Exploring the potential of cardiopulmonary exercise testing (CPET) for tailored pulmonary rehabilitation in people with interstitial lung disease (ILD): A systematic review protocol.

Background: This review aims to identify which cardiopulmonary exercise test (CPET) derived variables can be used to personalise pulmonary rehabilitation (PR) for people with interstitial lung diseases. A 'one size fits all' approach does not benefit every patient due to a multitude of unique characteristics, subsets and phenotypes. No ILD-specific, tailored pulmonary rehabilitation guidelines exist in this area and exercise programme development is lacking. This leads to wide variation in the success within the literature and clinical practice.

Methods: MEDLINE, Embase, CINAHL, SPORTDiscus and the Cochrane Database of Systematic Reviews will be searched to identify studies that utilise CPET variables for PR development. Quality assessment is to be performed using the Critical Appraisal Skills Program (CASP) checklists for single cohort studies and randomised controlled studies.

Discussion: The primary outcomes found within the included studies for peak volume of oxygen consumption (VO _2peak), work rate (WR _peak), oxygen consumption at anaerobic threshold (VO ₂-AT), heart rate and rate of perceived exertion (RPE) would help determine which variables are optimal for prescription success. Identification of reliable methods to tailor PR for people with interstitial lung disease would enhance what is already known and potentially lead to best practice guideline development.

Registration: In accordance with the guidelines, this systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 07 May 2024 (registration number CRD42024543174).