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

不同特征的肺康复计划对间质性肺病患者的益处:系统评价和荟萃分析

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Abstract

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

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