Home-based Pulmonary Rehabilitation in Interstitial Lung Disease

Pulmonary rehabilitation (PR) is a comprehensive, multidisciplinary intervention incorporating exercise training, education, and behavior change, shown to improve dyspnea, exercise capacity, and health-related quality of life (HRQoL) in ILD patients. However, access to center-based PR is limited in many settings, including ours, due to geographic, logistical, and socioeconomic barriers. Home-based pulmonary rehabilitation (HPR) may offer a scalable, accessible alternative with comparable outcomes to conventional PR. The drawback of HPR is the lack of monitoring, which may be overcome by incorporating a telemonitoring program to improve adherence. Data on the effectiveness of HPR in ILD populations-especially in resource-limited settings-are scarce. Therefore, this study aims to evaluate the impact of a 6-week home-based PR program on HRQoL and exercise capacity in patients with fibrotic ILD in India. The study hypothesis is that participants undergoing HPR will demonstrate clinically meaningful improvements in disease-specific HRQoL and six-minute walk distance compared to those receiving usual care.

Inclusion Criteria: 1. Age between 18 and 75 years 2. Diagnosis of an ILD by clinician using standard guidelines 3. Having breathlessness graded 1 to 3 on the modified Research Council (mMRC) scale 4. On stable therapy with immunosuppressants or antifibrotics for 3 or more months Exclusion Criteria: 1. Pregnant or lactating women 2. Unwilling to participate in the study 3. Not able to walk or perform upper and lower limb movements 4. Requiring supplemental oxygen