What happened?
A 67-year-old man with polymyositis-associated interstitial lung disease was transferred to a rehabilitation hospital after a complicated acute illness. He had severe malnutrition, marked muscle loss and rapid shallow breathing that restricted exercise tolerance.
Clinical findings
- At rehabilitation admission, weight was 32.0 kg, BMI 12.10 kg/m² and skeletal muscle index 3.8 kg/m².
- Resting respiratory rate was 40 breaths per minute, with severe exercise-related tachypnoea.
- The patient had dysphagia and a prolonged period of inadequate nutritional intake during the acute illness.
Rehabilitation described in the report
- Physiotherapy combined belt-electrode skeletal muscle electrical stimulation with carefully titrated aerobic and resistance exercise.
- Nutrition was progressively increased with oral nutritional supplements and monitoring for complications; exercise was adjusted or paused when respiratory symptoms were severe.
Reported outcomes
- At discharge, body weight increased by 4.6 kg and skeletal muscle mass increased from 13.9 to 15.5 kg; skeletal muscle index rose to 4.4 kg/m².
- Continuous aerobic exercise duration increased to 30 minutes and six-minute walk distance was 306 metres.
Clinical lessons to consider
- Exercise tolerance in complex respiratory disease may be limited by both cardiopulmonary impairment and severe malnutrition.
- Coordinate physiotherapy, nutrition and medical monitoring, particularly when refeeding risk is present.
- Adjust exercise intensity to respiratory response and clinical stability.
Limitations — what this case cannot tell us
- Single case with multiple simultaneous interventions; the separate effects of nutrition, electrical stimulation and exercise cannot be determined.
- The patient's severe and specific clinical context limits generalisability.
Original source
Yosuke Morimoto, Tomoki Yanase, Tomohiro Matsuo, Takuro Ohtsubo, Kazuna Tokihisa, Ai Shinbo, Kosuke Miyamoto, Katsuhiro Ueno, Shuichi Kozawa. “Aggressive Nutrition Therapy in a Rehabilitation Hospital for Severe Tachypnoea and Profound Weight Loss With Interstitial Lung Disease: A Case Report.” Respirology Case Reports, 2026. DOI: 10.1002/rcr2.70623
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