Comparative Effectiveness of Rehabilitation Programs for Adults with Post-Tuberculosis Lung Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Persistent respiratory and functional impairments after pulmonary tuberculosis can reduce exercise capacity and health-related quality of life. This systematic review and meta-analysis evaluated structured rehabilitation in adults with post-tuberculosis lung disease (PTLD). Methods: The review followed PRISMA 2020 and was prospectively registered in PROSPERO (CRD420261338253). PubMed/MEDLINE, Scopus, Web of Science Core Collection, CENTRAL, and PEDro were searched from inception, with final bibliographic updating through 5 September 2026 and trial registry cross-linking through 28 August 2026. Results: Seven randomized trial reports were included. Two directly comparable adjusted ISWT trials are presented as the main exercise capacity findings: a study published in 2026 reported +54.36 m (95% CI 17.22 to 91.51) and a research conducted in 2026 reported +123.0 m (95% CI 81.1 to 164.8). The pooled random-effects estimate was +87.98 m (95% Hartung–Knapp CI −348.01 to 523.96), but this estimate is presented secondarily because the interval was extremely wide with only two contributing trials. A 120-participant RCT reported an adjusted 6MWD benefit of +87.4 m (95% CI 74.2 to 100.6). A newly identified three-arm RCT (n = 180) reported statistically significant omnibus between-group differences, but substantial baseline imbalance and unusual control group reporting patterns limit device-versus-control interpretation. Certainty was very low for exercise capacity, dyspnea, health-related quality of life, pulmonary function, inspiratory muscle strength, and adverse events. Conclusions: Accordingly, the evidence is very uncertain regarding the effects of structured rehabilitation on these outcomes and regarding the magnitude and generalizability of any benefit in PTLD.