Safety of Pulmonary Rehabilitation in Acute Exacerbations of Interstitial Lung Disease: A Multicentre Study

ABSTRACT Background and Objective The safety of pulmonary rehabilitation (PR) during acute exacerbations of interstitial lung disease (AE‐ILD) remains uncertain. Utilising a real‐world, multicentre clinical context, this study investigated the incidence of PR associated adverse events in hospitalised patients with AE‐ILD. Methods This multicentre, prospective observational study was conducted over 82 months at five hospitals in Japan. A total of 295 patients with AE‐ILD who received PR during hospitalisation were enrolled. Seven types of adverse events were predefined, and their incidence during daily PR sessions was recorded. Patient characteristics, PR content, and clinical outcomes were analysed. Results A total of 3986 PR sessions were performed. Twenty‐four adverse events (0.6%) were reported, the most common of which was transient hypoxaemia (SpO 2 < 85% for > 3 min; 79.2%), followed by hypotension (12.5%) and arrhythmia (8.3%). None of the adverse events required additional treatment or prolonged hospitalisation. Patients who experienced adverse events had significantly lower baseline functional status and underwent more PR sessions than those without adverse events. Conclusion PR during AE‐ILD was found to be safe when delivered by trained physiotherapists following appropriate risk management procedures. Study findings provide novel evidence supporting the implementation of PR as part of comprehensive care, including during AE‐ILD.