Pulmonary Rehab for Interstitial Lung Disease and Idiopathic Pulmonary Fibrosis

Pulmonary rehabilitation can be performed safely and most likely improves exercise capacity, symptoms, and quality of life in people with interstitial lung disease (ILD), including those with idiopathic pulmonary fibrosis (IPF), according to a review published in the Cochrane Database of Systematic Reviews.

In order to clarify the long-term benefit and strengthen the rationale for incorporating pulmonary rehabilitation into standard clinical management of patients with ILD, researchers reviewed data from 21 studies on the effects of pulmonary rehabilitation on exercise capacity, shortness of breath, and quality of life in 909 patients with ILD.

They found that immediately following pulmonary rehabilitation, patients could walk further than those who had not undertaken pulmonary rehabilitation and also improved their maximum exercise capacity, reported less shortness of breath, and improved quality of life. Likewise, patients with IPF experienced comparable improvements in exercise capacity, shortness of breath, and quality of life following pulmonary rehabilitation.

In addition, 6 to 12 months following pulmonary rehabilitation, patients with pulmonary fibrosis could still walk further and sustained some improvements in shortness of breath and quality of life compared with those who had not undertaken pulmonary rehabilitation. Notably, in patients with IPF, it is less certain whether improvements are sustained 6 to 12 months following pulmonary rehabilitation.

Investigators found no studies that described any side effects of pulmonary rehabilitation. The researchers noted that the quality of evidence was generally low to moderate, mostly due to inadequate reporting of methods, assessors knowing which treatment had been given, and variability in some results.

“These results support the inclusion of pulmonary rehabilitation as part of the management for people with ILD,” concluded the authors. They added, “Further well‐designed randomised trials are needed to determine the optimal exercise prescription, and to investigate ways to promote longer‐lasting improvements, particularly for people with IPF.”

Reference

Dowman L, Hill CJ, May A, Holland AE. Pulmonary rehabilitation for interstitial lung disease. Cochrane Database of Syst Rev. 2021;2:CD006322. doi:10.1002/14651858.CD006322.pub4