Pulmonary rehabilitation outcomes for a patient with Bronchiolitis Obliterans Organizing Pneumonia: Case study

Background and purpose. The purpose of this retrospective case report is to examine the pulmonary rehabilitation (PR) outcomes for a patient with Bronchiolitis Obliterans Organizing Pneumonia (BOOP); which is a rare condition that is not often treated in a pulmonary rehabilitation setting.;Patient and setting. The patient is a 65 year old female with BOOP diagnosis, who was treated in the outpatient PT department of a large urban tertiary care hospital. She underwent two successive courses of pulmonary rehabilitation during a 15 month period as her disease progressed.;Intervention. The first episode of care consisted of 35 sessions of pulmonary rehabilitation and the second included 39 sessions with an average frequency of 2 sessions per week. Each session lasted for 1 hour. The training program included a prescription for aerobic conditioning on both a bicycle ergometer and a treadmill, and strength training with Theraband and free weights.;Outcomes. The patient was evaluated at the initiation and conclusion of each episode with standardized tools including: 6 Minute Walk Test and CRQ-SR. Results showed clinically meaningful improvement in functional capacity measured by 6MWT and in health related quality of life scores measured by CRQ-SR post-pulmonary rehabilitation episode one. However scores on the CRQ-SR declined following the second episode of pulmonary rehabilitation and there was no demonstrated change in 6 MWT.;Discussion and conclusions. This patient demonstrated significant variability in her physiologic and clinical measures from the initiation of treatment through the second episode of rehabilitation. In addition to her physical therapy management, the patient received changing doses of medications and other medical management, (oxygen) over the extended course of care. The patient presented a very inconsistent pattern of improvement and decline in both her symptoms and functional performance. Consequently, additional study will be necessary to understand if this patient represents a typical presentation and pattern of symptoms and response for the BOOP population or, if her course is unique. To the author's knowledge, this is the first published case report on pulmonary rehabilitation for a patient with Bronchiolitis Obliterans Organizing Pneumonia.