Effectiveness of home-based pulmonary rehabilitation in patients with interstitial lung disease: a systematic review and meta-analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background Interstitial lung disease (ILD) is characterised by progressive dyspnoea, reduced exercise capacity and impaired health-related quality of life (HRQoL). Home-based pulmonary rehabilitation (HBPR) may expand access to pulmonary rehabilitation. This study aimed to evaluate the clinical effectiveness of HBPR in adults with ILD.Methods Four databases were searched from inception to 1 May 2025. Randomised controlled trials (RCTs) and pre–post studies (PPS) enrolling adults with ILD undergoing HBPR were included. Primary outcomes were exercise capacity and HRQoL. Secondary outcomes included pulmonary symptoms, emotional status and pulmonary function. Random-effects models were applied using mean difference (MD) or standardised MD (SMD). Subgroup analyses evaluated adherence (≥70% vs <70%), intervention duration and supervision (telerehab vs non-telerehab). Risk of bias was assessed using RoB 2.0 for RCTs and the National Institutes of Health Quality Assessment Tool for uncontrolled PPS.Results 15 studies (7 RCTs, 8 PPS; 685 patients) were included. In RCTs, HBPR was associated with improvements in exercise capacity (6 min walk test MD 20.88 m; 95% CI 1.09 to 40.67) and HRQoL (St. George’s Respiratory Questionnaire MD 5.84 points; 95% CI 3.16 to 8.51) compared with usual care. PPS demonstrated significant postintervention improvements in exercise capacity (SMD 0.68; 95% CI 0.29 to 1.07) and HRQoL (SMD 1.53; 95% CI 0.72 to 2.33), with reductions in anxiety (SMD 0.22; 95% CI 0.07 to 0.38), depression (SMD 0.19; 95% CI 0.03 to 0.35) and fatigue (SMD 0.33; 95% CI 0.13 to 0.52). Subgroup analyses suggested greater effects with longer intervention durations (notably 48 weeks) and structured supervision (telerehab), as well as better HRQoL with adherence ≥70%. Using Grading of Recommendations, Assessment, Development and Evaluation, the overall certainty of evidence was very low to low.Conclusions Current evidence suggests that HBPR, particularly when prolonged, actively supervised and delivered with good adherence, may improve exercise capacity and HRQoL in patients with ILD.
Source: BMJ Open Respiratory Research
Institutions: Taipei Tzu Chi Hospital, Tzu Chi University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,085
OpenAlex ID: W7225099606