Zhao Qian, Mo Nan, Li Rui, Wei Tian Tian, Xu WenJin, Wang Jie, Li ShanShan, Zhu Huifang, Miao Guiling
Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, 210000, China.
Department of Nursing, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China.
BMC Pulm Med. 2025 Jul 28;25(1):356. doi: 10.1186/s12890-025-03804-9.
The effects of exercise-based interventions in patients with interstitial lung disease ( ILD) are not fully understood. To better understand the effects of exercise training on functional exercise capacity, we conducted a meta-analysis.
This systematic review and meta-analysis aimed to evaluate the effects of exercise training on the functional exercise capacity of adults with ILD.
We searched the PubMed, Embase, Web of Science, and Cochrane Library databases from inception to July 2024 and the reference lists of the included articles. All RCT that included exercises and outcomes assessed the functional exercise capacity of adults with ILD. Data were pooled with the mean difference or standardized, random-effect model, and 95% confidence intervals ( CI) using RevMan V.5.4. We also used Cochrane risk-of-bias tool and GRADE to rate the quality of the evidence.
Sixteen RCTs with 899 participants were included. Exercise interventions significantly improved 6MWD ( ILD: MD = 35.88 m(m), 95% CI: 22.65-49.10, P < 0.00001; IPF: MD = 28.84 m, 95% CI: 14.73-42.95, P < 0.0001), enhanced peak work rate ( ILD: MD = 3.79 watts, 95% CI: 0.66-6.92, P < 0.05; IPF: MD = 5.98 watts, 95% CI: 2.34-9.63, P < 0.01), VO2 peak ( IPF: MD = 0.84 ml/kg/min, 95% CI: 0.18-1.50, P < 0.05), alleviate dyspnea ( ILD:MD = -0.46, 95% CI:-0.68,-0.23, P < 0.0001; IPF: MD = -0.33, 95% CI:-0.63,-0.03, P < 0.05), depressive symptoms ( ILD:MD = -1.94, 95% CI:-3.67, -0.22, P < 0.05), and improved health-related quality of life( HRQoL) ( ILD:MD = -6.39, 95% CI:-8.67,-4.12, P < 0.00001; IPF: MD = -6.58, 95% CI:-9.42,-3.75, P < 0.00001). In the subgroup with different intervention durations, functional exercise and quality of life improvements were maintained during the short-to long-term follow-up. However, dyspnea was significant only after 6 months of intervention.
Exercise training demonstrated significant improvements in exercise tolerance and HRQoL in patients with ILD, particularly IPF, with sustained benefits observed over long-term intervention. Additionally, exercise alleviates dyspnea and depressive symptoms, with effects maintained during short to medium-term interventions. These findings support the safe incorporation of exercise training into standard therapeutic regimens for ILD. Future studies should prioritize the optimization of high-quality exercise protocols tailored to specific ILD subtypes and determine optimal strategies for maximizing clinical benefits.
基于运动的干预措施对间质性肺疾病（ILD）患者的影响尚未完全明确。为了更好地了解运动训练对功能性运动能力的影响，我们进行了一项荟萃分析。
本系统评价和荟萃分析旨在评估运动训练对成年ILD患者功能性运动能力的影响。
我们检索了从数据库建立至2024年7月的PubMed、Embase、Web of Science和Cochrane图书馆数据库以及纳入文章的参考文献列表。所有纳入运动及相关结果评估成年ILD患者功能性运动能力的随机对照试验（RCT）。使用RevMan V.5.4软件，采用均数差或标准化随机效应模型合并数据，并计算95%置信区间（CI）。我们还使用Cochrane偏倚风险工具和GRADE对证据质量进行评级。
纳入16项RCT，共899名参与者。运动干预显著改善了6分钟步行距离（ILD：均数差（MD）=35.88米，95%CI：22.65 - 49.10，P < 0.00001；特发性肺纤维化（IPF）：MD = 28.84米，95%CI：14.73 - 42.95，P < 0.0001），提高了峰值工作率（ILD：MD = 3.79瓦，95%CI：0.66 - 6.92，P < 0.05；IPF：MD = 5.98瓦，95%CI：2.34 - 9.63，P < 0.01）、最大摄氧量（IPF：MD = 0.84毫升/千克/分钟，95%CI：0.18 - 1.50，P < 0.05），减轻了呼吸困难（ILD：MD = -0.46，95%CI：-0.68，-0.23，P < 0.0001；IPF：MD = -0.33，95%CI：-0.63，-0.03，P < 0.05）、抑郁症状（ILD：MD = -1.94，95%CI：-3.67，-0.22，P <
