Exercise Therapy for Combined Pulmonary Fibrosis and Emphysema: Protocol for a Scoping Review

Abstract

Objective: This scoping review aims to explore the exercise therapy topics, identify the research gaps, and assess the needs for future research on exercise therapy for patients with combined pulmonary fibrosis and emphysema (CPFE). Introduction: CPFE, first proposed by Cottin et al. in 2005, combines features of pulmonary emphysema and diffuse pulmonary fibrosis, leading to significant clinical challenges, including severe impairments in pulmonary diffusion capacity and high incidences of complications like pulmonary hypertension and lung cancer. Despite its prevalence and impact, there is a notable lack of clinical guidelines and established treatment protocols for CPFE, particularly in the domain of respiratory rehabilitation. This gap underscores the critical need for a comprehensive review of exercise therapy in rehabilitation interventions to inform clinical management and enhance patient outcomes. Inclusion criteria: The review will include studies involving adults over 18 with CPFE, focusing on rehabilitation interventions primarily composed of exercise therapy. We will consider experimental and observational study designs, reviews, and unpublished data. Exclusions include studies focusing solely on activities of daily living training or self-management education conducted independently, as well as those focused solely on pharmacotherapy or nutritional therapy without a rehabilitation context, and those not reporting intervention outcomes. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement Extension for Scoping Reviews and the Joanna Briggs Institute framework, this review will search databases such as MEDLINE, the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and others, including trial registries like World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov. The search will be comprehensive, including ongoing trials and relevant guidelines. Study selection will involve independent screening and data extraction by reviewers, using a predefined data extraction form. The review will present findings in a qualitative synthesis, identifying key the rehabilitation topics, the research gaps, and future the needs for patients with CPFE