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Characteristics of pulmonary rehabilitation programs and their effects on exercise capacity and health related quality of life (HRQoL) in patients with interstitial lung disease: A systematic review and meta-analysis

Salazar JJ 1 , Mirza FT 2 , Uzzaman MN 3 , Shunmugam RH 4 , Shazana NZ 5 , Pinnock H 6 Show all authors , Hirani N 7 , Rabinovich RA 8

Affiliations 

  • 1 CIR Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom. Electronic address: s1879414@ed.ac.uk
  • 2 Centre for Physiotherapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Selangor, Malaysia. Electronic address: fatim_mirza@uitm.edu.my
  • 3 Usher Institute, University of Edinburgh, Edinburgh, United Kingdom. Electronic address: m.n.uzzaman@sms.ed.ac.uk
  • 4 Department of Library & Information Science, Faculty of Arts & Social Sciences, Universiti Malaya, Kuala Lumpur, Malaysia. Electronic address: ranita@um.edu.my
  • 5 Rehabilitation Department, KPJ Bandar Dato' Onn Specialist Hospital, Bandar Dato' Onn, Malaysia. Electronic address: zawanimustaffa@gmail.com
  • 6 Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom. Electronic address: hilary.pinnock@ed.ac.uk
  • 7 CIR Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom. Electronic address: n.hirani@ed.ac.uk
  • 8 CIR Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom. Electronic address: roberto.rabinovich@ed.ac.uk
Respir Med, 2025 Jan 04;237:107936.
PMID: 39756486 DOI: 10.1016/j.rmed.2024.107936

Abstract

BACKGROUND: Interstitial Lung Disease (ILD) is characterized by dyspnoea, reduced exercise capacity and poor health related quality of life (HRQoL). The evidence to support the benefits of pulmonary rehabilitation (PR) on exercise capacity (EC) and HRQoL in this population is still limited. We aimed to determine the effect of the different PR components on exercise capacity and HRQoL in patients with ILD.

METHODS: We searched five databases (January 1990 to August 2024) using Population: ILD patients; Intervention: PR; Comparison: no PR; Outcomes: exercise capacity (e.g., 6-min walk test [6MWT] and HRQoL (e.g., St George's respiratory questionnaire [SGRQ]); Study type: randomised controlled trials (RCT). We used Cochrane risk-of-bias tool and GRADE to rate the quality of the evidence.

FINDINGS: We identified 11 RCTs (476 ILD patients; 8 countries). 10 studies provided data for exercise capacity (6MWD) and 7 studies for HRQoL (SGRQ). Both 6MWD and SGRQ improved ≥ their respective mínimum clinically-important difference of 45m and 7 units respectively, in studies where PR programme was i) >8 weeks (n = 5) [6MWD: MD 58m, 95 % CI 37 to 79, p 8 weeks, fully supervised and incorporated HIIT had a better clinical impact on EC and HRQoL.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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