Effectiveness of Tele-rehabilitation in idiopathic pulmonary fibrosis: a systematic review and meta-analysis

For idiopathic pulmonary fibrosis (IPF), pulmonary rehabilitation (PR) offers clinical benefits but faces accessibility challenges. Tele-rehabilitation (TR) utilizes digital solutions to expand PR access. This systematic review evaluates the therapeutic impact of TR on pulmonary function, exercise capacity, dyspnea severity, and health-related quality of life among patients with IPF. A systematic search of 5 international databases identified qualifying studies published up to April 2025. Analyses were carried out in R software, with effect estimates presented as mean differences (MDs) and 95% confidence intervals. The analysis included 6 trials (4 randomized controlled trials and 2 single-arm prospective studies) totaling 195 participants. Exercise capacity, evaluated using the 6-minute walk distance (6MWD), exhibited a significant improvement (MD = 36.48, P < 0.001) compared to control groups at 8–12 weeks. Pre- and post-intervention comparisons indicated statistically significant enhancements in 6MWD following the TR intervention at 8–24 weeks (MD = 37.46, P < 0.001). The burden of dyspnea, assessed via the modified British Medical Research Council (mMRC) scale, significantly decreased following TR implementation at 8–12 weeks (MD=-1.18, P < 0.001). In terms of quality-of-life measures, although the TR group showed improved mean total King’s Brief Interstitial Lung Disease (K-BILD) questionnaire scores at 24 weeks in intergroup (MD = 4.97, P = 0.118) and pre-post intragroup comparisons (MD = 1.60, P = 0.525), these changes did not achieve statistical significance. Regarding pulmonary function metrics, the forced vital capacity (FVC) percentage predicted increased from baseline to 8–12 weeks follow-up in the TR cohort; however, these differences were not statistically significant (MD = 1.06, P = 0.608). This systematic review and meta‑analysis suggests that tele‑rehabilitation may significantly improve exercise capacity and dyspnoea in patients with IPF. However, due to the limited number of studies and short follow‑up periods, no firm conclusions can be drawn regarding changes in lung function (e.g., FVC). Larger, long‑term RCTs are warranted to confirm these preliminary findings.