An 8-month exercise rehabilitation program improved brain oxygenation during exercise in patients with IPF

<bold>Introduction:</bold> Patients with Idiopathic pulmonary fibrosis (IPF) often present exercise intolerance, exertional dyspnea and desaturation. Recent studies have reported that a reduction in brain oxygenation during exercise, possibly contributes to the development of exercise limitations in IPF patients. Exercise training has been shown to elicit favorable changes in the exercise tolerance of IPF patients. Whether brain oxygenation can be improved with exercise training has not been investigated. <bold>Aim:</bold> To examine whether an 8-month exercise-rehabilitation program can improve brain oxygenation during exercise in IPF patients. <bold>Methods:</bold> Fourteen IPF patients (69±6yrs, DLCO 57.6±14.0% predicted) underwent maximal cardiopulmonary testing (CPET), with continuous monitoring of brain oxygenation via Near-Infrared-Spectroscopy (NIRS), before and after an 8-month rehabilitation program. The program was implemented twice/week and included breathing exercises, aerobic and strength training. <bold>Results:</bold> Exercise training significantly increased cerebral oxygenated hemoglobin during CPET (0.2±2.0 vs 0.9±2.0μM, pre- vs post rehab; p<0.05). Participants increased (p<0.05) exercise time (10.2±4.4 vs 11.8±3.0min), workload (88.6±38.5 vs 102.2±31.4 Watts), and VO2peak (82.1±13.3 vs 94.0±20.24% pred.), with no significant changes in exercise desaturation (SpO2delta -7.5±4.1 vs -7.0±4.7%). <bold>Conclusions:</bold> A long-term exercise rehabilitation program in IPF patients, along with improvements in exercise time, work, and aerobic capacity, significantly improved brain oxygenation during exercise. Whether the enhanced brain oxygenation is also associated with better cognitive performance, requires further investigation.