Background: Pulmonary rehabilitation (PR) is increasingly used across the lung-cancer care pathway, but the scope, effectiveness, and optimal delivery of programmes remain variably reported. Objective: To examine the effectiveness of PR in adults undergoing lung cancer surgery across preoperative perioperative, and post operating settings. Methods: We conducted a narrative synthesis of studies evaluating PR interventions in patients undergoing lung cancer resection. Eligible designs included randomised, non-randomised trials and observational studies published between 2021 and 2025. Interventions were classified by timing (preoperative, perioperative, postoperative) and by completeness of PR content. Full PR was defined as programmes including structured exercise training, at least one respiratory-specific component, and structured education and/or supportive interventions. Outcomes of interest included postoperative pulmonary complications (PPCs), length of stay (LOS), functional capacity, ventilatory function, symptoms and health-related quality of life (HRQoL). Results: Across perioperative phases, PR was feasible and safe, with consistent improvements in functional capacity and patient-reported outcomes. Preoperative PR reliably improved presurgical fitness with reductions in PPCs and LOS most evident in supervised and physiologically targeted programmes. Perioperative PR integrated within enhanced recovery pathways supported early mobilisation and respiratory recovery. Postoperative PR accelerated recovery of exercise capacity, respiratory symptoms, and HRQoL beyond expected natural recovery. Programmes classified as Full PR demonstrated more consistent and broader benefits across outcome domains compared with Partial PR. Substantial heterogeneity in intervention design and outcome measurement was observed. Conclusions: Pulmonary rehabilitation is an effective, multidimensional intervention across the surgical lung cancer continuum. Comprehensive, multimodal programmes appear to confer the greatest clinical benefit. Standardisation of PR content and outcome measurement is needed to strengthen evidence synthesis and guide implementation in perioperative lung cancer care.

Background/Objective: Post-COVID survivors present significant respiratory deficiency that has been associated with ongoing shortness of breath and impaired lung function. Inspiratory muscle training (IMT) is increasingly used in survivors of COVID-19 rehabilitational programs as a means to facilitate recovery of the respiratory system. Yet, its home-based effectiveness across clinically relevant outcomes remains unclear. This systematic review aimed to present current evidence on home- or tele-delivered IMT in the post-COVID-19 population. Methods: PubMed, Scopus, Cochrane library and Science Direct were systematically searched for studies evaluating home-based (or telerehabilitation) IMT, alone or as part of a respiratory muscle training program, in adults with post-COVID-19 symptoms. The primary outcome was inspiratory muscle strength. Secondary outcomes included dyspnea, pulmonary function, exercise capacity and health-related quality of life. The methodological quality of the included studies was assessed via the PEDro scale. Owing to clinical and methodological heterogeneity, we performed only a qualitative synthesis. Results: Eight studies met the inclusion criteria. Two included both inspiratory and expiratory muscles training and three included physical training as well. The methodological quality was found to be good. IMT consistently increased inspiratory muscle strength across trials. Respiratory muscle training (RMT) programs that combined inspiratory and expiratory training also improved maximal expiratory pressure. IMT reduced dyspnea versus control/sham or baseline and several studies reported improvements in exercise capacity and physical function. Spirometry/DLCO changes were small or null in most cohorts. HRQoL gains were domain-specific in anxiety and depression. Adherence was generally good. No serious adverse events attributable to IMT were reported. Conclusions: Home-based IMT for adults with post-COVID-19 conditions is safe and seems to improve inspiratory muscle strength and dyspnea, with signs of benefit for exercise capacity, physical function, and selected HRQoL domains. Effects on ventilatory efficiency and conventional lung function appear limited. Future multicenter, sham-controlled RCTs should further explore the characteristics of IMT, employ core outcome sets, include longer follow-up, and predefine phenotype-based subgroups.