Effect of Pulmonary rehabilitation on the exercise tolerance in sputum positive pulmonary TB patients

Usual care (control arm)

The participants in the control arm will receive standard of care at NTEP centres. Sputa examination, CXR, spirometry, transition dyspnoea index, 6MWT, and QOL assessment will be done at baseline (at randomisation), at 16 weeks post randomisation, at 6,12 and 18 months post ATT completion.

Pulmonary Rehabilitation (PR) (trial intervention arm)

In addition to usual care described above, participants in the intervention arm will receive PR. PR will consist of a 16-week programme offered to participants, with sessions occurring twice weekly for at least 1 hour- 6 weeks initially in an outpatient basis, 6 weeks later at home followed by two weeks each in outpatient basis and at home or will be done as an intense 8 weeks daily monitored program on admission and 8 weeks program being done at home. At home PR adherence will be ensured over telephonic communication.

16-week outpatient program

2 days in a week for 8 weeks in Outpatient department and for 8 weeks at home.

 16 weeks inpatient program

8 weeks daily monitored program and 8 weeks at home.

 Â·         Health education awareness sessions on lung health, verbal advice to quit smoking and reduce exposure to biomass smoke, stress management.

• Lower and upper limb strength training and extensor exercises
• Respiratory exercises (stretching and relaxing)
• Lower limb endurance training (walking exercises)
• Healthy food intake- Nutritional counselling on balanced diet
• Secretion clearance techniques.
• Breathing techniques including Yoga techniques.

Exercise intensity during each session is incremental and graded according to symptom tolerance.