Pulmonary rehabilitation in interstitial lung disease

This review provides a summary of the recent advances in pulmonary rehabilitation in those with interstitial lung diseases (ILD), with focus on the effects of exercise in improving functional capacity and quality of life, the role of education, and the recent rise of virtual rehabilitation as an alternative means of delivery. There has been a large expansion into the use of pulmonary rehabilitation in ILD over the past decade, with experiments occurring across four continents. The recent literature suggests a robust role for pulmonary rehabilitation in the non-pharmacological management of ILD, with metaanalysis reinforcing this claim. Positive effects of ILD are not limited to improved quality of life and functional exercise capacity. Educational portions of rehabilitation complement the physical exercises with expectation management and mental health support. The COVID-19 pandemic fostered the use of virtual pulmonary rehabilitation, which has yielded encouraging results thus far. More evidence is needed to solidify the use of telerehabilitation programs in these patients. Other areas requiring further investigation include the use of pulmonary rehabilitation in post COVID-19 pulmonary fibrosis, as the field is relatively new. As well, inspiratory muscle training and breathing exercises still lack the necessary evidence to support their supplemental or isolated use in ILD.