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 disease associated with significant dyspnea and limited exercise capacity. This systematic review aimed to synthesize evidence of exercise interventions during pulmonary rehabilitation that aim to improve exercise capacity, dyspnea, and healthrelated quality of life (HRQL) in IPF patients. Methods: Searches were performed in MEDLINE, Embase, CENTRAL, SPORTDiscus, PubMed and PEDro from inception to January 2019 using search terms for: (I) participants: 'IPF or interstitial lung disease'; (II) interventions: 'aerobic training or resistance training or respiratory muscle training'; and (III) outcomes: 'exercise capacity or dyspnea or health-related quality of life'. Two reviewers independently screened titles, abstracts and full texts to identify eligible studies. Methodological quality of studies was assessed using the Downs and Black checklist and meta-analyses were performed. Results: Of 1,677 articles identified, 14 were included (four randomized controlled trials and 10 prospective pre-post design studies) that examined 362 patients receiving training and 95 control subjects. Exercise capacity was measured with the 6-minute walk distance, peak oxygen consumption, peak work rate, or endurance time for constant work rate cycling, which increased after exercise [aerobic exercise; aerobic and breathing exercises; aerobic and inspiratory muscle training (IMT) exercises] compared to the control groups. Dyspnea scores improved after aerobic and breathing exercises. HRQL also improved after aerobic exercise training alone or combined with breathing exercises. Aerobic training alone or combined with IMT or breathing exercises improved exercise capacity. Conclusions: Breathing exercises appears to complement exercise training towards improved dyspnea and HRQL in patients with IPF.

Integrative medicine considerations for convalescence from mild-to-moderate COVID-19 disease

“…92 , 93 Hanada et al published a systematic review of 14 studies examining the effect of specific types of pulmonary rehabilitation (PR) on hypoxia and pulmonary function in patients with idiopathic pulmonary fibrosis (IPF). 94 The authors report that aerobic exercise plus either diaphragmatic breathing exercises or inspiratory muscle training (IMT) significantly increased 6-minute walk distance, leading the authors to conclude that breath work added to aerobic exercise may be an important addition to the treatment of pulmonary fibrosis. 95 Borge et al did a systematic review of breathing exercises including diaphragmatic breathing (DB), pursed-lip breathing (PLB), yoga breathing relaxation techniques (RT), and body position exercises (BPEs) in COPD patients.…”

Thromboinflammation and COVID-19: The Role of Exercise in the Prevention and Treatment

“…A minimum of 150 min per week (30 min−5 days/week) of moderate aerobic exercise (5-7 on a scale of 0-10, where 0 is super easy and 10 is exhaustive) was recommended by the American College of Sports Medicine to achieve the health benefits of exercise. Moderate aerobic exercise is applied to improve immunity and metabolic complications that can reduce the poor prognosis of COVID-19 (23).…”

Effect of Home-Based Pulmonary Rehabilitation on Functional Capacity in People With Idiopathic Pulmonary Fibrosis- A Systematic Review Protocol

“…Pharmacotherapy (pirfenidone and nintedanib) is a promising approach in the management of mild to moderately impaired lung function tests among IPF 8 . Additionally, IPF involves the application of homebased pulmonary rehabilitation (PR) program to optimise functional outcomes 9,10 . Individually tailored exercise training is the cornerstone of PR.…”

“…Individually tailored exercise training is the cornerstone of PR. The exercise training component included both aerobic and strength training 9,11 and each session may consist of up to 30 minutes of aerobic training 12 . PR, a systematic technique, improves dyspnoea, enhances exercise e ciency, and improves health-related quality of life (HRQoL) 13 .…”

“…Previous systematic reviews for supervised exercise training programs have exhibited clinical bene ts in ameliorating exercise capacity, dyspnoea and quality of life in individuals with IPF 9,12,22 . A systematic review 9 included studies conducted a mixture of centre-and home-based setting to assess the effects of exercise-based PR in individuals with IPF. As the subgroup analysis was not conducted it is di cult to comment on which of the two settings proved to be bene cial.…”