Abstract：
OBJECTIVE: This study was designed to synthesize the efficacy and safety of breathing exercises in interstitial lung disease (ILD) patients by reviewing the literature and comparing the impact of different control group types, ILD subtypes, breathing exercise action modes or methods, and intervention durations on clinical efficacy.
METHODS: Systematic searches were conducted across 9 electronic databases, including PubMed, to retrieve English and Chinese studies reporting on ILD patients from inception to February 12, 2024. Study selection and data extraction were independently conducted by two researchers. The quality of the included studies was assessed using the Cochrane risk of bias tool. The data were analysed using RevMan 5.4 and STATA 17.0 software.
RESULTS: The search identified 25 studies. Compared to the control group, the breathing exercise group exhibited significantly improved lung function (FVC%pred: MD = 3.46, 95%CI = 1.04 to 5.88; DLCO%pred: MD = 3.20, 95% CI = 2.91 to 3.48), dyspnoea (MRC or mMRC scale: MD = - 0.50, 95%CI = - 0.77 to - 0.22), exercise capacity (6MWD: MD = 32.65, 95% CI = 14.77 to 50.53), and HRQoL (SGRQ: MD = - 6.53, 95% CI = - 8.72 to - 4.34) in ILD patients. According to the subgroup analysis, significant improvements consistent with the overall results were observed in the control group with usual treatment. Compared with the control group, breathing exercises had varying degrees of improvement in the mixed diagnostic group, known-cause group, and fibrotic group of ILD patients; breathing exercises alone significantly improved DLCO%pred, MRC (or mMRC), and SGRQ; and the improvement in breathing exercises as part of pulmonary rehabilitation (PR) was more notable. Different durations of breathing exercise could promote the efficacy of different aspects of treatment for ILD patients.
CONCLUSIONS: Compared with usual treatment, breathing exercises can improve lung function, exercise capacity, and HRQoL in ILD patients, particularly without high requirements for intervention duration. The efficacy of breathing exercises varies for different ILD subtypes, and incorporating breathing exercises as part of PR can be more beneficial for ILD patients. No studies have shown significant risks for ILD patients engaging in breathing exercises.
METHODS: Systematic searches were conducted across 9 electronic databases, including PubMed, to retrieve English and Chinese studies reporting on ILD patients from inception to February 12, 2024. Study selection and data extraction were independently conducted by two researchers. The quality of the included studies was assessed using the Cochrane risk of bias tool. The data were analysed using RevMan 5.4 and STATA 17.0 software.
RESULTS: The search identified 25 studies. Compared to the control group, the breathing exercise group exhibited significantly improved lung function (FVC%pred: MD = 3.46, 95%CI = 1.04 to 5.88; DLCO%pred: MD = 3.20, 95% CI = 2.91 to 3.48), dyspnoea (MRC or mMRC scale: MD = - 0.50, 95%CI = - 0.77 to - 0.22), exercise capacity (6MWD: MD = 32.65, 95% CI = 14.77 to 50.53), and HRQoL (SGRQ: MD = - 6.53, 95% CI = - 8.72 to - 4.34) in ILD patients. According to the subgroup analysis, significant improvements consistent with the overall results were observed in the control group with usual treatment. Compared with the control group, breathing exercises had varying degrees of improvement in the mixed diagnostic group, known-cause group, and fibrotic group of ILD patients; breathing exercises alone significantly improved DLCO%pred, MRC (or mMRC), and SGRQ; and the improvement in breathing exercises as part of pulmonary rehabilitation (PR) was more notable. Different durations of breathing exercise could promote the efficacy of different aspects of treatment for ILD patients.
CONCLUSIONS: Compared with usual treatment, breathing exercises can improve lung function, exercise capacity, and HRQoL in ILD patients, particularly without high requirements for intervention duration. The efficacy of breathing exercises varies for different ILD subtypes, and incorporating breathing exercises as part of PR can be more beneficial for ILD patients. No studies have shown significant risks for ILD patients engaging in breathing exercises.
摘要：
目的：本研究旨在通过回顾文献并比较不同对照组类型的影响来综合间质性肺病（ILD）患者呼吸锻炼的有效性和安全性，ILD亚型,呼吸锻炼动作模式或方法，和干预持续时间对临床疗效的影响。
方法：在9个电子数据库中进行了系统搜索，包括PubMed,检索从开始到2024年2月12日关于ILD患者的英文和中文研究报告。研究选择和数据提取由两名研究人员独立进行。使用Cochrane偏倚风险工具评估纳入研究的质量。使用RevMan5.4和STATA17.0软件分析数据。
结果：搜索确定了25项研究。与对照组相比,呼吸运动组肺功能明显改善(FVC%pred:MD=3.46,95CI=1.04~5.88;DLCO%pred:MD=3.20,95%CI=2.91~3.48),呼吸困难（MRC或mMRC量表：MD=-0.50，95CI=-0.77至-0.22），运动能力（6MWD：MD=32.65，95%CI=14.77至50.53），ILD患者的HRQoL（SGRQ：MD=-6.53，95%CI=-8.72至-4.34）。根据亚组分析,在常规治疗的对照组中观察到与总体结果一致的显著改善.与对照组相比,混合诊断组的呼吸练习有不同程度的改善，已知原因组,和纤维化组的ILD患者;单独的呼吸练习显着改善DLCO%pred,MRC（或mMRC），和SGRQ；作为肺康复（PR）的一部分，呼吸锻炼的改善更为显着。不同持续时间的呼吸锻炼可以提高ILD患者不同治疗方面的疗效。
结论：与常规治疗相比，呼吸练习可以改善肺功能，锻炼能力,和ILD患者的HRQoL，特别是对干预持续时间没有很高的要求。呼吸练习的功效因不同的ILD亚型而异，将呼吸练习作为PR的一部分对ILD患者更有益。没有研究显示ILD患者参与呼吸练习的重大风险。
方法：在9个电子数据库中进行了系统搜索，包括PubMed,检索从开始到2024年2月12日关于ILD患者的英文和中文研究报告。研究选择和数据提取由两名研究人员独立进行。使用Cochrane偏倚风险工具评估纳入研究的质量。使用RevMan5.4和STATA17.0软件分析数据。
结果：搜索确定了25项研究。与对照组相比,呼吸运动组肺功能明显改善(FVC%pred:MD=3.46,95CI=1.04~5.88;DLCO%pred:MD=3.20,95%CI=2.91~3.48),呼吸困难（MRC或mMRC量表：MD=-0.50，95CI=-0.77至-0.22），运动能力（6MWD：MD=32.65，95%CI=14.77至50.53），ILD患者的HRQoL（SGRQ：MD=-6.53，95%CI=-8.72至-4.34）。根据亚组分析,在常规治疗的对照组中观察到与总体结果一致的显著改善.与对照组相比,混合诊断组的呼吸练习有不同程度的改善，已知原因组,和纤维化组的ILD患者;单独的呼吸练习显着改善DLCO%pred,MRC（或mMRC），和SGRQ；作为肺康复（PR）的一部分，呼吸锻炼的改善更为显着。不同持续时间的呼吸锻炼可以提高ILD患者不同治疗方面的疗效。
结论：与常规治疗相比，呼吸练习可以改善肺功能，锻炼能力,和ILD患者的HRQoL，特别是对干预持续时间没有很高的要求。呼吸练习的功效因不同的ILD亚型而异，将呼吸练习作为PR的一部分对ILD患者更有益。没有研究显示ILD患者参与呼吸练习的重大风险。
