Clinical significance and safety of combined treatment with chemotherapy and pulmonary rehabilitation regarding health-related quality of life and physical function in nontuberculous mycobacterial pulmonary disease |
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| Affiliation: | 1. Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan;2. Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, 204-8522, Japan;3. Department of Physical Therapy, Faculty of Social Work Studies, Josai International University, 1 Gumyo, Togane, Chiba, 283-8555, Japan;4. Department of Rehabilitation, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, 187-8510, Japan;5. Department of Clinical Mycobacteriosis, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan;1. Department of Respiratory Medicine, Tokyo Women''s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan;2. Department of Genomic Medicine, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan;3. Department of Central Laboratories, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan;4. Department of Otorhinolaryngology, Head & Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan;1. Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan;2. Department of Clinical Laboratory, Kyoto University Hospital, Kyoto, Japan;3. Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan;4. Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan;5. Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan;1. Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan;2. Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan;3. Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan;4. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan;1. Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;2. Department of Thoracic Surgery, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan;3. Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;4. Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;1. Kanazawa University Health Service Center, Kakuma-machi, Kanazawa, Ishikawa, 920-1192, Japan;2. Department of Otorhinolaryngology, Head & Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan;3. Department of Clinical Laboratory, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan;4. Department of Otorhinolaryngology, Head & Neck Surgery, Graduate School of Medical Science Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan;5. Department of Respiratory Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan |
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| Abstract: | ![]()
BackgroundIn the treatment of patients with nontuberculous mycobacterial pulmonary disease (NTM-PD), pulmonary rehabilitation (PR) has been recommended as a non-pharmacological therapy. However, no study has validated the combination of chemotherapy and PR in this context. This study investigated the effect of chemotherapy and supervised PR on health-related quality of life (HRQoL) and physical function in NTM-PD patients.MethodsThis prospective cohort study included patients diagnosed with NTM-PD who had a planned hospitalization of at least 3 weeks for chemotherapy and PR. HRQoL (Leicester Cough Questionnaire [LCQ] and chronic obstructive pulmonary disease assessment test [CAT]), physical function (incremental shuttle walk distance [ISWD], quadriceps force), and C-reactive protein levels were assessed before and after treatment, and the corresponding data were analyzed in conjunction with clinical data. The adverse events of PR were also investigated.ResultsForty-two patients who met the study criteria were included in the analysis. After treatment, all LCQ item scores, total CAT score and sub-item scores related to respiratory symptoms, ISWD, quadriceps force, and C-reactive protein levels were found to have improved significantly. In the chronic cough with excessive sputum production (CCS) group, the proportions of responders who showed improvements in LCQ and CAT scores and ISWD greater than the corresponding minimal clinically important difference were significantly greater than those in the non-CCS group. No PR-related adverse events were reported.ConclusionsCombined treatment with chemotherapy and PR may improve HRQoL and physical function, and supervised PR can be provided safely. |
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| Keywords: | Nontuberculous mycobacterial pulmonary disease Pulmonary rehabilitation Chemotherapy Health-related quality of life Physical function ACTs" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040" }," $$" :[{" #name" :" text" ," _" :" airway clearance techniques BMI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" body mass index CAT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0060" }," $$" :[{" #name" :" text" ," _" :" COPD assessment test CCS" },{" #name" :" keyword" ," $" :{" id" :" kwrd0070" }," $$" :[{" #name" :" text" ," _" :" chronic cough with excessive sputum production COPD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0080" }," $$" :[{" #name" :" text" ," _" :" chronic obstructive pulmonary disease CRP" },{" #name" :" keyword" ," $" :{" id" :" kwrd0090" }," $$" :[{" #name" :" text" ," _" :" C-reactive protein ES" },{" #name" :" keyword" ," $" :{" id" :" kwrd0100" }," $$" :[{" #name" :" text" ," _" :" effect size HRQoL" },{" #name" :" keyword" ," $" :{" id" :" kwrd0110" }," $$" :[{" #name" :" text" ," _" :" health-related quality of life ISWD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0120" }," $$" :[{" #name" :" text" ," _" :" incremental shuttle walk distance ISWT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0130" }," $$" :[{" #name" :" text" ," _" :" incremental shuttle walk test LCQ" },{" #name" :" keyword" ," $" :{" id" :" kwrd0140" }," $$" :[{" #name" :" text" ," _" :" Leicester Cough Questionnaire mMRC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0150" }," $$" :[{" #name" :" text" ," _" :" modified Medical Research Council NTM-PD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0160" }," $$" :[{" #name" :" text" ," _" :" nontuberculous mycobacterial pulmonary disease PNI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0170" }," $$" :[{" #name" :" text" ," _" :" prognostic nutritional index PR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0180" }," $$" :[{" #name" :" text" ," _" :" pulmonary rehabilitation QF" },{" #name" :" keyword" ," $" :{" id" :" kwrd0190" }," $$" :[{" #name" :" text" ," _" :" quadriceps force |
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