Long-term assessment of pulmonary rehabilitation for patients with neuromuscular diseases using the Breathing Intolerance Index.

Abstract

Treating respiratory problems in patients with neuromuscular diseases requires pulmonary rehabilitation that is customized to each individual based on an evaluation of their respiratory function. In addition to assessment of ventilatory mechanics such as lung capacity and peak cough flow, it is important to assess breathing intolerance. The Breathing Intolerance Index (BITI) was proposed as a method for quantifying breathing intolerance. We examined long-term changes in BITI in patients with neuromuscular diseases and investigated the efficacy of BITI as an index for introducing various respiratory instruments and changing program settings in pulmonary rehabilitation. Participants were nine patients with neuromuscular diseases who underwent long-term pulmonary rehabilitation. In comparisons of the initial and final BITI assessments, seven of the nine patients showed improvement or no change, suggesting that the pulmonary rehabilitation was a success. In two patients, a pulmonary rehabilitation program was started or revised based on the BITI assessment, after which their BITI score improved. BITI may therefore be a useful index for starting or revising pulmonary rehabilitation. Further studies are needed to determine the best assessment and measurement periods.