Is pulmonary rehabilitation in acute exacerbations of ILD safe?

When done by trained physiotherapists after risk management procedures, pulmonary rehabilitation (PR) during acute exacerbations (AEs) of interstitial lung disease (ILD) is safe, suggests a recent study.

A group of researchers examined the incidence of PR-related adverse events in hospitalized patients with AE-ILD using a real-world, multicentre clinical context. They conducted this prospective observational study over 82 months at five hospitals in Japan.

Overall, 295 patients with AE-ILD who received PR during hospitalization were included in the study. Seven types of adverse events were predefined, and such incidence during daily PR sessions were then recorded. The researchers also analysed patient characteristics, PR content, and clinical outcomes.

Nearly 4,000 PR sessions were performed, with 24 adverse events (0.6 percent) reported. The most common was transient hypoxaemia (SpO₂ <85 percent for >3 min; 79.2 percent), followed by hypotension (12.5 percent) and arrhythmia (8.3 percent). None of these events warranted more treatment or extended hospital stay.

Furthermore, patients who experienced an adverse event had a significantly lower functional status at baseline and went through more PR sessions than those without adverse events.

“[These] findings provide novel evidence supporting the implementation of PR as part of comprehensive care, including during AE-ILD,” the researchers said.