Physical Training and Pulmonary Rehabilitation in Patients with Cystic Fibrosis: A Systematic Review and...

Physical training and Pulmonary Rehabilitation in Patients with Cystic Fibrosis: A Systematic Review and Meta-Analysis of Clinical Trials. Pulmonary rehabilitation and physical training are essential components of the comprehensive management of patients with cystic fibrosis. Despite documented benefits for some clinical outcomes, uncertainty exists regarding their overall effects. Therefore, the objective of the present meta-analysis is to determine the effectiveness of physical training and pulmonary rehabilitation in patients with CF.

This systematic review and meta-analysis of randomized controlled trials published between 1990 and 2025 was conducted using the PubMed, Cochrane Clinical Trial, SCOPUS, Science Direct, Web of Science, Scielo, and LILAC databases. The risk of bias was evaluated using the RoB 2 tool, the quality of the evidence with the Jadad scale, and the certainty of the evidence for each outcome was assessed according to GRADE guidelines. This meta-analysis was developed using the statistical packages RevMan 5.4^® and Jamovi 2.3.28^®.

Twenty-three studies with a total of 800 patients with CF were included. This meta-analysis showed that pulmonary rehabilitation and physical training did not affect pulmonary function, as observed in FEV1 (SMD: 0.05; 95% CI: -0.09 to 0.20; p = 0.46) and FVC (SMD: 0.11; 95% CI: -0.04 to 0.27; p = 0.14). However, it has a discrete impact on exercise capacity, producing an increase in VO₂ max (MD: 2.74; 95% CI: 0.43 to 5.04; p = 0.02). Subgroup analyses did not yield relevant findings, and sensitivity analyses did not produce modifications in the direction or magnitude of the effect.

The intervention evaluated in this meta-analysis does not have effects on pulmonary function but may influence exercise capacity, particularly VO₂ max. It is recommended to interpret the findings with caution due to the limited certainty of the available evidence.