Aerobic and Breathing Exercises Improve Dyspnea, Exercise Capacity and Quality of Life in Idiopathic Pulmonary Fibrosis Patients: Systematic Review and Meta-Analysis

Abstract

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease associated with significant dyspnea and limited exercise capacity. The purpose of this systematic review was to synthesize evidence of various exercise interventions that aim to improve exercise capacity and dyspnea in IPF patients. Methods: Comprehensive searches were performed in MEDLINE, Embase, CENTRAL, SPORTDiscus, PubMed and PEDro. Two reviewers independently screened titles, abstracts and full texts to determine eligible studies. Methodological quality of studies was assessed using the Downs and Black checklist and meta-analyses were performed. Results: Of 1499 articles identified, 14 were included (four randomized controlled trials and 10 prospective observational studies with pre-post design). The mean quality assessment score was 58±8%. Aerobic capacity measured by 6 minute walk distance, maximal oxygen consumption and peak work rate significantly improved in the exercise groups (aerobic; aerobic and breathing exercise; aerobic and inspiratory muscle training) versus control groups. Dyspnea scores significantly improved after aerobic and breathing exercises. HRQL increased after aerobic exercise training versus control when measured with St. George’s Respiratory Questionnaire and Short-Form 36 Health Survey. Conclusion: Pulmonary rehabilitation programs with aerobic and breathing exercises are beneficial in IPF patients for improving exercise capacity, dyspnea and quality of life.