and 0.002 for SGRQ symptom score, SGRQ activity score, SGRQ impact score, SGRQ total score respectively. Depression Anxiety Stress Scale (DASS) Stress score decreased by 6.7, DASS Anxiety score decreased by 6.6, and DASS Depression score decreased by 5.5 points. Intergroup comparison revealed both bronchiectasis predominant group and fibrosis predominant group responded similarly to PR.

Conclusion: PR improved parameters assessing dyspnea, quality of life and mental health indices significantly. Improvement in functional capacity was not statically significant. Both the morphological variants responded similarly to the PR.

Keywords: Bronchiectasis; Dyspnea; Fibrosis; Quality of life.

MeSH terms

Adult
Bronchiectasis*
Dyspnea / etiology
Humans
Pulmonary Disease, Chronic Obstructive* / diagnosis
Quality of Life
Surveys and Questionnaires
Tuberculosis*