Effect of pulmonary rehabilitation on dyspnea and exercise tolerance in patients with interstitial lung disease: a systematic review

Abstract

Purpose

Pulmonary rehabilitation (PR) and exercise training have proven effective for dyspnea and exercise tolerance for individuals with chronic obstructive pulmonary disease (COPD) but little is known of its effect on interstitial lung disease (ILD). There is a need in the literature to systematically review the effect of these interventions on individuals with ILD concerning exercise tolerance and/or dyspnea.

Methods

This systematic review utilized PRISMA guidelines to conduct the reporting of the findings and was registered with PROSPERO (CRD42020186513). Databases searched included: PubMed, CINAHL, ProQuest, Scopus, and Web of Science. Independent screening was performed by two authors with a third acting as a tiebreaker when consensus was not reached. Randomized control trials (RCTs) were included with subjects over 18 years old with a diagnosis of ILD who complete either pulmonary rehabilitation (PR) or exercise training interventions and included the six minutes walk test (6MWT) to measure exercise tolerance and/or outcomes to measure dyspnea. Studies were also included if they were published between 2008 through the date of study collection. A quality assessment was then performed on each RCT using the PEDro score with those with a rating of six or greater being included.

Results

Eight studies meeting inclusion criteria were included in this review with statistical significance reported in seven of the studies for short-term improvements and in two of the studies for long-term improvements in exercise tolerance. Six reported statistical significance for short-term improvements in dyspnea and two studies reported statistical significance for long-term improvements of dyspnea.

Conclusion

Individuals with ILD demonstrate improvements in exercise tolerance and symptoms of dyspnea after participating in PR or exercise training interventions.

Keywords:

• Six-minute Walk Test (6MWT)
• dyspnea
• interstitial lung disease (ILD)
• exercise training

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Additional information

Notes on contributors

Nicholas DePietro

Nicholas DePietro, SPT, is a third-year doctor of physical therapy student at Walsh University. Upon graduation in May 2021, he will begin his career as a physical therapist and plans to pursue a career in acute care with a specialization in cardiopulmonary therapy.

Jennifer Rinaldi

Jennifer Rinaldi, SPT, is a third-year doctor of physical therapy student at Walsh University. She plans on beginning her career as a physical therapist in the inpatient or acute care settings upon graduating in May 2021.

Courtney Nieschwitz

Courtney Nieschwitz, SPT, is a third-year doctor of physical therapy student at Walsh University. Upon graduation in May 2021, she will begin her career as a physical therapist and plans to specialize in orthopedics and geriatrics.

Heather Robinson

Heather Robinson, SPT is a third-year doctor of physical therapy student at Walsh University. After graduation in May 2021, she plans to work in an outpatient orthopedic clinic or inpatient rehabilitation hospital serving the people of Northeast Ohio.

Alysha Walter

Alysha Walter, PT, DPT, CCS is an Assistant Clinical Professor of the Doctor of Physical Therapy program at Walsh University. She is a physical therapist with research interests in physical therapy management of cardiovascular and pulmonary disorders.