Pulmonary Rehabilitation Improves Functional Status in Oncology Patients

Morris GS, Gallagher GH, Baxter MF, Brueilly KE, Scheetz JS, Ahmed MM, Shannon VR. Pulmonary rehabilitation improves functional status in oncology patients. Objective: To determine if participation in a pulmonary rehabilitation (PR) program improved the functional and physiologic status of oncology patients with chronic symptoms of shortness of breath, fatigue, and/or exercise intolerance. Design: Retrospective chart review. Setting: Comprehensive cancer center. Patients: Oncology patients (N=30) (either a solid or a hematologic malignancy) with chronic dyspnea, exercise intolerance, and/or decreased functional status who had participated in an outpatient PR program. Interventions: The PR program used an individualized, progressive aerobic exercise program (2-3 sessions/wk for 8-12 weeks) that consisted of treadmill walking, riding on a bicycle ergometer and exercising on a sliding board. This program also included a didactic educational and psychosocial component. Main Outcome Measures: Functional status and exercise tolerance was assessed by the 6-minute walk test (6MWT) conducted at the beginning and end of the program. Self reports of perceived exertion and dyspnea were collected during and after these tests. Physiologic status was assessed by calculating 6-minute walk work (body mass × 6-minute walk distance). Results: Participation in the outpatient PR program significantly increased the 6-minute walk distance (21%, P<.05) and 6-minute walk work (17%, P<.05). Dyspnea and perceived exertion scores were similar at the pre- and postrehabilitation 6MWT despite the greater physiologic demand of the post-rehabilitation 6-minute walk. No adverse events occurred during the study. Conclusions: The current study, although limited in size, suggests that participation in a comprehensive outpatient PR program is safe and of benefit in a heterogeneous population of oncology patients with pulmonary symptoms.