Effectiveness of home-based pulmonary rehabilitation in patients with interstitial lung disease: a systematic review and meta-analysis
6 affiliations
- 1Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Taipei City, Taiwan
- 2Department of Internal Medicine, Taipei Tzu Chi Hospital, Taipei City, Taiwan
- 3Department of Chinese Medicine, Taipei Tzu Chi Hospital, Taipei City, Taiwan
- 4School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
- 5Department of Pulmonary Medicine, Taipei Tzu Chi Hospital, Taipei City, Taiwan
- 6School of Medicine, Tzu Chi University, Hualien, Taiwan
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.
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BibTeX
@article{huang2026effectiveness,
title = {{Effectiveness of home-based pulmonary rehabilitation in patients with interstitial lung disease: a systematic review and meta-analysis}},
author = {Chih-Chieh Huang and Yu-Hsu Liu and Po-Chun Hsieh and Chou-Chin Lan},
journal = {BMJ Open Respiratory Research},
year = {2026},
month = nov,
doi = {10.1136/bmjresp-2026-004199},
url = {https://doi.org/10.1136/bmjresp-2026-004199},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Effectiveness of home-based pulmonary rehabilitation in patients with interstitial lung disease: a systematic review and meta-analysis
AU - Chih-Chieh Huang
AU - Yu-Hsu Liu
AU - Po-Chun Hsieh
AU - Chou-Chin Lan
PY - 2026
DA - 2026/11/02
JO - BMJ Open Respiratory Research
DO - 10.1136/bmjresp-2026-004199
UR - https://doi.org/10.1136/bmjresp-2026-004199
AB - 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.
SN - 2052-4439
ER -