The impact of physical activity on people with idiopathic pulmonary fibrosis and the associated experience - a mixed methods structured review.

introductionThe aim of this study is to review literature on the relationship between physical activity (PA) and idiopathic pulmonary fibrosis (IPF), specifically investigating the effect of PA on IPF outcomes reported in RCTs, the relationship between PA and IPF outcomes over time in longitudinal cohort studies and the lived experience of PA among people with IPF in qualitative studies.

methodsFollowing the PRISMA checklist, a structured search strategy was developed by two reviewers and applied to six databases up to June 2024. Grey literature was excluded. Randomised control trials, longitudinal studies and qualitative research papers were included. Screening was completed independently by two reviewers, followed by manual screening. Data extraction was completed manually using extraction tables.

resultsOf 4,092 articles retrieved, fourteen were included: five randomised control trials and one follow-up study; five longitudinal and three qualitative studies. PA significantly improved QOL in four trials that analysed this outcome, with two studies reporting a p-value of < 0.001 and two others reporting p-values of < 0.04 and < 0.01. Longitudinal studies demonstrated low device-measured PA and high self-reported sedentary time correlated with poorer morbidity and mortality. Lower aerobic fitness measured using 6MWT correlated with higher mortality. Qualitative research identified progressing disease and respiratory symptoms as barriers, while social support and telehealth facilitated PA engagement.

conclusionShort-term improvements are observed in physical capacity and QOL by incorporating PA in IPF management. Aerobic testing and PA correlate well with morbidity and mortality outcomes. Positive patient perspective on PA further supports PA prescription in IPF.