Although exercise training in interstitial lung disease (ILD) has been shown to be both safe and effective, it should be customised in the individual patient. Moreover, access to pulmonary rehabilitation for patients with idiopathic pulmonary fibrosis (IPF) needs to improve in the Nordic countries.
According to Dr Jana de Brandt (Umeå University, Sweden), the ATS/ERS/JRS/ALAT Guideline provides specific recommendations for pulmonary rehabilitation for patients with IPF who have a generally poor prognosis and for whom there is no cure, apart from a possible lung transplantation [1,2]. The aims of exercise training within the relatively short lifespan left for these patients should primarily focus to improve quality of life and, if eligible for lung transplantation, to optimally prepare patients for surgery. Whether pulmonary rehabilitation is effective on different disease parameters in ILD was assessed in a literature review. Randomised controlled trials and quasi‐randomised controlled trials implementing pulmonary rehabilitation were compared with no pulmonary rehabilitation or with other interventions in patients with ILD (see Table) .
Table: Effectiveness of pulmonary rehabilitation on various disease parameters in ILD 
A study by Perez-Bogerd et al. demonstrated that it is feasible for ILD patients to undertake pulmonary rehabilitation with 69% of patients with IPF completing the program compared with 63% of patients with COPD . However, some considerations need to be considered when prescribing pulmonary rehabilitation in IPF, Dr de Brandt mentioned. “Early referral, well-trained staff, and comorbidities are important issues, and the training program should be customised accordingly. Also, training does not stand alone; education and self-management are also key components of the program which we offer our ILD patients [5,6].”
Dr de Brandt noted that access to non-pharmacological treatment for IPF patients – including pulmonary rehabilitation – is very patchy across Europe. For instance, Finland has no pulmonary rehabilitation services specialised for ILD patients and pulmonary rehabilitation is even unavailable in some university hospitals. In Denmark, pulmonary rehabilitation is limited and often not designed for patients with ILD . “This means there is a big challenge lying ahead of us,” concluded Dr de Brandt .
- Strongman H, et al. Adv Ther. 2018 May;35(5):724-736.
- Raghu G, et al. Adv Ther. 2022;205(9):e18–e47.
- Dowman L, et al. Cochrane Database Syst Rev. 2021 Feb 1;2(2):CD006322.
- Perez-Bogerd S, et al. Respir Res. 2018 Sep 20;19(1):182.
- Matsuo S, et al. J Clin Med. 2021;10(14):3153.
- Wickerson L, et al. J Cardiopulm Rehabil Prev. 2018 Nov;38(6):419-424.
- EU-IPFF. https://www.eu-ipff.org/who-we-are
- De Brandt J. Exercise adaptations and -prescription in IPF. Nordic Lung Congress 2022, 01–03 June, Copenhagen, Denmark.
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Table of Contents: NLC 2022
NLC 2022 Highlights Podcast
Respiratory Disease and Physical Activity
Physical activity improves asthma control
Tailored exercise needed for COPD patients
Exercise training for IPF patients is feasible but access needs to be improved
Respiratory Disease and Reproduction
Asthma increases risks around delivery
PRO-ART study: unravelling the link between asthma and subfertility
Early-onset and uncontrolled asthma: strong association with recurrent pregnancy loss
Palliative Care in Respiratory Diseases
Advance care planning
Biologics in Asthma
Severe asthma in the spotlights
Common comorbidities in severe asthma
Treatable Traits in Obstructive Airway Diseases
Targeting treatable traits allows a personalised approach to management of (severe) asthma
Challenges in Upper Airway Diseases
Exercise-induced laryngeal obstruction (EILO) is often misdiagnosed
The role of biologics in CRSwNP
The ULANC Group: working together in CRSwNP/asthma
Interstitial Lung Diseases (ILD)
Rheumatoid arthritis-associated ILD
Thoracic ultrasound: a new diagnostic imaging tool in RA-ILD?
Update on treatment of fibrotic ILD
Lung Cancer Screening in the Nordics
Lung cancer screening in Denmark
Points of interest for radiologists screening for lung cancer
E-cigarettes impose detrimental effects on health
Effects of passive vaping in COPD patients
Vaping amongst adolescents: an alarming trend
Tuberculosis and Sarcoidosis
New antigens in sarcoidosis
Detection of latent TB infection key to preventing the spread of the disease
New antigens in sarcoidosis
Fatigue syndrome in sarcoidosis