Review Article

Pulmonary Rehabilitation Strategies for the Treatment of Pneumoconiosis: A Narrative Review

Abstract

Pneumoconiosis is a collection of lung diseases caused by inhaling mineral dust that poses an important risk to public health worldwide. Effective clinical treatments are currently limited, but pulmonary rehabilitation (PR) has shown promise in treating respiratory diseases. This review aims to assess the effectiveness of PR strategies for treating pneumoconiosis. We searched research studies that investigated the effectiveness of PR interventions for pneumoconiosis patients in international scientific databases and comprehensively reviewed PR strategies for the treatment of pneumoconiosis. Pneumoconiosis patients are increasingly being treated with a multimodal PR program. PR interventions could save healthcare costs, reduce dyspnea, improve exercise performance, and enhance overall health-related quality of life in patients with pneumoconiosis. PR interventions are effective in improving respiratory function and quality of life in patients with pneumoconiosis. However, further research is needed to determine the optimal PR strategies for pneumoconiosis patients and to investigate the long-term effects of these interventions.

1. Austin ED, Loyd JE (2014). The genetics of pulmonary arterial hypertension. Circ Res, 115(1):189-202.
2. Perret JL, Plush B, Lachapelle P, et al (2017). Coal mine dust lung disease in the modern era. Respirology, 22(4):662-70.
3. Shen CH, Chen HJ, Lin TY, et al (2015). Association between pneumoconiosis and pulmonary emboli. Thromb Haemost, 113(5):952-7.
4. Zhang L, Zhu L, Li Z, et al (2014). Analysis on the disease burden and its impact factors of coal worker's pneumoconiosis inpatients. Beijing Da Xue Xue Bao Yi Xue Ban, 46(2):226-31.
5. Li Y, Cheng Z, Fan H, et al (2022). Epigenetic Changes and Functions in Pneumoconiosis. Oxid Med Cell Longev, 2022: 2523066.
6. Ye M, Wang Y, WAN R (2011). Research on Disease Burden of Pneumoconiosis Patients in Chongqing City. Mod. Prev Med, 38:840-2.
7. Liang Y, Wong O, Fu H, et al (2003). The economic burden of pneumoconiosis in China. Occup Environ Med, 60(6): 383–384.
8. Gupta M, Mehrara V, Singh T, et al (2022). Pneumoconiosis-an ignored occupational lung disease and Pulmonary Rehabilitation to improve the health related quality of life. J Compr Health, 10(1):37-9.
9. Nici L, Donner C, Wouters E, et al (2006). American thoracic society/European respiratory society statement on pulmonary rehabilitation. Am J Respir Crit Care Med, 173(12):1390-413.
10. Tsang EW, Kwok H, Chan AK, et al (2018). Outcomes of community-based and home-based pulmonary rehabilitation for pneumoconiosis patients: a retrospective study. BMC Pulm Med, 18(1):113.
11. Jenkins AR, Gowler H, Curtis F, et al (2018). Efficacy of supervised maintenance exercise following pulmonary rehabilitation on health care use: a systematic review and meta-analysis. Int J Chronic Obstruct Pulm Dis, 13:257-273.
12. Ryrsø CK, Godtfredsen NS, Kofod LM, et al (2018). Lower mortality after early supervised pulmonary rehabilitation following COPD-exacerbations: a systematic review and meta-analysis. BMC Pulm Med, 18(1):154.
13. Nici L, ZuWallack RL (2014). Pulmonary rehabilitation: definition, concept, and history. Clin Chest Med, 35(2):279-82.
14. Hill NS (2006). Pulmonary rehabilitation. Proc Am Thorac Soc, 3(1):66-74.
15. McCarthy B, Casey D, Devane D, et al (2015). Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 2015(2):CD003793.
16. Dale MT, McKeough ZJ, Troosters T, et al (2015). Exercise training to improve exercise capacity and quality of life in people with non‐malignant dust‐related respiratory diseases. Cochrane Database Syst Rev, 2015(11):CD009385.
17. Hoy RF, Chambers DC (2020). Silica‐related diseases in the modern world. Allergy, 75(11):2805-17.
18. Rosengarten D, Fox BD, Fireman E, et al (2017). Survival following lung transplantation for artificial stone silicosis relative to idiopathic pulmonary fibrosis. Am J Ind Med, 60(3):248-54.
19. Cockcroft A, Saunders M, Berry G (1981). Randomised controlled trial of rehabilitation in chronic respiratory disability. Thorax, 36(3):200-3.
20. Dowman LM, McDonald CF, Hill CJ, et al (2017). The evidence of benefits of exercise training in interstitial lung disease: a randomised controlled trial. Thorax, 72(7):610-9.
21. Baudouin S, Waterhouse J, Tahtamouni T, et al (1990). Long term domiciliary oxygen treatment for chronic respiratory failure reviewed. Thorax, 45(3):195-8.
22. Litow FK, Petsonk EL, Bohnker BK, et al (2015). Occupational interstitial lung diseases. J Occup Environ Med, 57(11):1250-4.
23. Odintseva O, Semenikhin V, Lee G (2015). Total broncho-alveolar lavage in respiratory diseases among coal mining workers. Med Tr Prom Ekol, 2015(5):25-9.
24. Burmeister R, Rhoderick JF, Holian A (2019). Prevention of crystalline silica-induced inflammation by the anti-malarial hydroxychloroquine. Inhal Toxicol, 31(7):274-84.
25. Zhang H, Sui J-N, Gao L, et al (2018). Subcutaneous administration of infliximab-attenuated silica-induced lung fibrosis. Int J Occup Med Environ Health, 31(4):503-15.
26. Huang H, Chen M, Liu F, et al (2019). N-acetylcysteine tiherapeutically protects against pulmonary fibrosis in a mouse model of silicosis. Biosci Rep, 39(7):BSR20190681.
27. Helal MG, Said E (2019). Carvedilol attenuates experimentally induced silicosis in rats via modulation of P-AKT/mTOR/TGFβ1 signaling. Int Immunopharmacol, 70:47-55.
28. El-Kashef DH (2018). Nicorandil ameliorates pulmonary inflammation and fibrosis in a rat model of silicosis. Int Immunopharmacol, 64:289-97.
29. Mroz MM, Ferguson JH, Faino AV, et al (2018). Effect of inhaled corticosteroids on lung function in chronic beryllium disease. Respir Med, 138 Suppl:S14-S9.
30. Du S, Li C, Lu Y, et al (2019). Dioscin alleviates crystalline silica-induced pulmonary inflammation and fibrosis through promoting alveolar macrophage autophagy. Theranostics, 9(7):1878-92.
31. Li N, Feng F, Wu K, et al (2019). Inhibitory effects of astragaloside IV on silica-induced pulmonary fibrosis via inactivating TGF-β1/Smad3 signaling. Biomed Pharmacother, 119:109387.
32. Liu H, Yu H, Cao Z, et al (2019). Kaempferol modulates autophagy and alleviates silica-induced pulmonary fibrosis. DNA Cell Biol, 38(12):1418-26.
33. Feng F, Cheng P, Zhang H, et al (2019). The protective role of tanshinone IIA in silicosis rat model via TGF-β1/Smad signaling suppression, NOX4 inhibition and Nrf2/ARE signaling activation. Drug Des Devel Ther, 13:4275-4290.
34. Zhang Y, Li C, Li S, et al (2019). Dihydrotanshinone I alleviates crystalline silica-induced pulmonary inflammation by regulation of the Th immune response and inhibition of STAT1/STAT3. Mediators Inflamm, 9:2019:3427053.
35. Bandeira E, Oliveira H, Silva JD, et al (2018). Therapeutic effects of adipose-tissue-derived mesenchymal stromal cells and their extracellular vesicles in experimental silicosis. Respir Res, 19(1):1-10.
36. Chen S, Cui G, Peng C, et al (2018). Transplantation of adipose-derived mesenchymal stem cells attenuates pulmonary fibrosis of silicosis via anti-inflammatory and anti-apoptosis effects in rats. Stem Cell Rese Ther, 9(1):110.
37. Qi XM, Luo Y, Song MY, et al (2021). Pneumoconiosis: current status and future prospects. Chin Med J(Engl), 134(8):898-907.
38. Spruit M, Singh S, Garvey C, et al (2013). ATS/ERS task force on pulmonary rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med, 188(8):e13-64.
39. Spruit M, Pitta F, Garvey C, et al (2014). ERS Rehabilitation and Chronic Care, and Physiotherapists Scientific Groups; American Association of Cardiovascular and Pulmonary Rehabilitation; ATS Pulmonary Rehabilitation Assembly and the ERS COPD Audit team. Differences in content and organisational aspects of pulmonary rehabilitation programmes. Eur Respir J, 43(5):1326-37.
40. Rochester CL, Vogiatzis I, Holland AE, et al (2015). An official American Thoracic Society/European Respiratory Society policy statement: enhancing implementation, use, and delivery of pulmonary rehabilitation. Am J Respir Crit Care Med, 192(11):1373-86.
41. Girdhar A, Agarwal P, Singh A (2020). Pulmonary Rehabilitation in Chronic Obstructive Pulmonary. Cardiorespiratory Fitness:1. DOI: 10.5772/intechopen.81742
42. Morgan M, Calverley P, Clark C, et al (2001). Pulmonary rehabilitation: British Thoracic Society standards of care subcommittee on pulmonary rehabilitation. Thorax, 56(11):827-34.
43. Li PW, Yu DS, Tam SY (2021). The Lived Experience of Patients and Family Caregivers in Managing Pneumoconiosis. Qual Health Res, 31(9):1645-56.
44. Casaburi R, Porszasz J, Burns MR, et al (1997). Physiologic benefits of exercise training in rehabilitation of patients with severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 155(5):1541-51.
45. Maltais F, LeBlanc P, Jobin J, et al (1997). Intensity of training and physiologic adaptation in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 155(2):555-61.
46. Ringbaek T, Broendum E, Hemmingsen L, et al (2000). Rehabilitation of patients with chronic obstructive pulmonary disease. Exercise twice a week is not sufficient! Respir Med, 94(2):150-4.
47. Troosters T, Gosselink R, Decramer M (2000). Short-and long-term effects of outpatient rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Am J Med, 109(3):207-12.
48. Higashimoto Y, Ando M, Sano A, et al (2020). Effect of pulmonary rehabilitation programs including lower limb endurance training on dyspnea in stable COPD: a systematic review and meta-analysis. Respir Investig, 58(5):355-66.
49. Lake FR, Henderson K, Briffa T, et al (1990). Upper-limb and lower-limb exercise training in patients with chronic airflow obstruction. Chest, 97(5):1077-82.
50. Suhas KM, Alaparthi GK, Krishnan SK, et al (2020). Upper Limb Extremity Muscle-Dysfunction in Chronic Obstructive Pulmonary Disease: A Narrative Review. Curr Respir Med Rev, 16(1):11-20.
51. José A, Holland AE, Selman JP, et al (2021). Home-based pulmonary rehabilitation in people with bronchiectasis: a randomised controlled trial. ERJ Open Res, 7(2): 00021-2021.
52. Society AT (1999). Pulmonary rehabilitation-1999. Am J Respir Crit Care Med, 159(5 Pt 1):1666-82.
53. Horowitz MB, Littenberg B, Mahler DA (1996). Dyspnea ratings for prescribing exercise intensity in patients with COPD. Chest, 109(5):1169-75.
54. Chen L, Xu W, Ma X, et al (2020). The Effect of Respiratory Rehabilitation Training on the Life Quality of Pneumoconiosis Patients. J Clin Nurs Res, 4(4):5-8.
55. Jimborean G, Ianosi E, Croitoru A, et al (2017). Respiratory muscle training in chronic obstructive pulmonary disease. Pneumologia, 66(3):128-30.
56. Franklin E, Anjum F (2021). Incentive spirometer and inspiratory muscle training. StatPearls [Internet]: StatPearls Publishing.Available from: https://www.ncbi.nlm.nih.gov/books/NBK572114/
57. Kuhajda D, Obradović D, Ciobanu LD (2022). Non Invasive Ventilation, Pulmonary Rehabilitation and Chest Physiotherapy-1. Teaching Pearls in Noninvasive Mechanical Ventilation[Book]. Springer, p. 435-43.
58. Postolache P, Săndulache Ș, Ghimuș C, et al (2022). Assessment of Exercise Capacity: A Key Element in Pulmonary Rehabilitation. DOI: 10.5772/intechopen.106211
59. Bhammar DM, Jones HN, Lang JE (2022). Inspiratory Muscle Rehabilitation Training in Pediatrics: What Is the Evidence? Can Respir J, 2022:5680311.
60. Troosters T, Casaburi R, Gosselink R, et al (2005). Pulmonary rehabilitation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 172(1):19-38.
61. Vanfleteren LE, Gloeckl R (2019). Add‐on interventions during pulmonary rehabilitation. Respirology, 24(9):899-908.
62. Emtner M, Porszasz J, Burns M, et al (2003). Benefits of supplemental oxygen in exercise training in nonhypoxemic chronic obstructive pulmonary disease patients. Am J Respir Crit Care Med, 168(9):1034-42.
63. Palange P, Crimi E, Pellegrino R, et al (2005). Supplemental oxygen and heliox:‘new’tools for exercise training in chronic obstructive pulmonary disease. Curr Opin Pulm Med, 11(2):145-8.
64. McDonald CF (2022). Home oxygen therapy. Aust Prescr, 45(1):21-24.
65. Zhao H, Xie Y, Wang J, et al (2020). Pulmonary Rehabilitation Can Improve the Functional Capacity and Quality of Life for Pneumoconiosis Patients: A Systematic Review and Meta-Analysis. BioMed Res Int, 2020: 6174936.
66. Neish CM, Hopp JW (1988). The role of education in pulmonary rehabilitation. J Cardiopulm Rehabil Prev, 8(11):439-41.
67. Coventry PA, Hind D (2007). Comprehensive pulmonary rehabilitation for anxiety and depression in adults with chronic obstructive pulmonary disease: systematic review and meta-analysis. J Psychosom Res, 63(5):551-65.
68. Cornelison SD, Pascual RM (2019). Pulmonary rehabilitation in the management of chronic lung disease. Med Clin North Am , 103(3):577-84.
69. Renfroe K (1988). Effect of progressive relaxation on dyspnea and state anxiety in patients with chronic obstructive pulmonary disease. Heart Lung, 17(4):408-13.
70. Celli BR, Cote CG, Marin JM, et al (2004). The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 350(10):1005-12.
71. Ferreira IM, Brooks D, Lacasse Y, et al (2000). Nutritional support for individuals with COPD. Chest, 117(3):672-8.
72. Weekes C, Emery P, Elia M (2009). Dietary counselling and food fortification in stable COPD: a randomised trial. Thorax, 64(4):326-31.
73. Rochester CL (2019). Patient assessment and selection for pulmonary rehabilitation. Respirology, 24(9):844-53.
74. Vaishali K, Sinha MK, Maiya AG, Bhat A (2019). The initial steps in pulmonary rehabilitation: How it all began? Lung India, 36(2):139-141.
75. Kawaji T, Hasegawa T, Uchiyama Y (2022). Dyspnea and outcome expectations are associated with physical activity in persons with pneumoconiosis: a cross-sectional study. BMC Pulm Med, 22(1):335.
76. Bolton CE, Bevan-Smith EF, Blakey JD, et al (2013). British Thoracic Society guideline on pulmonary rehabilitation in adults: accredited by NICE. Thorax, 68 Suppl 2:ii1-ii30.
77. Evans R, Singh S, Collier R, et al (2009). Pulmonary rehabilitation is successful for COPD irrespective of MRC dyspnoea grade. Respir Med, 103(7):1070-5.
78. Kalamara EI, Ballas ET, Pitsiou G, et al (2021). Pulmonary rehabilitation for cystic fibrosis: A narrative review of current literature. Monaldi Arch Chest Dis 91(2).
79. Xiao K, Liu J, Ding X, et al (2019). Comprehensive rehabilitation of individualized exercise program for coal workers pneumoconiosis in Huaibei Coal Mine Group. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi, 37(5):357-61.
80. Dale MT, McKeough ZJ, Munoz PA, et al (2014). Exercise training for asbestos-related and other dust-related respiratory diseases: a randomised controlled trial. BMC Pulm Med, 14:180.
81. Huang X, Chen H, Long R, et al (2019). Development and validation of the quality of life scale for Chinese coal miners with pneumoconiosis (QOL-CMP): Measurement method and empirical study. J Clean Prod, 232:1062-75.
82. Han B, Yan B, Zhao N, et al (2013). The influence of the functional capacity on subjective well-being and quality of life of patients with silicosis. Aging Ment Health, 17(6):707-13.
83. Ma P, Nagamatsu Y (2023). The impact of community-based pulmonary rehabilitation on the health and lives of migrant workers with pneumoconiosis in China: a qualitative study exploring patient experience. J Global Health Rep, 7:e2023026.
84. XIAO S, GAO J, HUA Z, et al (2019). Effect of exercise-based short-term rehabilitation therapy on pulmonary function of coal workers' pneumoconiosis. China Occup Med, 46(1):67-70. [In Chinease]
85. Pan W, Chen JL (2017). Effect of rehabilitation exercise training on pulmonary function and exercise endurance of patients with pneumoconiosis. Chin J Rehabil Med, 32:465–7. [In Chinease]
86. Wang F (2017). Effect of comprehensive treatment on exercise endurance of patients with coal worker's pneumoconiosis. For all Health, 5:48-53. [In Chinease]
87. Qu WJ (2017). Application of health education and exercise training in improving pulmonary function of pneumoconiosis patients. Chin J Convalescent Med, 26:331–4.
88. Yun X (2015). Therapeutic effect of rehabilitation therapy based on one year movement in patients with coal worker's pneumoconiosis in Datong Coal Mine Group. North China Univ Sci Technol. 8:15-24. [In Chinease]
89. Liu J, Wang JY, Li DH (2015). Application of heath education with sports training on pulmonary function among pneumoconiosis patients. Chin J Modern Nurs, 21:1241–4. [In Chinease]
90. F. Li JSG, Han Y, Chen L (2015). Effect evaluation of comprehensive pulmonary rehabilitation on patients with coal workers pneumoconiosis. Clin Med, 35:30–2. [In Chinease]
91. Li XY, Hu W, Zhang ZH, et al (2015). Effect of comprehensive lung rehabilitation on respiratory function in patients with pneumoconiosis. Chin J Rehabil Med, 29:123-4. [In Chinease]
92. Liu CZ (2014). Effect of health education combined with respiratory muscle training on quality of life in patients with coal workers' pneumoconiosis. Occup Health, 30:2392–4. [In Chinease]
93. Ma LL (2014). Effect of pulmonary rehabilitation therapy on pulmonary ventilation function in patients with stable silicosis. Occup Health, 30:2395-9. [In Chinease]
94. Dale MT, McKeough ZJ, Munoz PA, et al (2014). Exercise training for asbestos-related and other dust-related respiratory diseases: a randomised controlled trial. BMC Pulm Med, 14:180.
95. Jin Y, Yao M, Wenjing L, et al (2014). Pulmonary rehabilitation therapy of pneumoconiosis patients. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi, 32(11):849-50. [In Chinease]
96. Zhang ZH, Shang B, Li XY, et al (2012). Observation on the curative effect of pulmonary rehabilitation therapy in patients with pneumoconiosis. Chin J Ind Hyg Occup Dis, 30:612- 3. [In Chinease]
97. Cao DF, Zhang ZH, Gao P, et al (2010). Observation on curative effect of comprehensive pulmonary rehabilitation therapy on pneumoconiosis. Chin J Ind Med, 23:271-2. [In Chinease]
98. Liu QG, Zhao SY, Zheng X, et al (2009). Observation on the effect of multidisciplinary cooperative respiratory rehabilitation in patients with pneumoconiosis. Chin J Ind Hyg Occup Dis, 27:670–2. [In Chinease]
99. Dong AQ, Li KC, Tang D, et al (2009). The effect of systematic rehabilitation on QOL of patients with stage II pneumoconiosis. Chin J Rehabil Med, 24:927–9. [In Chinease]
100. Vogelmeier CF, Criner GJ, Martinez FJ, et al (2017). Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med, 195(5):557-82.
101. Chaplin E, Hewitt S, Apps L, et al (2017). Interactive web-based pulmonary rehabilitation programme: a randomised controlled feasibility trial. BMJ Open, 7(3):e013682.
102. Horton EJ, Mitchell KE, Johnson-Warrington V, et al (2018). Comparison of a structured home-based rehabilitation programme with conventional supervised pulmonary rehabilitation: a randomised non-inferiority trial. Thorax, 73(1):29-36.
103. Polkey MI, Qiu ZH, Zhou L, et al (2018). Tai Chi and pulmonary rehabilitation compared for treatment-naive patients with COPD: a randomized controlled trial. Chest, 153(5):1116-24.
104. Papp ME, Wändell PE, Lindfors P, et al (2017). Effects of yogic exercises on functional capacity, lung function and quality of life in participants with obstructive pulmonary disease: a randomized controlled study. Eur J Phys Rehabil Med, 53(3):447-61.
105. Troosters T, Blondeel A, Janssens W, et al (2019). The past, present and future of pulmonary rehabilitation. Respirology, 24(9):830-7.
106. Holland AE, Cox NS, Houchen-Wolloff L, et al (2021). Defining modern pulmonary rehabilitation. An official American thoracic Society workshop report. Ann Ame Thorac Soc, 18(5):e12-e29.
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IssueVol 52 No 11 (2023) QRcode
SectionReview Article(s)
DOI https://doi.org/10.18502/ijph.v52i11.14024
Keywords
Pneumoconiosis Pulmonary rehabilitation Treatment

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Zhou D, Fu D, Yan L, Peng L. Pulmonary Rehabilitation Strategies for the Treatment of Pneumoconiosis: A Narrative Review. Iran J Public Health. 2023;52(11):2234-2247.