Effects of Pulmonary Rehabilitation on Lung Hyperinflation in Patients with COPD: A Systematic Review and Meta-analysis.

Respiratory medicine 2026-09-29Keyword sweep match

Pôrto EF, da Silva GME, Shimizu Gaspar HH, Camargo GG, Cassalati RA, Freitas Fernandes BJ, Matuo N, Faria Saint' Clair BG, Damielewski GS, de Moraes Coutinho Silva GY, de Aro Cardoso MG, de Azeredo NF, Gomes EP, de Castro AAM, Medeiros DF

Abstract

Background Pulmonary rehabilitation (PR) is a cornerstone in the management of chronic obstructive pulmonary disease (COPD), although its effects on lung hyperinflation remain incompletely understood. Objective To evaluate the effects of pulmonary rehabilitation on static and dynamic hyperinflation in patients with COPD through a systematic review and meta-analysis. Methods Electronic databases were systematically searched to identify studies investigating the effects of PR on markers of lung hyperinflation. The primary outcome was inspiratory capacity (IC), while secondary outcomes included the RV/TLC ratio, residual volume (RV), and other hyperinflation-related variables. Random-effects meta-analyses were performed using Review Manager 5.3. Results A comprehensive electronic search was conducted in PubMed, Embase, Web of Science, EBSCOhost, SciELO, and Scopus databases, on October 14, 2025. Nine studies met the inclusion criteria, with eight contributing to the quantitative synthesis. PR demonstrated a consistent trend toward improving ventilatory mechanics, including increases in inspiratory capacity and reductions in RV/TLC ratio and residual volume. Although pooled estimates for some outcomes did not reach statistical significance, the direction of effect consistently favored reduced hyperinflation after rehabilitation. Between-study heterogeneity was generally low, indicating consistent findings across the included studies despite methodological differences. Conclusion Pulmonary rehabilitation appears to improve lung mechanics by reducing hyperinflation in patients with COPD, potentially contributing to reduced dyspnea and enhanced exercise tolerance. While the magnitude of these physiological changes is modest, they support the role of PR as an important non-pharmacological intervention. Further high-quality studies using standardized methods for assessing dynamic hyperinflation are warranted to strengthen the current evidence.

View at publisher (DOI: 10.1016/j.rmed.2026.109172)