Breathing retraining to improve dyspnoea and walking distance in patients with interstitial lung diseases : a randomised controlled trial

Abstract

Objective Dyspnoea is the hallmark progressive symptom in interstitial lung disease (ILD). Breathing retraining

in chronic obstructive pulmonary disease (COPD) im- proves dyspnoea and walking distance (Garrod et al.

2005) but there is a dearth of evidence for ILD. This study aimed to identify whether breathing retraining incorporated during pulmonary rehabilitation (PR), leads to better dyspnoea and functional scores.

Design 27 patients with ILD were randomly distributed to a

control group (CG) who underwent a 12-week hospi- tal-based PR programme or experimental group (EG),

receiving PR with breathing retraining. The 6-minute

walk test and dyspnoea scores were assessed at base- line and on completion.

Results

Statistical improvements in walking distance were re- corded in the EG median 416.25; (IQR 368–463) week

0 to 475m (IQR 437–521) week 12; p = 0.017 and dysp- noea post exertion (median 3.00; IQR 1–5) week 0 to

2.50 (IQR 0.3–4) week 12; p = 0.033). The CG obtained a less, but statistically significant improvement 360m (IQR 330–405) week 0 to 412.50m (IQR 394–450) week 12 (p = 0.003). When comparing outcomes at week 12 between groups, superior results in dyspnoea at rest (EG 0 (IQR 0–0); CG 2 (IQR 0–2); p = 0.029), and walking distances (EG 475m (IQR 437–521); CG 412.50 (IQR 394–450; p = 0.015) were recorded for the EG.

Conclusion

Breathing retraining added to PR, resulted in improve- ments in dyspnoea scores and functional capacity in

patients with ILD.