The timing of the commencement of pulmonary rehabilitation in hospitalized patients with acute exacerbation of COPD: a systematic review and network meta-analysis

Initiating PR within two weeks post-discharge is most effective for reducing readmissions, alleviating dyspnoea, and enhancing quality of life, whereas initiating after 48 h of admission provides greater benefits for improving exercise capacity. These findings support a pragmatic rehabilitation pathway combining early in-hospital and structured post-discharge PR. Further high-quality RCTs are needed to confirm optimal timing strategies.