{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:38:35Z","timestamp":1789115915503,"version":"build-2803163510"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:p>Pulmonary rehabilitation (PR) is a cornerstone in the management of chronic respiratory diseases (CRD), but access remains severely limited in low- and middle-income countries (LMICs) because of cost, infrastructure, and workforce barriers. This mini narrative review synthesized evidence on the effectiveness, feasibility, and implementation of low-cost PR strategies designed with minimal equipment and simplified delivery models. Low-cost PR was considered not only as exercise training using minimal or improvised equipment, but as a context-adapted rehabilitation model that preserves essential PR components while adapting to local health-system, workforce, cultural, and socioeconomic constraints. Searches were conducted in PubMed, Scopus, Web of Science, and SciELO (2014\u20132024); twenty publications were included, comprising randomized controlled trials, quasi-experimental studies, systematic reviews, clinical guidelines, and implementation research. Across studies, low-cost PR consistently improved exercise capacity, symptoms, and health-related quality of life, measured by 6MWT, ISWT, SGRQ, and CAT. Home-based and community programs demonstrated feasibility and safety, often comparable to conventional PR; supervision and structured education enhanced adherence, while properly instructed unsupervised programs also showed non-inferior outcomes. Tai Chi and Nordic walking emerged as culturally adaptable, low-cost alternatives. However, evidence remains heterogeneous and predominantly COPD-focused, with limited data for other CRD and few studies in primary healthcare, restricting generalizability to the broader CRD burden in LMICs. Effective scale-up requires attention to workforce availability, primary healthcare integration, contextual barriers to home-based rehabilitation, digital accessibility, education, equity, and long-term sustainability. Further high-quality trials and implementation studies are needed to consolidate evidence and inform policies that integrate context-adapted, affordable PR into healthcare systems.<\/jats:p>","DOI":"10.3389\/fresc.2026.1706188","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T07:56:07Z","timestamp":1789113367000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Low-cost pulmonary rehabilitation for chronic respiratory diseases: a narrative review"],"prefix":"10.3389","volume":"7","author":[{"given":"Else Sali\u00e9s","family":"Fonseca","sequence":"first","affiliation":[{"name":"Center for Advanced Study and Research in Sports, Federal University of Goi\u00e1s","place":["Goi\u00e2nia, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Velloso","sequence":"additional","affiliation":[{"name":"Laboratory for Assessment and Research in 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