Home-Based Pulmonary Rehab for Patients With Pulmonary Fibrosis

Inclusion criteria

• confirmed diagnosis of IPF based on the criteria of the American Thoracic Society/European Respiratory Society 2011 guidelines;
• ≥ 40 years-of-age;
• ambulatory without the use of an assistive device;
• stable clinical condition (i.e., no pulmonary exacerbation for at least 6 weeks);
• no changes in medication for at least 4 weeks before enrollment;
• currently sedentary (i.e., exercise or participate in sports less than 3 times per week for 20 min in the past 6 months) and do not play any exergames;
• report dyspnea on exertion leading to a limitation in performing daily activities (i.e., Medical Research Council (MRC) dyspnea grade >1);
• able to read and follow exercise directions in English on the television screen;
• have permission from their treating physician to participate in moderate-intensity exercise;
• able to provide informed consent by understanding the nature of study participation.

Exclusion criteria

• contraindication for moderate-intensity exercise (e.g., unstable cardiac disease),
• severe musculoskeletal, vestibular, or neurological disorders limiting exercise performance, or inability to perform the 6-min walk test or 15-step test,
• requires > 6 lpm supplemental oxygen therapy via nasal cannula during exercise to maintain SpO2 >88%;
• MRC dyspnea grade 4 or 5; IPF patients with MRC dyspnea grade 4 or 5 have been reported to show little or no improvement, or deteriorated following pulmonary rehab;
• stage 2 hypertension,
• anemia (hemoglobin < 8 g/dL);
• collagen vascular disease;
• obstructive lung disease,
• non-parenchymal restrictive lung disease,
• occupational lung disease (pneumoconiosis, hypersensitivity pneumonitis),
• sarcoidosis,
• other idiopathic interstitial pneumonia;
• currently participating or have participated (in the past 30 days) in another clinical trial which can affect the outcomes of the proposed study; or
• planning to move out of Alabama within the next 6 months.