Abstract
Interstitial lung diseases (ILDs) comprise a heterogeneous group of disorders (such as idiopathic pulmonary fibrosis, sarcoidosis, asbestosis, and pneumonitis) characterized by lung parenchymal impairment, inflammation, and fibrosis. The shortness of breath (i.e., dyspnea) is a hallmark and disabling symptom of ILDs. Patients with ILDs may also exhibit skeletal muscle dysfunction, oxygen desaturation, abnormal respiratory patterns, pulmonary hypertension, and decreased cardiac function, contributing to exercise intolerance and limitation of day-to-day activities. Pulmonary rehabilitation (PR) including physical exercise is an evidence-based approach to benefit functional capacity, dyspnea, and quality of life in ILD patients. However, despite recent advances and similarities with other lung diseases, the field of PR for patients with ILD requires further evidence. This mini-review aims to explore the exercise-based PR delivered around the world and evidence supporting prescription modes, considering type, intensity, and frequency components, as well as efficacy and safety of exercise training in ILDs. This review will be able to strengthen the rationale for exercise training recommendations as a core component of the PR for ILD patients.
Highlights
Numerous pathophysiological responses to exercise are observed in interstitial lung disease (ILD) patients, such as ventilatory, diffusional, cardiovascular, and skeletal
Moderno et al [75] evaluated ILD patients during three submaximal exercise tests (60% of maximum load) in three different situations: with proportional assist ventilation, with continuous positive airway pressure and without ventilatory support; the results suggest that patients on proportional assist ventilation had greater increased exercise tolerance and reduction in oxygenation and dyspnea
Pulmonary rehabilitation (PR) is an important part of comprehensive care for ILD patients in a similar way to chronic obstructive pulmonary disease patients [63]
Summary
Exercise-Rehabilitation for Interstitial Lung Diseases of the lung parenchyma, resulting in the presence of dyspnea, decreased pulmonary function, impaired gas exchange, reduced cardiovascular function, and exercise intolerance [2, 3]. Numerous pathophysiological responses to exercise are observed in ILD patients, such as ventilatory (i.e., abnormal breathing patterns, ventilatory inefficiency, higher oxygen cost of breathing), diffusional (i.e., impaired pulmonary gas exchange, arterial hypoxemia), cardiovascular (i.e., increased pulmonary artery pressures), and skeletal
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