Rehabilitation in Pulmonary Fibrosis

Pulmonary fibrosis encompasses idiopathic pulmonary fibrosis and other progressive fibrosing interstitial lung diseases that cause progressive dyspnea, reduced exercise capacity, and oxygen desaturation. Antifibrotic therapy with pirfenidone or nintedanib slows decline but does not address symptom burden directly.

Pulmonary rehabilitation is a guideline-recommended intervention that improves six-minute walk distance, dyspnea scores, and health-related quality of life in interstitial lung disease. Programs typically run for eight to twelve weeks with two to three supervised sessions per week and include aerobic exercise on treadmill or cycle and resistance training.

Oxygen titration during exercise prevents desaturation below ninety percent saturation and supports prescription of ambulatory oxygen for patients with exertional desaturation. Breathing retraining with pursed-lip and diaphragmatic patterns reduces dyspnea, and education on energy conservation, anxiety management, and advance care planning addresses the psychosocial burden of progressive disease.