Pulmonary rehabilitation in adults with asthma

Nonpharmacological strategies, including pulmonary rehabilitation (PR), are increasingly recognized as essential components of asthma management, particularly for individuals with persistent symptoms, poor asthma symptom control, or complex disease. This review summarize recent evidence on PR and related behavioural, lifestyle, and digital interventions, and explores emerging models to improve access and long-term effectiveness.

Current evidence demonstrate that PR improves asthma control, exercise capacity, quality of life, and several patient-reported outcomes across multiple asthma phenotypes. Benefits extend to those with obesity-associated asthma, elevated airway inflammation, and high psychosocial burden. Early data also suggest reductions in exacerbation frequency and steroid requirements. Nevertheless, PR remains markedly underutilized. Digital self-management interventions show promising, albeit inconsistent effects on asthma control, with adherence being a critical determinant of success. New models combining synchronous (real-time) supervision with modular digital components may address major access barriers and provide scalable support.

Although underutilized in routine care, PR and other structured nonpharmacological strategies offer clinically meaningful benefits for individuals with asthma. Flexible, digitally enabled delivery models aligned with disease complexity may help to expand reach, promote earlier intervention and support sustained behavioural change. Future work should prioritize phenotype-specific effectiveness, long-term outcomes and implementation frameworks.