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 analy...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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European Respiratory Society
2024-01-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/10/1/00735-2023.full |
| _version_ | 1797278873742737408 |
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| author | Judith Maria Brock Konstantina Kontogianni Frank C. Sciurba Gerard J. Criner Felix Herth |
| author_facet | Judith Maria Brock Konstantina Kontogianni Frank C. Sciurba Gerard J. Criner Felix Herth |
| author_sort | Judith Maria Brock |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-07T16:15:24Z |
| format | Article |
| id | doaj.art-e7155f4125104cac868e9cae3c01ad91 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-07T16:15:24Z |
| publishDate | 2024-01-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-e7155f4125104cac868e9cae3c01ad912024-03-04T11:30:00ZengEuropean Respiratory SocietyERJ Open Research2312-05412024-01-0110110.1183/23120541.00735-202300735-2023Utility of rehabilitation prior to bronchoscopic lung volume reduction: post hoc analysis of the VENT trialJudith Maria Brock0Konstantina Kontogianni1Frank C. Sciurba2Gerard J. Criner3Felix Herth4 Department for Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany Department for Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany Pulmonary Division, University of Pittsburgh Medical Center, Pittsburgh, PA, USA Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA Department for Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany 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.http://openres.ersjournals.com/content/10/1/00735-2023.full |
| spellingShingle | Judith Maria Brock Konstantina Kontogianni Frank C. Sciurba Gerard J. Criner Felix Herth Utility of rehabilitation prior to bronchoscopic lung volume reduction: post hoc analysis of the VENT trial ERJ Open Research |
| title | Utility of rehabilitation prior to bronchoscopic lung volume reduction: post hoc analysis of the VENT trial |
| title_full | Utility of rehabilitation prior to bronchoscopic lung volume reduction: post hoc analysis of the VENT trial |
| title_fullStr | Utility of rehabilitation prior to bronchoscopic lung volume reduction: post hoc analysis of the VENT trial |
| title_full_unstemmed | Utility of rehabilitation prior to bronchoscopic lung volume reduction: post hoc analysis of the VENT trial |
| title_short | Utility of rehabilitation prior to bronchoscopic lung volume reduction: post hoc analysis of the VENT trial |
| title_sort | utility of rehabilitation prior to bronchoscopic lung volume reduction post hoc analysis of the vent trial |
| url | http://openres.ersjournals.com/content/10/1/00735-2023.full |
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