Characteristics of rehabilitation programs for chronic respiratory diseases in Asia: A scoping review

The rates of chronic respiratory disease (CRD) is rising in Asia. Pulmonary rehabilitation (PR) has been shown to be a highly efficacious intervention for people with CRD. While PR models are well established in Western countries, environmental, cultural and societal factors may influence how rehabilitation programs for people with CRD are conducted in Asia. This review aims to identify the characteristics of rehabilitation programs for people with CRD within Asia and identify differences between these rehabilitation programs to the recently updated American Thoracic Society (ATS) PR guidelines. Utilising the PRISMA scoping review guidelines, five databases- CINAHL, Medline, Embase, Web of Science and Health and Medical Collection were searched from inception until 13th December 2023. A total of 137 studies (n = 19,128) were included in the review. As many as 113 studies (83 %) included aerobic exercises as part of rehabilitation, only 90 studies (66 %) included resistance training. Thirty-nine studies included interventions such as Tai Chi, Qigong and Yoga. Comparing to the 2023 ATS PR guidelines, only 22 % of the included studies evaluated a rehabilitation program that was consistent with the guidelines. Improvement in exercise capacity (76 %) and quality of life (QOL) (73 %) were the most frequent outcomes used to evaluate program efficacy. The results suggest that models of rehabilitation varied greatly within the Asia region, with some more heavily adapted to suit the local context as compared to others. Further consideration on how to balance adaptation of PR with fidelity of the intervention needs to be taken.