Pulmonary Rehabilitation Boosts QoL in Pediatric Chronic Respiratory Disease

Pediatric pulmonary rehabilitation was associated with significant improvements in exercise tolerance, strength, and quality of life (QoL) among children with chronic respiratory diseases, according to new findings presented at the American Thoracic Society (ATS) 2026 International Conference in Orlando, Florida. The study found that children in the program experienced meaningful functional gains despite no significant changes in pulmonary function testing (PFT).1

“This highlights that meaningful clinical improvement extends beyond spirometry and supports PR as an important component of care for children with chronic respiratory disease,” lead author Tauras Vucianis, a third-year medical student at University of Cincinnati College of Medicine, said in a statement.2

Pulmonary rehabilitation is well established in adults, with ATS guidelines strongly recommending it for stable COPD in 2023 based on moderate-quality evidence.3 However, pediatric programs remain uncommon because of limited data, lack of standardized protocols, and the need for age- and function-specific exercise approaches.1

To evaluate the feasibility and outcomes of pediatric pulmonary rehabilitation, Vucianis and colleagues retrospectively examined children who completed a pulmonary rehabilitation program between March 2017 and August 2025 at Cincinnati Children’s Hospital Medical Center. Eligibility criteria required completion of a baseline evaluation and participation in ≥ 5 rehabilitation sessions.1

The study included 51 unique patients, with a mean age of 14.4 years; 55% were male. Underlying lung disease patterns were classified as obstructive in 45%, restrictive in 39%, and mixed in 6% of participants. Program duration averaged 18.8 sessions, with approximately 9 days between sessions.

Although spirometric measures remained stable after rehabilitation, investigators observed statistically significant improvements across multiple exercise and functional performance measures. The 6-minute walk test distance increased from 1234.5 feet at baseline to 1464.6 feet following pulmonary rehabilitation (P =.0001). Functional strength measures also improved substantially, including 30-second sit-to-stand repetitions, which increased from 13.7 to 17.9 repetitions (P =.0002), and modified push-ups, which increased from 15.4 to 27.6 repetitions (P =.0022). Performance on the 8-foot-up-and-go test improved as well, with times decreasing from 4.48 seconds to 3.88 seconds (P =.0001).

Patient-reported quality of life outcomes similarly improved after rehabilitation. Pediatric Quality of Life Inventory (PedsQL) scores increased from 64.95 to 70.74 among patients (P =.027), while parent-reported scores improved from 60.67 to 68.40 (P =.021).

Patients and caregivers favorably viewed the rehabilitation program, supporting the feasibility and acceptability of pediatric pulmonary rehabilitation implementation in clinical practice.

“One of the main goals of our program is to increase patients’ confidence in the self-management of their disease and to promote physical activity outside of the medical facility,” Vucianis said. “We are always thrilled to hear when our former participants are continuing to implement their own exercise programs long after their [pulmonary rehabilitation] sessions have ended.”

Investigators said future research will evaluate the durability of rehabilitation benefits, optimal timing of intervention, and the impact of pediatric [pulmonary rehabilitation] on additional clinical outcomes among children with chronic respiratory diseases.

Another Program-Focused Study Presented at ATS 2026

A study found the NYC Public Housing Mold Program, known as NYCHA’s Mold Busters initiative, was associated with a significant reduction in asthma-related emergency department (ED) visits. Investigators reported an average decrease of 9 asthma ED visits per 1000 residents annually.

Across NYCHA public housing developments, this translated to an estimated 2798 fewer asthma-related ED visits per year from 2021 to 2023. Investigators linked the Mold Busters program, focused on mold remediation, ventilation improvements, and faster complaint response times, to reduced asthma burden in low-income, high-risk communities.

Analysis using differences-in-differences methods suggested asthma ED visits would have been about 25% greater without the intervention. Buildings with the steepest declines in mold complaints also saw the largest reductions in asthma ED visits, reinforcing the impact of large-scale housing-based environmental health interventions.

References

1. Vucianis T, Foster K, Nakamura A, et al. Benefits of Pulmonary Rehabilitation for Pediatric Chronic Respiratory Disease. Poster presented at ATS 2026 in Orlando, Florida, on May 17, 2026. https://ats2026.d365.events/education/abstracts/abstracts/1395cb7b-e3a2-4a0d-a091-447fc457daaf

2. Pediatric pulmonary rehab improves exercise ability, quality of life. EurekAlert! Published on May 17, 2026. Accessed May 16, 2026. https://www.eurekalert.org/news-releases/1127720

3. Rochester CL, Alison JA, Carlin B, et al. Pulmonary Rehabilitation for Adults with Chronic Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2023;208(4):e7-e26. doi:10.1164/rccm.202306-1066ST

4. Flores N, Casey J, Lovinsky-Desir S, et al. Large-Scale Mold Intervention Reduced Asthma Emergency Department Visits in New York City Public Housing Differentially Across Building and Neighborhood Characteristics. Poster presented at ATS 2026 in Orlando, Florida, on May 17, 2026.