The ILD-PR programme
anxiety, ’, arthritis, ’s syndrome, cough, breathlessness
GASTRO-OESOPHAGEAL REFLUX DISEASE, INCONTINENCE, ARTHRITIS, PROGRESSION, HEART
This was a circuit-based 8-week, twice weekly, outpatient programme, including only people with ILD and consisting of an hour of exercise and an hour of education. Exercise was set, supervised and progressed by two experienced physiotherapists, according to a standardised protocol for each group allocation. Supplementary oxygen was not used during the sessions. Participants already on LTOT continued to exercise with oxygen as recommended but were not given additional oxygen. Aerobic exercises included treadmill walking, brisk walking between two cones, cycle ergometer, trampette and step ups. Strength training exercises, upper and lower limb, were conducted using ‘Thera-bands’ and functional movements such as sit-to-stand and ball raises.A minimum of 30 min were dedicated to aerobic training. Aerobic training intensity at the MICT group was set at 60% maximum heart rate (HRmax) and progressed each week. In the HIIT group, intensity was set at 80% HRmax and patients were instructed to exercise in dynamic intervals followed by low-intensity exercise or rest. The aim in this group was to increase the amount of time on the ‘high-intensity’ phase each week.In the first week, the average time on HIIT (at 80% HRmax) for each aerobic exercise was 2.5 min, therefore HIIT was 12.5 min of the total 30 min session, and this time increased each week. Progression of training was determined by reducing time in the low-intensity phase of HIIT and/or increasing time in the target HR. Each participant’s individualised programme was recorded on exercise logs during the sessions.Heart rate and oxygen saturation were monitored using pulse oximeters and perceived exertion and breathlessness were recorded at set intervals using the modified 10-point Borg Scale and the Rate of Perceived Exertion Scale, respectively.The education session, on the second hour of the programme, was common for all participants and included presentations and discussion on topics important to patients with ILD, such as topics about breathing and breathlessness (mechanics of breathing, helpful/unhelpful breathing patterns, the Active Cycle of Breathing technique, useful positions for recovering, pacing), topics about ILD (what happens with ILD, cough, associated conditions-rheumatoid arthritis, gastro-oesophageal reflux disease, Sjögren’s syndrome, Bird fancier’s lung, IPF) and topics about managing the condition (why healthier lifestyle is important?, keeping good posture, barriers to activity/exercise, dietary advice, smoking, incontinence, relaxation information, mood, anxiety and breathlessness, self-management and goal setting).On the first day of the programme all participants were given an ‘ILD-Pulmonary rehabilitation booklet’ designed by our team, which contained information and pictures of all exercises, an exercise diary and summary of the education topics (see 
