Pulmonary rehabilitation in diffuse interstitial lung diseases: evidence and clinical applications

Diffuse interstitial lung diseases (ILD) are a heterogeneous group of diseases characterized by inflammation and fibrosis in the pulmonary interstitium, significantly affecting the gas exchange capacity and quality of life of patients. The most common forms of ILD include idiopathic pulmonary fibrosis (IPF), sarcoidosis, and interstitial pneumonias associated with autoimmune diseases, all of which have a considerable impact on respiratory function. The management of ILD is complex, including pharmacological treatments and non-pharmacological interventions, such as pulmonary rehabilitation (PR) programs, essential for the improvement of symptoms and quality of life. Pulmonary rehabilitation involves physical training, patient education, and psychosocial support, aiming to increase exercise tolerance and reduce symptoms. RR is tailored to the individual needs of patients, taking into account the severity of hypoxemia and associated comorbidities. Recent studies suggest that RR can have a significant positive impact on patients with ILD, even in advanced forms of the disease. Pulmonary rehabilitation programs are performed by multidisciplinary teams and require detailed assessments for appropriate adjustment of the exercises. The core component includes aerobic and strength exercises, adapted to prevent desaturation and excessive fatigue. Psychological support is also essential, given that patients frequently experience anxiety and depression. Through a personalized approach, pulmonary rehabilitation offers patients with ILD an effective way to manage symptoms, thereby improving residual lung function and quality of life. This intervention is becoming an integral part of the care of patients with progressive lung disease, with documented long-term benefits.