200 Section - Even in case of devastating acute exacerbation of idiopathic pulmonary fibrosis, hybrid pulmonary rehabilitation could be of help

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Corresponding Author/Autor a quien dirigir la corr(s)

MS

Min-Keun Song, PhD

Professor
Chonnam National University Hospital
Gwangju, Kwangju-jikhalsi, Republic of Korea

Co-Author/Coautor(s)

HP

Hyeng-Kyu Park, PhD

Professor
Chonnam National University Hospital
Gwangju, Kwangju-jikhalsi, Republic of Korea
JH

Jae-Young Han, PhD

Professor
Chonnam National University Hospital
Gwangju, Kwangju-jikhalsi, Republic of Korea
IC

In Sung Choi, MD, PhD

Professor
Chonnam National University Hospital
Gwangju, Kwangju-jikhalsi, Republic of Korea

Presenting Author/Autor expositor(s)

WK

Won jae Kim, MD

Resident
Chonnam National University Hospital
Gwangju, Kwangju-jikhalsi, Republic of Korea

Case Diagnosis: Acute exacerbation of idiopathic pulmonary fibrosis

Case Description: A 63-year-old man with idiopathic pulmonary fibrosis (IPF) presented with dyspnea 12 days after COVID-19 infection. Functional examinations and chest CT indicated acute exacerbation of IPF. Hybrid rehabilitation began with passive range of motion (ROM) exercise in the intensive care unit (ICU), and progressed to active assisted ROM exercise with occupational therapy after liberation from mechanical ventilation. As consciousness improved, huffing and inspiratory resistive exercise were introduced. After transfer to the ward, endurance training at sixty percent of maximal capacity was applied. Electrical stimulation therapy was added for ICU-acquired peripheral polyneuropathy confirmed by electrodiagnostic study. Portable oxygen were prescribed to prevent hypoxemia and fatigue. For continuous rehabilitation, we provided home-based exercise protocol; 30 minutes of gait training, stair climbing under supervision, and lower extremities ergometer. 3 months after discharge, overall functional assessment showed improvement.

Discussions: The known course of idiopathic pulmonary fibrosis (IPF) is progressive decline in pulmonary function, respiratory failure and death. The efficacy of pulmonary rehabilitation in IPF remains uncertain, although pulmonary rehabilitation is known to be successful for other pulmonary diseases. Also, appropriate protocol in IPF is still lacking. In our patient, stratified hybrid rehabilitation led to remarkable functional improvement. Timely rehabilitation from critical care unit to outpatient management should be considered for all patients with IPF. Future research should aim to establish clinically efficient rehabilitative intervention for idiopathic pulmonary fibrosis.

Conclusions:

Idiopathic pulmonary fibrosis (IPF) is thought to lead to functional decline and death associated with respiratory failure, especially in the case of acute exacerbation. However in our patient, hybrid rehabilitation resulted in significant improvement in functional outcomes. Timely and continuous rehabilitation from critical care to outpatient management should be considered in patients with IPF.