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Pulmonary Rehabilitation in Iranian Outpatients With Mustard Gas Lung Disease: A Randomised Controlled Trial Publisher Pubmed



Ghanei M1 ; Philip KEJ2 ; Moghadam MRS3 ; Hosseini H4 ; Babaie A5 ; Roustanezhad M5 ; Hopkinson NS2
Authors
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Authors Affiliations
  1. 1. Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
  2. 2. National Heart and Lung Institute, Imperial College London, London, United Kingdom
  3. 3. Centre for Pneumology and Thoracic Surgery, Lung Clinic Hemer, Hemer, Germany
  4. 4. Clinical Trial Center, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Janbazan Medical and Engineering Research Center, Tehran, Iran

Source: BMJ Open Published:2024


Abstract

Objective People with mustard gas lung disease experience cough, sputum, breathlessness and exercise limitation. We hypothesised that pulmonary rehabilitation (PR) would be beneficial in this condition. Design An assessor-blind, two-armed, parallel-design randomised controlled clinical trial. Setting Secondary care clinics in Iran. Participants 60 men with breathlessness due to respiratory disease caused by documented mustard gas exposure, mean (SD) age 52.7 (4.36) years, MRC dyspnoea score 3.5 (0.7), St. George's Respiratory Questionnaire (SGRQ) 72.3 (15.2). Interventions Participants were allocated either to a 6-week course of thrice-weekly PR (n=31) or to usual care (n=29), with 6-week data for 28 and 26, respectively. Outcome measures Primary endpoint was change in cycle endurance time at 70% baseline exercise capacity at 6 weeks. Secondary endpoints included 6 min walk distance, quadriceps strength and bulk, body composition and health status. For logistical reasons, blood tests that had been originally planned were not performed and 12-month follow-up was available for only a small proportion. Results At 6 weeks, cycle endurance time increased from 377 (140) s to 787 (343) s with PR vs 495 (171) s to 479 (159) s for usual care, effect size +383 (231) s (p<0.001). PR also improved 6 min walk distance+103.2 m (63.6-142.9) (p<0.001), MRC dyspnoea score -0.36 (-0.65 to -0.07) (p=0.016) and quality of life; SGRQ -8.43 (-13.38 to -3.48) p<0.001, as well as quadriceps strength+9.28 Nm (1.89 to 16.66) p=0.015. Conclusion These data suggest that PR can improve exercise capacity and quality of life in people with breathlessness due to mustard gas lung disease and support the wider provision of this form of care. Trial registration number IRCT2016051127848N1. © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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