Principles of Rehabilitation and Reactivation: Interstitial Lung Disease, Sarcoidosis and Rheumatoid Disease with Respiratory Involvement

The interstitial lung diseases (ILDs) are characterised by dyspnoea on exertion, exercise-induced hypoxaemia, reduced skeletal muscle function and exercise intolerance. Evidence from nine randomised controlled trials shows that pulmonary rehabilitation improves exercise capacity, dyspnoea and quality of life in ILD, with moderately large effect sizes from 0.59 to 0.68. Participants with idiopathic pulmonary fibrosis, the most common and most progressive of the ILDs, achieve benefits in exercise capacity and quality of life that are of equal magnitude to those seen in other ILDs, with effect sizes from 0.59 to 0.75. Whole body exercise training is a core component of pulmonary rehabilitation for ILD. The standard exercise prescription used for other chronic lung diseases is effective in ILD, including 8 weeks of training with at least two supervised sessions per week and at least 30 min of aerobic training per session. However, the unique presentation and underlying pathophysiology of ILD may require modifications of the exercise prescription for individual patients. Those with connective tissue disease may present with joint pain and stiffness that require modification of the standard exercise prescription, including reduction in weight-bearing exercise. Some patients with severe disease Published online: January 21, 2015 Anne E. Holland Department of Physiotherapy, La Trobe University Level 4, The Alfred Centre, 99 Commercial Rd Melbourne, VIC 3004 (Australia) E-Mail a.holland @ alfred.org.au © 2015 S. Karger AG, Basel 0025–7931/15/0892–0089$39.50/0 www.karger.com/res Previous article in this series: Osadnik CR, Rodrigues FMM, Camillo CA, Loeckx M, Janssens W, Dooms C, Troosters T: Principles of rehabilitation and reactivation. Respiration 2015;89:2–11. D ow nl oa de d by : 54 .1 91 .4 0. 80 9 /1 7/ 20 17 3 :5 4: 45 A M