Effect of pulmonary rehabilitation on lung function and quality of life in pulmonary tuberculosis survivors with post-tuberculosis lung disease: A Systematic review and meta- analysis

Background Post-tuberculosis lung disease (PTLD) is a significant global public health challenge. While its contribution to long-term morbidity and impaired quality of life is increasingly acknowledged, evidence regarding effective management strategies remains scarce. This systematic review and meta-analysis aimed to evaluate the effectiveness of pulmonary rehabilitation in improving clinical and functional outcomes among individuals with a history of tuberculosis. Methods This review conducted by followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Interventional studies, randomized controlled trials, and cohort studies reporting outcomes on lung function, quality of life, and exercise tolerance on post-tuberculosis lung disease patients were included. A comprehensive literature search was conducted in PubMed, Embase, Google scholar, and Scopus between July 25 and August 1, 2025. Data were extracted by two individuals using a structured, pre-designed Excel form. The extracted data were cleaned and analyzed using R software version 4.5. Health related quality of life was assessed using the St. George’s Respiratory Questionnaire (SGRQ). A random-effects model was applied for the meta-analysis, with subgroup analyses and meta-regression conducted to investigate potential sources of heterogeneity. Results A total of 13 studies comprising 2,300 participants were included. The pooled mean change of 6-minute walk distance (6MWD) was 69.43 meters (95% CI: 31.01;113.84). The pooled mean change in FEV₁, FVC, FEV1/FVC were 0.07L (95% CI: 0.01;0.14), 0.06 L (95% CI: -0.02;0.14), 1.06% (95% CI: -1.66; 3.78) and 2.64 mmHg (95% CI: 0.15;5.12) respectively. The mean change in SGRQ scores was − 18.85 (95% CI: −22.43; -15.27). Conclusion Pulmonary rehabilitation significantly improved exercise capacity, oxygenation, and quality of life, with smaller FEV₁ with smaller or non-significant improvements in FVC and FEV1/FVC ratio. The integration of PR into routine PTLD management is recommended to optimize clinical and functional outcomes. Further high-quality randomized controlled trials are needed to evaluate the long-term benefits and refine rehabilitation protocols. Clinical trial number: not applicable