REVIEW ARTICLE (META-ANALYSIS)
Effectiveness of Pulmonary Rehabilitation in Interstitial Lung Disease, Including Coronavirus Diseases: A Systematic Review and Meta-analysis

https://doi.org/10.1016/j.apmr.2021.03.035Get rights and content

Objective

A meta-analysis of randomized controlled trials (RCTs) was conducted to determine the effect of pulmonary rehabilitation on functional capacity and quality of life in interstitial lung diseases, including those caused by coronaviruses.

Data Sources

MEDLINE, EMBASE, SPORTDiscus, Cochrane Library, Web of Science, and MedRxiv from inception to November 2020 were searched to identify documents.

Study Selection

Publications investigating the effect of pulmonary rehabilitation on lung function (forced vital capacity [FVC]), exercise capacity (6-minute walk distance [6MWD]), health related quality of life (HRQOL), and dyspnea were searched.

Data Extraction

The data were extracted into predesigned data extraction tables. Risk of bias was evaluated with the Cochrane Risk of Bias tool (RoB 2.0).

Data Synthesis

A total of 11 RCTs with 637 interstitial lung disease patients were eligible for analyses. The pooled effect sizes of the association for pulmonary rehabilitation were 0.37 (95% confidence interval [CI], 0.02-0.71) for FVC, 44.55 (95% CI, 32.46-56.64) for 6MWD, 0.52 (95% CI, 0.22-0.82) for HRQOL, and 0.39 (95% CI, –0.08 to 0.87) for dyspnea. After translating these findings considering clinical improvements, pulmonary rehabilitation intervention increased predicted FVC by 5.5%, the 6MWD test improved by 44.55 m, and HRQOL improved by 3.9 points compared with baseline values. Results remained similar in sensitivity analyses.

Conclusions

Although specific evidence for pulmonary rehabilitation of coronavirus disease 2019 patients has emerged, our data support that interstitial lung disease rehabilitation could be considered as an effective therapeutic strategy to improve the functional capacity and quality of life in this group of patients.

Keywords

Coronavirus
COVID-19
Pulmonary fibrosis
Rehabilitation
SARS virus

List of abbreviations

6MWD
6-minute walk distance
CI
confidence interval
CoV
coronavirus
COVID-19
coronavirus disease 2019
ES
effect size
FVC
forced vital capacity
HRQOL
health-related quality of life
ILD
interstitial lung disease
RCT
randomized controlled trial
SARS
severe acute respiratory syndrome

Cited by (0)

Supported by the Consejería de Educación, Cultura y Deportes-Junta de Comunidades de Castilla-La Mancha and Fondo Europeo de Desarrollo Regional funds (grant no. SBPLY/17/180501/000533).

Disclosures: none.

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