Comprehensive Pulmonary Rehabilitation in Post-Tuberculosis Lung Disease: Current Approaches and Effectiveness (Review)

Abstract

Respiratory diseases are among the most common conditions in adults and are characterized by substantial variability in clinical course, a risk of complications, and long-term functional limitations. Despite advances in modern anti-tuberculosis therapy and the growing proportion of microbiologically cured patients, pulmonary tuberculosis often leaves persistent respiratory symptoms, reduced exercise tolerance, and impaired quality of life. In the post-treatment period, many individuals develop post-tuberculosis lung disease (PTLD), manifested by ventilatory impairment, muscle dysfunction, gas-exchange abnormalities, and reduced exercise capacity. This creates a vicious cycle in which dyspnea limits physical activity, decreased activity worsens functional impairment, and the resulting deconditioning further reduces exercise capacity, even in the absence of an active infectious process. Objective — to review the available evidence on comprehensive pulmonary rehabilitation in patients who have recovered from pulmonary tuberculosis and to summarize current approaches to breathing interventions and physical therapy programs aimed at restoring functional status. The analyzed publications indicate that pulmonary rehabilitation programs incorporating self-management education, breathing techniques aimed at optimizing respiratory patterns and reducing the work of breathing, as well as aerobic and resistance training with gradual progression, improve exercise tolerance, reduce dyspnea severity, and enhance quality-of-life outcomes. Individualization of rehabilitation strategies is essential, considering the phenotype of functional impairment, comorbid conditions, baseline physical fitness, and the feasibility of adapting programs to outpatient and home-based settings, which increases accessibility for patients.Comprehensive pulmonary rehabilitation in patients who have recovered from pulmonary tuberculosis is a clinically relevant and appropriate component of post-treatment care, with the potential to reduce long-term functional limitations and facilitate return to an active life. However, broader implementation of this approach in post-tuberculosis follow-up and stronger interdisciplinary collaboration across tuberculosis, pulmonology, and primary care services are needed.