# Benefits of different characteristics of pulmonary rehabilitation programs in patients with interstitial lung disease: a systematic review and meta-analysis

## TL;DR

Pulmonary rehabilitation improves exercise endurance and quality of life in patients with interstitial lung disease, with optimal benefits seen in specific program durations and content.

## Contribution

This study provides a systematic review and meta-analysis showing tailored pulmonary rehabilitation benefits for interstitial lung disease patients.

## Key findings

- Pulmonary rehabilitation improves exercise endurance, hypoxemia, and quality of life in ILD patients.
- Programs lasting 4–8 weeks and including breathing training show optimal benefits.
- Home-based and tele-rehabilitation are as effective as in-person methods for enhancing endurance.

## Abstract

Interstitial lung disease (ILD) is defined by progressive pulmonary fibrosis, restrictive ventilatory dysfunction, and hypoxemia, with significant differences in disease presentation, clinical course, and prognosis. This study aims to evaluate the clinical benefits of pulmonary rehabilitation with different characteristics in ILD patients.

This study searched electronic databases (PubMed, Embase, Web of Science, Cochrane Library, Clinical trials) and included 33 articles in a meta-analysis (1671 ILD patients). Two investigators independently appraised relevance, trial quality, and data extraction.

The meta-analysis demonstrated that pulmonary rehabilitation is effective in enhancing exercise endurance, alleviating exertional hypoxemia, and improving quality of life among ILD patients. Key outcomes (all p < 0.05): 6-min walk distance (6MWD) [MD = −46.04; 95% CI (−52.63, −39.45)], lowest oxygen saturation during the 6-min walk test (6MWT) [MD = −1.97; 95% CI (−2.11, −1.84)], Borg scale score [MD = 1.20; 95% CI (0.79, 1.60)], and the MOS 36-item Short Form Health Survey (SF-36) [MD = −4.57; 95% CI (−7.19, −1.94)]. Subgroup analyses were performed based on duration, content, and implementation methods. Patients with 4–8 weeks duration showed optimal benefits. Content including breathing training improved exercise endurance more effectively. Medical guidance, home-based, and tele-rehabilitation all enhanced endurance, with no significant differences.

Pulmonary rehabilitation has a positive therapeutic effect on ILD patients, significantly enhancing exercise endurance and tolerance, and improving quality of life. However, it is essential to assess the patient’s condition and tailor the pulmonary rehabilitation plan to the individual to achieve the best therapeutic outcomes.