Abstract
Interstitial lung diseases are a large group of lung conditions characterized by inflammation and fibrosis. Interstitial lung disease in connective tissue diseases and rheumatoid arthritis is a severe complication of these pathologies. Apart from the pharmacological treatment, exercise training could help reduce breathing difficulties and increase physical strength, lower the burden of disease, help improving self-esteem and fight against depression and anxiety. Exercise training can be done either alone, or enhanced by auxiliary methods like oxygen administration, neuromuscular electrical stimulation or improving the strength of respiratory muscles. Possible associated lung diseases should be always taken into account. Even if exercise training is generally considered safe for this category of patients, there are also risks like exercise-induced hypoxemia, arrhythmia or pulmonary hypertension. Exercise training in this setting should be performed by dedicated physiotherapists after specialist prescription and under surveillance in a safe environment.
Highlights
Interstitial lung diseases (ILD) are a large group of chronic lung conditions patophysiologically defined by chronic lung inflammation associated with scarring of the tissue
External factors such as infections, gastroesophageal reflux disease (GERD), smoking, environmental toxins, certain medication, can lead to epithelial cell injury and aberrant repair, alveolar macrop hage activation, neutrophil recruitment, and oxidative stress. In this context of exposures, the host’s immune tolerance is affected, leading to chronic inflammation. All these cellular processes eventually are ending in alveolar destruction, endothelial cell dysfunction, collagen deposition; over time, increased extracellular matrix turnover will result in the development of fibrosis
Even though there are no specific guidelines regarding the pulmonary rehabilitation in the treatment of patients with connective tissue diseases (CTDs)-ILD and rheumatoid arthritis (RA)-ILD, there is no evidence to suggest that physical exercise has severe adverse effects on these patients, either
Summary
Interstitial lung diseases (ILD) are a large group of chronic lung conditions patophysiologically defined by chronic lung inflammation associated with scarring of the tissue. These diseases are characterized by a restrictive ventilatory pattern [1]. External factors such as infections, gastroesophageal reflux disease (GERD), smoking, environmental toxins, certain medication, can lead to epithelial cell injury and aberrant repair, alveolar macrop hage activation, neutrophil recruitment, and oxidative stress In this context of exposures, the host’s immune tolerance is affected, leading to chronic inflammation (cellular and humoral autoimmunity). The aim of this review is to define the principles of rehabilitation in CTD-ILD and RAILD and to identify other needs that have not been previously addressed
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