Utility of rehabilitation prior to bronchoscopic lung volume reduction: post hoc analysis of the VENT trial
Background and objective Rehabilitation programmes are a valuable treatment modality for patients with COPD to increase exercise capacity and quality of life. The utility of pulmonary rehabilitation prior to bronchoscopic lung volume reduction (BLVR) is unclear. - Methods We performed a post hoc ana...
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| Main Authors: | , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
January 22, 2024
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| In: |
ERJ Open Research
Year: 2024, Volume: 10, Issue: 1, Pages: 1-9 |
| ISSN: | 2312-0541 |
| DOI: | 10.1183/23120541.00735-2023 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1183/23120541.00735-2023 Verlag, kostenfrei, Volltext: https://openres.ersjournals.com/content/10/1/00735-2023 
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| Author Notes: | Judith Maria Brock, Konstantina Kontogianni, Frank C. Sciurba, Gerard J. Criner and Felix Herth |
| Summary: | Background and objective Rehabilitation programmes are a valuable treatment modality for patients with COPD to increase exercise capacity and quality of life. The utility of pulmonary rehabilitation prior to bronchoscopic lung volume reduction (BLVR) is unclear. - Methods We performed a post hoc analysis of the Valve for Emphysema Palliation Trial (VENT) trial, the first multicentre randomised trial comparing the safety and efficacy of BLVR. Patients completed a pulmonary rehabilitation programme prior to BLVR over 6-10 weeks and maintained by daily practice, consisting of endurance training, strength training and upper/lower limb exercise. Lung function and exercise parameters (6-min walk distance (6MWD)) were assessed before and after rehabilitation and we tried to identify predictors for pulmonary rehabilitation benefit. - Results Lung function and exercise capacity of 403 patients (mean±sd age 63.3±7.4 years, 37.5% female, mean±sd forced expiratory volume in 1 s 30.1±7.6 L) were analysed. Exercise capacity significantly improved from 331.6±98.8 m to 345.6±95.3 m (p<0.001) in 6-min walk testing (6MWT), with 40.3% showing clinically meaningful improvements. Patients also experienced less dyspnoea after 6MWT, while pulmonary function parameters did not change significantly overall. Patients with lower exercise capacity at screening (6MWD <250 m) benefited more from pulmonary rehabilitation. The indication and prerequisites for BLVR were still present in all patients after pulmonary rehabilitation. - Conclusion The national mandatory requirements for rehabilitation prior to BLVR, which apply to all COPD patients, should be reconsidered and specified for COPD patients who really benefit. - Tweetable abstract ERSpublications - click to tweetPulmonary rehabilitation is an essential tool for patients with severe COPD. Given the only modest improvements in exercise capacity, mandatory requirements for rehabilitation before bronchoscopic lung volume reduction should be reconsidered. https://bit.ly/3Mheiu7 |
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| Item Description: | Online veröffentlicht: 22. Januar 2024 Gesehen am 11.06.2024 |
| Physical Description: | Online Resource |
| ISSN: | 2312-0541 |
| DOI: | 10.1183/23120541.00735-2023 |