Pulmonary Rehabilitation in Post Tuberculosis Patients: A Longitudinal Cohort Study

Abstract RATIONALE: Tuberculosis a significant challenge to public healthcare in Brazil. Despite advances in diagnostic and treatment methods, most patients are not fully recovered after medication. Pulmonary rehabilitation is a multidisciplinary approach that combines educational activities, aerobic and strengthening exercises. This study aims to present the increase of life quality to patients post tuberculosis infections. METHODS: The study utilized a unicentric longitudinal cohort study to evaluate the effects of pulmonary rehabilitation on patients with a history of tuberculosis (TB). Patients who had been diagnosed and treated for TB, exhibiting respiratory impairments, were monitored before and after a 16-week supervised rehabilitation program focusing on respiratory muscle strength, aerobic capacity, and physical endurance. Data was collected on 10 patients from Bahia, Brazil, and included social demographic details (age, sex, race), clinical symptoms (smoking status, cough, sputum, dyspnea, hemoptysis during TB infection), pulmonary function tests (spirometry: VEF1, FVC), 6-minute walk test (6MWT) (distance, SpO2, and Borg scales for dyspnea and fatigue), and thoracic imaging exam. RESULTS: Among the 10 patients, ages ranged from 38 to 85 years; 7 were male and 3 female. 80% were non-white. 40% never smoked, and 60% were former smokers. Symptoms included cough (70%), sputum (70%), dyspnea (90%), and hemoptysis (10%). Only 20% were infected more than once. The comorbidities were chronic obstructive pulmonary disease (60%), arterial hypertension (50%), and asthma (20%). Spirometry showed a post-BD increase in mean values: FEV1 by 14.33%, FVC by 5.20%, and FEV1/FVC by 4.73%. In 6MWT, there was a 28.6% average increase in distance traveled and an initial SpO₂ of 0.5%. Borg values showed a decrease: dyspnea baseline dropped by 26.4%, dyspnea final by 27.2%, and fatigue baseline by 0.5%. Final SpO₂ and Borg fatigue final showed no change. Thoracic imaging revealed bronchiectasis in 80%, calcified nodules in 80%, fibroatelectasis in 30%, reticular opacities in 30%, tree-in-bud pattern in 10%, and panlobular emphysema in 10%. CONCLUSION: These findings conclude that pulmonary rehabilitation is crucial as an adjuvant treatment for TB rehabilitation. It was clear the increased results. The study shows the importance of rehabilitation in a short amount of time, and it can become a great ally to a better quality of life of those affected. Even though it is an initial study, we intend to extend it to see the results on a larger scale with more patients in a larger amount of time.