Pulmonary rehabilitation in patients with interstitial lung disease associated with rheumatoid arthritis or connective tissue disease: From mechanisms to practice

Abstract

Interstitial lung diseases are a large group of lung conditions characterized by inflammation and fibrosis. Interstitial lung disease in connective tissue diseases and rheumatoid arthritis is a severe complication of these pathologies. Apart from the pharmacological treatment, exercise training could help reduce breathing difficulties and increase physical strength, lower the burden of disease, help improving self-esteem and fight against depression and anxiety. Exercise training can be done either alone, or enhanced by auxiliary methods like oxygen administration, neuromuscular electrical stimulation or improving the strength of respiratory muscles. Possible associated lung diseases should be always taken into account. Even if exercise training is generally considered safe for this category of patients, there are also risks like exercise-induced hypoxemia, arrhythmia or pulmonary hypertension. Exercise training in this setting should be performed by dedicated physiotherapists after specialist prescription and under surveillance in a safe environment.