Current best practice in rehabilitation in interstitial lung disease

Abstract

Interstitial lung disease (ILD) is a group of chronic respiratory diseases characterized by dyspnoea on exertion and decline in health-related quality of life (HRQL). People with ILD experience significant exercise limitation with contributors that include ventilatory limitation, impaired gas exchange, decreased cardiac function and skeletal muscle dysfunction. Pulmonary rehabilitation (PR) is well established in patients with chronic obstructive pulmonary disease (COPD) as a means to overcome exercise limitation and improve activity-related dyspnoea. There is increasing evidence for similar effects of PR in people with ILD. This review discusses the evidence for PR in ILD, outlines the essential components of PR in this population, and highlights special considerations for exercise training in people with ILD. Possible future directions for PR research in people with ILD are explored.

Keywords: education; exercise limitation; exercise training; interstitial lung disease; pulmonary rehabilitation.

Figure 1.

Comprehensive pulmonary rehabilitation for interstitial lung disease. The gears with red, green and yellow colour present expected PR outcomes, exercise training and nonexercise training, respectively. The green gear is bigger than the yellow gear, because exercise training has more evidence than nonexercise training. The cogs of gears indicate their components. Comprehensive intervention in PR can be accomplished when the gears mesh together and cogs work well. Cooperation and smooth connection of all gears are vital to make PR successful. HRQL, health-related quality of life; UL, upper limb; LL, lower limb; PR, pulmonary rehabilitation.