Effects of exercise training on exercise capacity of patients with interstitial lung disease: a systematic review and meta-analysis

Abstract Background The effects of exercise-based interventions in patients with interstitial lung disease ( ILD) are not fully understood. To better understand the effects of exercise training on functional exercise capacity, we conducted a meta-analysis. Objective This systematic review and meta-a...

Full description

Saved in:
Bibliographic Details
Main Authors: Qian Zhao, Nan Mo, Rui Li, Tian Tian Wei, WenJin Xu, Jie Wang, ShanShan Li, Huifang Zhu, Guiling Miao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Pulmonary Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12890-025-03804-9
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849344255807455232
author Qian Zhao
Nan Mo
Rui Li
Tian Tian Wei
WenJin Xu
Jie Wang
ShanShan Li
Huifang Zhu
Guiling Miao
author_facet Qian Zhao
Nan Mo
Rui Li
Tian Tian Wei
WenJin Xu
Jie Wang
ShanShan Li
Huifang Zhu
Guiling Miao
author_sort Qian Zhao
collection DOAJ
description Abstract Background The effects of exercise-based interventions in patients with interstitial lung disease ( ILD) are not fully understood. To better understand the effects of exercise training on functional exercise capacity, we conducted a meta-analysis. Objective This systematic review and meta-analysis aimed to evaluate the effects of exercise training on the functional exercise capacity of adults with ILD. Methods We searched the PubMed, Embase, Web of Science, and Cochrane Library databases from inception to July 2024 and the reference lists of the included articles. All RCT that included exercises and outcomes assessed the functional exercise capacity of adults with ILD. Data were pooled with the mean difference or standardized, random-effect model, and 95% confidence intervals ( CI) using RevMan V.5.4. We also used Cochrane risk-of-bias tool and GRADE to rate the quality of the evidence. Results Sixteen RCTs with 899 participants were included. Exercise interventions significantly improved 6MWD ( ILD: MD = 35.88 m(m), 95% CI: 22.65–49.10, P < 0.00001; IPF: MD = 28.84 m, 95% CI: 14.73–42.95, P < 0.0001), enhanced peak work rate ( ILD: MD = 3.79 watts, 95% CI: 0.66–6.92, P < 0.05; IPF: MD = 5.98 watts, 95% CI: 2.34–9.63, P < 0.01), VO2 peak ( IPF: MD = 0.84 ml/kg/min, 95% CI: 0.18–1.50, P < 0.05), alleviate dyspnea ( ILD:MD = -0.46, 95% CI:-0.68,-0.23, P < 0.0001; IPF: MD = -0.33, 95% CI:-0.63,-0.03, P < 0.05), depressive symptoms ( ILD:MD = -1.94, 95% CI:-3.67, -0.22, P < 0.05), and improved health-related quality of life( HRQoL) ( ILD:MD = -6.39, 95% CI:-8.67,-4.12, P < 0.00001; IPF: MD = -6.58, 95% CI:-9.42,-3.75, P < 0.00001). In the subgroup with different intervention durations, functional exercise and quality of life improvements were maintained during the short-to long-term follow-up. However, dyspnea was significant only after 6 months of intervention. Conclusion Exercise training demonstrated significant improvements in exercise tolerance and HRQoL in patients with ILD, particularly IPF, with sustained benefits observed over long-term intervention. Additionally, exercise alleviates dyspnea and depressive symptoms, with effects maintained during short to medium-term interventions. These findings support the safe incorporation of exercise training into standard therapeutic regimens for ILD. Future studies should prioritize the optimization of high-quality exercise protocols tailored to specific ILD subtypes and determine optimal strategies for maximizing clinical benefits.
format Article
id doaj-art-5e67a582889f40958ecfab2815f4d57b
institution Kabale University
issn 1471-2466
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series BMC Pulmonary Medicine
spelling doaj-art-5e67a582889f40958ecfab2815f4d57b2025-08-20T03:42:43ZengBMCBMC Pulmonary Medicine1471-24662025-07-0125112110.1186/s12890-025-03804-9Effects of exercise training on exercise capacity of patients with interstitial lung disease: a systematic review and meta-analysisQian Zhao0Nan Mo1Rui Li2Tian Tian Wei3WenJin Xu4Jie Wang5ShanShan Li6Huifang Zhu7Guiling Miao8Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolDepartment of Nursing, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolDepartment of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolDepartment of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolDepartment of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolDepartment of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolDepartment of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolDepartment of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolAbstract Background The effects of exercise-based interventions in patients with interstitial lung disease ( ILD) are not fully understood. To better understand the effects of exercise training on functional exercise capacity, we conducted a meta-analysis. Objective This systematic review and meta-analysis aimed to evaluate the effects of exercise training on the functional exercise capacity of adults with ILD. Methods We searched the PubMed, Embase, Web of Science, and Cochrane Library databases from inception to July 2024 and the reference lists of the included articles. All RCT that included exercises and outcomes assessed the functional exercise capacity of adults with ILD. Data were pooled with the mean difference or standardized, random-effect model, and 95% confidence intervals ( CI) using RevMan V.5.4. We also used Cochrane risk-of-bias tool and GRADE to rate the quality of the evidence. Results Sixteen RCTs with 899 participants were included. Exercise interventions significantly improved 6MWD ( ILD: MD = 35.88 m(m), 95% CI: 22.65–49.10, P < 0.00001; IPF: MD = 28.84 m, 95% CI: 14.73–42.95, P < 0.0001), enhanced peak work rate ( ILD: MD = 3.79 watts, 95% CI: 0.66–6.92, P < 0.05; IPF: MD = 5.98 watts, 95% CI: 2.34–9.63, P < 0.01), VO2 peak ( IPF: MD = 0.84 ml/kg/min, 95% CI: 0.18–1.50, P < 0.05), alleviate dyspnea ( ILD:MD = -0.46, 95% CI:-0.68,-0.23, P < 0.0001; IPF: MD = -0.33, 95% CI:-0.63,-0.03, P < 0.05), depressive symptoms ( ILD:MD = -1.94, 95% CI:-3.67, -0.22, P < 0.05), and improved health-related quality of life( HRQoL) ( ILD:MD = -6.39, 95% CI:-8.67,-4.12, P < 0.00001; IPF: MD = -6.58, 95% CI:-9.42,-3.75, P < 0.00001). In the subgroup with different intervention durations, functional exercise and quality of life improvements were maintained during the short-to long-term follow-up. However, dyspnea was significant only after 6 months of intervention. Conclusion Exercise training demonstrated significant improvements in exercise tolerance and HRQoL in patients with ILD, particularly IPF, with sustained benefits observed over long-term intervention. Additionally, exercise alleviates dyspnea and depressive symptoms, with effects maintained during short to medium-term interventions. These findings support the safe incorporation of exercise training into standard therapeutic regimens for ILD. Future studies should prioritize the optimization of high-quality exercise protocols tailored to specific ILD subtypes and determine optimal strategies for maximizing clinical benefits.https://doi.org/10.1186/s12890-025-03804-9Interstitial lung diseaseExercise trainingSystematic reviewMeta-analysis
spellingShingle Qian Zhao
Nan Mo
Rui Li
Tian Tian Wei
WenJin Xu
Jie Wang
ShanShan Li
Huifang Zhu
Guiling Miao
Effects of exercise training on exercise capacity of patients with interstitial lung disease: a systematic review and meta-analysis
BMC Pulmonary Medicine
Interstitial lung disease
Exercise training
Systematic review
Meta-analysis
title Effects of exercise training on exercise capacity of patients with interstitial lung disease: a systematic review and meta-analysis
title_full Effects of exercise training on exercise capacity of patients with interstitial lung disease: a systematic review and meta-analysis
title_fullStr Effects of exercise training on exercise capacity of patients with interstitial lung disease: a systematic review and meta-analysis
title_full_unstemmed Effects of exercise training on exercise capacity of patients with interstitial lung disease: a systematic review and meta-analysis
title_short Effects of exercise training on exercise capacity of patients with interstitial lung disease: a systematic review and meta-analysis
title_sort effects of exercise training on exercise capacity of patients with interstitial lung disease a systematic review and meta analysis
topic Interstitial lung disease
Exercise training
Systematic review
Meta-analysis
url https://doi.org/10.1186/s12890-025-03804-9
work_keys_str_mv AT qianzhao effectsofexercisetrainingonexercisecapacityofpatientswithinterstitiallungdiseaseasystematicreviewandmetaanalysis
AT nanmo effectsofexercisetrainingonexercisecapacityofpatientswithinterstitiallungdiseaseasystematicreviewandmetaanalysis
AT ruili effectsofexercisetrainingonexercisecapacityofpatientswithinterstitiallungdiseaseasystematicreviewandmetaanalysis
AT tiantianwei effectsofexercisetrainingonexercisecapacityofpatientswithinterstitiallungdiseaseasystematicreviewandmetaanalysis
AT wenjinxu effectsofexercisetrainingonexercisecapacityofpatientswithinterstitiallungdiseaseasystematicreviewandmetaanalysis
AT jiewang effectsofexercisetrainingonexercisecapacityofpatientswithinterstitiallungdiseaseasystematicreviewandmetaanalysis
AT shanshanli effectsofexercisetrainingonexercisecapacityofpatientswithinterstitiallungdiseaseasystematicreviewandmetaanalysis
AT huifangzhu effectsofexercisetrainingonexercisecapacityofpatientswithinterstitiallungdiseaseasystematicreviewandmetaanalysis
AT guilingmiao effectsofexercisetrainingonexercisecapacityofpatientswithinterstitiallungdiseaseasystematicreviewandmetaanalysis