Salazar Jaime Jiménez, Mirza Fatim Tahirah, Uzzaman Md Nazim, Shunmugam Ranita Hisham, Shazana Nik Zawani, Pinnock Hilary, Hirani Nikhil, Rabinovich Roberto A
CIR Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
Centre for Physiotherapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Selangor, Malaysia.
Respir Med. 2025 Feb;237:107936. doi: 10.1016/j.rmed.2024.107936. Epub 2025 Jan 4.
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.
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.
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 < 0.00001; SGRQ: MD -9.7, 95 % CI -12.6 to -6.7, p < 0.00001], ii) fully supervised [6MWD (n = 5): MD 53.6m, 95 % CI 39 to 68, p < 0.00001; SGRQ (n = 2): MD -9.38, 95 % CI -12.93 to -5.84, p < 0.00001] and iii) incorporated high-intensity interval training (HIIT) (n = 2) [6MWD: MD 77m, 95 % CI 45 to 109, p < 0.00001; SGRQ: MD -10.3, 95 % CI -13.7 to -6.9, p < 0.00001] INTERPRETATION: PR programs of >8 weeks, fully supervised and incorporated HIIT had a better clinical impact on EC and HRQoL.
间质性肺疾病（ILD）的特征为呼吸困难、运动能力下降以及健康相关生活质量（HRQoL）较差。支持肺康复（PR）对该人群运动能力（EC）和HRQoL有益的证据仍然有限。我们旨在确定不同的PR组成部分对ILD患者运动能力和HRQoL的影响。
我们检索了五个数据库（1990年1月至2024年8月），检索词为：人群：ILD患者；干预措施：PR；对照：无PR；结局指标：运动能力（如6分钟步行试验[6MWT]）和HRQoL（如圣乔治呼吸问卷[SGRQ]）；研究类型：随机对照试验（RCT）。我们使用Cochrane偏倚风险工具和GRADE对证据质量进行评级。
我们纳入了11项RCT（476例ILD患者；8个国家）。10项研究提供了运动能力（6MWD）的数据，7项研究提供了HRQoL（SGRQ）的数据。在PR方案为以下情况的研究中，6MWD和SGRQ均有改善，且均≥其各自最小临床重要差异，分别为45米和7个单位：i）>8周（n = 5）[6MWD：平均差（MD）58米，95%置信区间（CI）37至79，p < 0.00001；SGRQ：MD -9.7，95% CI -12.6至-6.7，p < 0.00001]，ii）全程监督[6MWD（n = 5）：MD 53.6米，95% CI 39至68，p < 0.00001；SGRQ（n = 2）：MD -9.38，95% CI -12.93至-5.84，p < 0.
