If you have pulmonary fibrosis or another interstitial lung disease (ILD), the idea of exercise can feel risky. Breathlessness shows up fast, and it is natural to wonder whether pushing yourself helps or hurts. The short answer from the research is that supervised pulmonary rehab appears to be safe for most people with ILD and probably helps, with some limits worth knowing.
Is pulmonary rehab safe for pulmonary fibrosis and ILD?
A Cochrane review looked at 21 studies with 909 people who had ILD. The authors concluded that pulmonary rehab can be performed safely in people with ILD. Ten studies reported on adverse events, and none occurred during rehab. Four studies recorded one death in a rehab participant, which the researchers judged unrelated to the program. You can read the full summary on the Cochrane page for pulmonary rehab in ILD.
That finding comes from supervised programs. It is not a promise for any one person. Your doctor decides whether rehab is right for you, and a good program watches how you respond and adjusts.
Does pulmonary rehab help ILD? What the research found
The same Cochrane review found these results, with the certainty of the evidence noted by the authors:
- Walking distance improved by about 40 meters right after rehab (moderate certainty), and part of that gain was still there 6 to 12 months later.
- Quality of life probably improved (moderate certainty).
- Breathlessness may have eased (low certainty).
- In people with idiopathic pulmonary fibrosis (IPF), the authors noted that only breathlessness and quality of life may stay better over the longer term.
The authors also said that more well designed trials are needed to find the best exercise plan and ways to make the benefits last, especially in IPF. The effect of rehab on survival over the long term is uncertain. Rehab is a way to feel and function better. It does not treat the scarring itself.
What the American Lung Association says
The American Lung Association describes pulmonary rehab as a program of exercise, education and support to help you learn to breathe and get stronger. It also says that staying physically active is one of the most important things you can do to maintain a good quality of life with pulmonary fibrosis, and it advises talking to your doctor about pulmonary rehab and which exercises you can do at home. See its page on physical activity and pulmonary fibrosis.
What a rehab program does for ILD breathlessness
Exercise matched to your level
Your plan starts where you are today. A clinician sets your walking, strength and stretching work and changes it as you improve. Our article on what happens in a rehab session walks through a typical visit.
Breathing techniques
The American Lung Association notes that deep breathing exercises such as pursed lip or belly breathing may help with breathlessness, and suggests asking your provider about them. See its page on managing symptoms of pulmonary fibrosis.
Using oxygen when you exercise
The American Lung Association says many people find that using oxygen when they exercise is a game changer. If you are prescribed oxygen, use it as directed and tell your rehab team how you use it with activity.
Education and support
Education sessions about your condition may include other patients, which many people find helpful. Every rehab session, the exercise sessions, is one on one.
Know your breathlessness map before you start
Here is something simple you can do this week that most articles skip. For a few days, jot down each activity that leaves you short of breath, such as showering, stairs, carrying groceries or talking on the phone. The American Lung Association advises talking to your provider about which activities cause shortness of breath, because knowing them helps you plan your day. Bring the list to your doctor and to your rehab team. It gives them a real starting point for your plan.
When to call your doctor
The American Lung Association says to call your healthcare provider right away if you have tightness in your chest, pain, fever or trouble breathing, since these can be signs of an acute exacerbation. Call your provider promptly about any new, changing or worsening symptoms.
How to get started with virtual pulmonary rehab
If you have ILD and commercial insurance, virtual pulmonary rehab may let you work with a clinician from home, without travel. Sessions are live by video, every rehab session is one on one, each patient gets an individualized treatment plan, and we meet every patient where they are. Our team includes licensed respiratory therapists and clinical exercise physiologists, and care is billed to commercial insurance. Bloom is not able to accept Medicare at this time. To learn how plans handle rehab, read does insurance cover pulmonary rehab, and for the referral step, see do you need a referral for pulmonary rehab. You can also read about our ILD and pulmonary fibrosis program.
Frequently asked questions
A Cochrane review of 21 studies found that pulmonary rehab can be done safely in people with interstitial lung disease. Of the studies that reported on it, none recorded adverse events during rehab. Your doctor still decides whether it fits you, and your rehab team should know about your oxygen needs and symptoms from the start.
The Cochrane review concluded that pulmonary rehab probably improves exercise capacity, breathlessness and quality of life in the short term. Walking distance improved by about 40 meters on average (moderate certainty). The authors note that more research is needed on the best exercise plan and on how to make gains last.
Often, yes. The American Lung Association says many people with pulmonary fibrosis find that using oxygen when they exercise is a game changer. Use oxygen exactly as your doctor prescribed, and tell your rehab team how much you use at rest and with activity.
No. Pulmonary rehab does not reverse lung scarring. It is a program of exercise, education and support that helps you build strength and learn to manage breathlessness.
Yes. Pulmonary rehab starts with a referral from the doctor treating your lung condition. The American Lung Association suggests talking to your doctor about pulmonary rehab and which exercises you can do at home.
Yes. Bloom offers virtual pulmonary rehab by live video. Every rehab session is one on one, with a personal treatment plan, run by licensed respiratory therapists and clinical exercise physiologists, and billed to commercial insurance. Education sessions about your condition may include other patients. Bloom is not able to accept Medicare at this time.
Next step
Not sure whether rehab fits you? Take our free 2 minute lung health assessment. Ready to talk? Call 1-866-972-8228 or fill out the see if you qualify form.
This article is for education only and is not medical advice. Talk with your doctor about what is right for you.
