Abstract
Objective: To evaluate the effect of various exercise interventions on lung function, specifically forced expiratory volume in 1 second (FEV1), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP), as well as on cardiorespiratory fitness (peak oxygen uptake [VO2peak]), and muscle strength (handgrip strength). The review also considers factors such as patient adherence, follow-up duration, and statistical significance to inform clinical practice. Methods: This systematic review followed preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines and was prospectively registered in international prospective register of systematic reviews. PubMed, Google Scholar, OVID, and Web of Science were systematically searched. Eligible studies were randomized controlled trials enrolling cystic fibrosis (CF) patients aged 7 or older, reporting outcomes related to pulmonary function, cardiorespiratory fitness, or muscle strength following aerobic, resistance, or mixed exercise interventions. Results: A total of 1,033 articles were identified through the database search. After screening and eligibility assessment, 4 randomized controlled trials involving 156 participants met the inclusion criteria. Both supervised and wearable activity tracker (WAT)-based exercise programs significantly improved VO2peak and exercise capacity, as demonstrated by the 6-minute walk test. Home-based programs enhanced upper limb muscle strength. However, improvements in FEV1 were inconsistent and tended to decline without ongoing training. No adverse events were reported. Conclusion: Structured exercise, particularly WAT based or supervised, supports better physical fitness in CF. Standardized protocols, longer-term follow-up, diverse participant inclusion, and strategies to improve adherence are needed in future research.