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ORIGINAL ARTICLE
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Pre-proof, online 24 February 2025
Pulmonary rehabilitation in patients with post-tuberculosis lung disease: a prospective multicentre study
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Denise Rossato Silva1, Fernanda Carvalho de Queiroz Mello2, Tatiana Senna Galvão3, Margareth Dalcolmo4, Ana Paula Cere dos Santos5, Diego de Faria Magalhães Torres6, Larissa Andre de Meirelles Café de Jesus3, Dina Visca7,8, Rosella Centis9, Lia D’Ambrosio10, Anh Tuan Dinh-Xuan11, Giovanni Battista Migliori9,
Corresponding author
giovannibattista.migliori@icsmaugeri.it

Address for correspondence: Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Via Roncaccio 16, Tradate, Varese, 21049, Italy
1 Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
2 Instituto de Doenças do Tórax, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brasil
3 Universidade Federal da Bahia, Salvador, Brasil
4 Centro de Referência Hélio Fraga, Fiocruz, Rio de Janeiro, Brasil
5 Programa de Pós-Graduação em Ciências Pneumológicas da UFRGS, Porto Alegre, Brasil
6 Hospital Universitário Clementino Fraga Filho, UFRJ, Rio de Janeiro, Brasil
7 Department of Medicine and Cardiopulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
8 Department of Medicine and Surgery, University of Insubria, Varese, Italy
9 Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
10 Public Health Consulting Group, Lugano, Switzerland
11 Department of Respiratory and Sleep Medicine. Cochin Hospital. University Paris Cité. 27 rue du faubourg Saint-Jacques, 75014 Paris, France
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ABSTRACT

Introduction: The majority of the studies on pulmonary rehabilitation (PR) in post-tuberculosis lung disease (PTLD) were from a single centre, had a low sample size and/or did not allow a complete functional evaluation before and after PR programme (PRP). The objective of this study was to evaluate if PTLD patients had benefits from PR in a large collaborating multicentre study conducted in reference centres in Brazil, Italy and France.

Methods: PTLD patients underwent a comprehensive 5-week PRP (Group 1), and were compared with non-rehabilitated patients (Group 2). Pulmonary function tests, 6-minute walk test (6MWT), and arterial blood gas analysis were measured two times: before and at the end of the PRP (Group 1), and at the beginning of the follow-up and after 3 months (Group 2).

Results: Eighty-five patients were included in Group 1 and 96 patients in Group 2. Several functional parameters improved after rehabilitation, such as forced expiratory volume in one second (FEV1), forced vital capacity (FVC), diffusing capacity of the lung for carbon monoxide (DLCO), distance walked in 6MWT, the initial and final SaO2 at 6MWT. In Group 2, several functional parameters decreased after 3 months.

Conclusions: We demonstrated the benefits from PRP in patients with PTLD, including improvements in lung function and in exercise capacity. National TB programmes should ensure the availability of accessible and quality post-treatment PRP for PTLD patients.

Keywords:
tuberculosis
Mycobacterium tuberculosis
post-tuberculosis lung disease
pulmonary rehabilitation
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