Pulmonary rehabilitation in post-tuberculosis lung disease: a systematic review

Tuberculosis (TB) remains a significant global health concern, resulting in illness and death for millions of individuals. Despite the availability of effective treatment options, a substantial number of people continue to suffer from long-term lung consequences known as post-tuberculosis lung disease (PTLD). PTLD may be associated with reduced exercise capacity, respiratory impairment, and diminished quality of life. Pulmonary rehabilitation (PR), an intervention that combines exercise and education to enhance pulmonary function and overall wellbeing, may offer a solution. The aim of this systematic review was to map the available evidence on PR interventions for PTLD, identify gaps in the literature, and synthesize findings on exercise capacity, quality of life, pulmonary function, and symptom outcomes to inform clinical practice and future research.

A systematic search was conducted across four electronic databases, Scopus, PubMed (MEDLINE), ProQuest, and EBSCO, for studies published between 2000 and 2026. The overall search yielded 1,085 articles. After reviewing titles and abstracts, we removed 163 duplicates and excluded 905 articles. A total of 17 articles met the inclusion criteria and were included in this systematic review.

Seventeen studies met the inclusion criteria, encompassing randomized controlled trials (RCTs) and observational study designs across multiple countries. PR consistently improved exercise capacity, with a 6 min walk distance (6MWD) increasing by 36-189 m (440.6 ± 70.8 m to 574.6 ± 168.9 m; 399 ± 62 m to 467 ± 65 m, p < 0.01) and a significant improvement in quality of life, as evidenced by reductions in St Georges Respiratory Questionnaire (SGRQ) scores of up to 13 points (p < 0.05) and significant between-group differences in some studies (p < 0.0001). Symptom outcomes also improved, including reductions in dyspnea and chest pain (44.8% to 24.1%). Pulmonary function findings were heterogeneous; some studies reported significant improvements in FEV₁ (2.94 ± 0.68 L to 3.18 ± 0.54 L, p < 0.001), whereas others showed no significant changes.

Despite certain limitations, all included studies demonstrated improvement in at least one key outcome domain. They collectively suggest that PR may be a valuable component of PTLD management, though further high-quality trials are needed to establish optimal protocols and confirm efficacy. PR has the potential to enhance the quality of life, exercise capacity, and lung function in patients with post-TB complications.