The Role of Cardiopulmonary Physical Therapy in Promoting Healthy Aging and Preventing Age-Related Respiratory Problems: A Systematic Review

Background: Population aging is associated with progressive declines in cardiopulmonary function and an increased burden of chronic respiratory conditions, underscoring the need for effective strategies that support healthy aging and functional independence. Objective: To systematically synthesize current evidence on the role of cardiopulmonary physical therapy (CPT) in promoting healthy aging and preventing age-related respiratory problems in older adults. Methods: A systematic review with narrative synthesis was conducted in accordance with established systematic review principles. PubMed, Scopus, Web of Science, and CINAHL were searched for English-language studies published between January 2019 and December 2024. Eligible studies included adults aged ≥60 years who received CPT or pulmonary rehabilitation interventions, with outcomes related to respiratory function, exercise capacity, quality of life, or functional independence. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Results: Ten studies involving at least 4,296 participants met the inclusion criteria, comprising randomized and non-randomized interventional studies, observational studies, and secondary evidence syntheses. CPT interventions were consistently associated with improvements in exercise capacity and health-related quality of life, while effects on respiratory function and preventive outcomes were mixed and dependent on intervention specificity. Overall certainty of evidence ranged from low to moderate, reflecting heterogeneity in study designs and predominantly moderate risk of bias. Conclusion: CPT appears to be a beneficial component of care for older adults, particularly for enhancing functional capacity and quality of life; however, evidence supporting direct preventive effects on age-related respiratory decline remains limited. Higher-quality, long-term studies are required to clarify the preventive role of CPT in healthy aging.