This prospective, multicentre observational study evaluated the safety of pulmonary rehabilitation (PR) during acute exacerbations of interstitial lung disease (AE-ILD) in 295 hospitalised patients across five Japanese hospitals over 82 months, tracking seven predefined adverse event types across all PR sessions.
Across 3,986 PR sessions, only 24 adverse events occurred (0.6% of sessions). Transient hypoxaemia (SpO2 <85% for >3 min) accounted for 79.2% of events, followed by hypotension (12.5%) and arrhythmia (8.3%). Critically, none of the adverse events required additional treatment or prolonged hospitalisation.
- Single-country (Japan) multicentre design limits generalisability to other healthcare settings and patient populations. - Observational design precludes causal conclusions about PR and outcomes. - No control group of AE-ILD patients not receiving PR, so comparative safety or efficacy cannot be assessed.
PR can be delivered safely to hospitalised AE-ILD patients when performed by trained physiotherapists with appropriate risk management protocols in place. Clinicians should be especially vigilant in patients with lower baseline functional status, who had a higher rate of adverse events.
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