Interstitial lung diseases cause scarring and stiffness of the lungs, leading to impaired breathing and reduced quality of life. The diaphragm, the main respiratory muscle, may become weakened in these patients. Pulmonary rehabilitation is a comprehensive program that includes exercise, education, and support to improve physical capacity and overall well-being.
This study will evaluate whether an eight-week pulmonary rehabilitation program improves the diaphragmatic index (measured by ultrasound), quality of life, exercise tolerance (through functional tests), muscle strength, and dyspnea perception in patients with interstitial lung diseases.
Participants will be recruited at the Antiguo Hospital Civil de Guadalajara "Fray Antonio Alcalde" between July and December 2025. The findings will provide new insights into the impact of pulmonary rehabilitation on diaphragmatic function and contribute scientific evidence to optimize the treatment of these conditions.
Age ≥ 18 years.
Confirmed diagnosis of interstitial lung disease (ILD) by pulmonology and imaging criteria.
Clinically stable for at least 4 weeks prior to enrollment (no exacerbations or hospitalizations).
Able to perform pulmonary rehabilitation and functional tests safely, as determined by medical evaluation.
Acute exacerbation of ILD or respiratory infection within the last 4 weeks.
Severe comorbidities limiting participation (e.g., unstable cardiac disease, uncontrolled hypertension, recent myocardial infarction < 3 months).
Advanced neuromuscular disease or musculoskeletal limitation that prevents exercise training.
Cognitive impairment or psychiatric condition interfering with protocol adherence.
Single group
Rehabilitation program
Other interventionParticipants will complete an 8-week structured pulmonary rehabilitation program, delivered in 2-3 supervised sessions per week at the Antiguo Hospital Civil de Guadalajara "Fray Antonio Alcalde". Each session will last 60-90 minutes and include the following components: Aerobic Training: Walking or cycling at 60-80% of maximum workload, progressively adjusted based on tolerance. Strength Training: Resistance exercises for major muscle groups (upper and lower limbs), 2-3 sets of 10-15 repetitions, individualized according to baseline strength. Breathing Techniques: Diaphragmatic and pursed-lip breathing, plus thoracic expansion exercises. Inspiratory Muscle Conditioning: Threshold device training at 30% of maximal inspiratory pressure (MIP), with progressive increments. Education Sessions: Information on disease self-management, energy conservation, medication adherence, and lifestyle recommendations.
Change in Diaphragmatic Index
Variation in diaphragmatic thickness and excursion measured by ultrasound between baseline and after 8 weeks of intervention.
Change in Quality of Life
Short Form Health Survey or Saint George
Change in Exercise Tolerance
Improvement in sit to stand test, 6 minutes walking test, Time up and go, and 4 meter gait speed
Change in Dyspnea Perception
Modified Borg Scale (0-10) or mMRC Dyspnea Scale.
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