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Couto N, Cid L, Alves S, Brito JP, Pimenta N, Bento T. Analysing the Effects of Different Types of Exercise on Dyspnoea and Fatigue in Adults through COPD-Systematic Review and Meta-Analysis of Randomised Clinical Trials. Healthcare (Basel) 2023; 11:healthcare11101449. [PMID: 37239735 DOI: 10.3390/healthcare11101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/09/2023] [Accepted: 05/14/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition, the main symptoms of which are dyspnoea and fatigue. Though exercise has been recommended for subjects with COPD, its benefits remain unclear. The aim of this study was to summarise, through a systematic review and meta-analysis, the available evidence on the effects of aerobic, resistance, stretching, and combined exercise on the main symptoms of COPD. METHODS Search was performed using the electronic databases PubMed and Web of Science. Randomised controlled trials (RCTs) with interventions based on aerobic, resistance and/or combined exercise published until July 2022 were identified. The effects were summarised based on standardised mean differences (95% confidence intervals) using random and fixed effect models. RESULTS Eight studies were selected, including a total of 375 subjects. The results obtained showed that resistance exercise, aerobic exercise and combined exercise seem to improve dyspnoea and fatigue symptoms in COPD subjects. CONCLUSIONS In general, we can conclude that exercise-based interventions appear to improve the main COPD symptoms and may benefit quality of life in this population.
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Affiliation(s)
- Nuno Couto
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5000-556 Vila Real, Portugal
| | - Luís Cid
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5000-556 Vila Real, Portugal
- Life Quality Research Center (CIEQV), 2040-413 Santarém, Portugal
| | - Susana Alves
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Life Quality Research Center (CIEQV), 2040-413 Santarém, Portugal
| | - João Paulo Brito
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5000-556 Vila Real, Portugal
- Life Quality Research Center (CIEQV), 2040-413 Santarém, Portugal
| | - Nuno Pimenta
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Kinetics, 1495-207 Lisbon, Portugal
- The Interdisciplinary Health Research Centre, Catholic University of Portugal, 1649-023 Lisbon, Portugal
| | - Teresa Bento
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5000-556 Vila Real, Portugal
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Kim S, Xu Y, Dore K, Gewurtz R, Larivière N, Letts L. Fatigue self-management led by occupational therapists and/or physiotherapists for chronic conditions: A systematic review and meta-analysis. Chronic Illn 2022; 18:441-457. [PMID: 34515530 PMCID: PMC9397391 DOI: 10.1177/17423953211039783] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effectiveness of occupational therapist-/physiotherapist-guided fatigue self-management for individuals with chronic conditions. METHODS Eight databases, including MEDLINE and EMBASE, were searched until September 2019 to identify relevant studies. Randomised controlled trials and quasi-experimental studies of self-management interventions specifically developed or delivered by occupational therapists/physiotherapists to improve fatigue symptoms of individuals with chronic conditions were included. A narrative synthesis and meta-analysis were conducted to determine the effectiveness of fatigue self-management. RESULTS Thirty-eight studies were included, and fatigue self-management approaches led by occupational therapists/physiotherapists were divided into six categories based on the intervention focus: exercise, energy conservation, multimodal programmes, activity pacing, cognitive-behavioural therapy, and comprehensive fatigue management. While all exercise programmes reported significant improvement in fatigue, other categories showed both significant improvement and no improvement in fatigue. Meta-analysis yielded a standardised mean difference of the overall 13 studies: 0.42 (95% confidence interval:-0.62 to - 0.21); standardised mean difference of the seven exercise studies was -0.55 (95% confidence interval: -0.78 to -0.31). DISCUSSION Physical exercises inspired by the self-management principles may have positive impacts on fatigue symptoms, quality of life, and other functional abilities.
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Affiliation(s)
- Sungha Kim
- 63662School of Rehabilitation Science, 3710McMaster University, Hamilton, ON, Canada
| | - Ying Xu
- 63662School of Rehabilitation Science, 3710McMaster University, Hamilton, ON, Canada
| | - Kelly Dore
- Department of Medicine, 12362McMaster Education Research, Innovation & Theory (MERIT), 12370David Braley Health Science Centre, Hamilton, ON, Canada
| | - Rebecca Gewurtz
- 63662School of Rehabilitation Science, 3710McMaster University, Hamilton, ON, Canada
| | - Nadine Larivière
- Department of Medicine, 12362McMaster Education Research, Innovation & Theory (MERIT), 12370David Braley Health Science Centre, Hamilton, ON, Canada
| | - Lori Letts
- 63662School of Rehabilitation Science, 3710McMaster University, Hamilton, ON, Canada
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Effects of Walking on Fatigue in Cancer Patients: A Systematic Review and Meta-analysis. Cancer Nurs 2021; 45:E270-E278. [PMID: 34870943 DOI: 10.1097/ncc.0000000000000914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Walking is a simple form of exercise that is easily accepted by patients. Exercise is one of the main ways to control cancer-related fatigue (CRF). However, there are conflicting data on the association between walking and severity of CRF. OBJECTIVE The aim of this study was to assess the overall effect of walking on CRF among adult cancer patients. METHODS Databases including PubMed, CINAHL, EMBASE, and Cochrane Library were systematically reviewed to identify suitable randomized controlled trials from inception to February 29, 2020. Two reviewers independently evaluated the risk of bias and extracted correlated data with Cochrane Handbook of Systematic Reviews on Interventions. The data analysis was performed by Review Manager 5.3. RESULTS A total of 12 studies with 1064 patients were identified. Integrated result analysis of walking yielded a statistically significant effect on CRF (standard mean difference [SMD], -0.66; 95% confidence interval [CI], -1.06 to -0.26). Subgroup analysis demonstrated that intervention time longer than 6 weeks (SMD, -0.89; 95% CI, -1.22 to -0.57) had a better effect on fatigue compared with that of less than 6 weeks (SMD, 0.03; 95% CI, -0.39 to 0.45). The study showed walking was statistically more effective than the control intervention in patients undergoing cancer treatment (SMD, -0.79; 95% CI, -1.16 to -0.42). Descriptive analysis also showed that walking was effective for cancer patients who completed treatment. CONCLUSIONS Walking is effective for CRF during and after cancer therapy. IMPLICATIONS FOR PRACTICE The results provide evidence for a general exercise form to relieve fatigue in cancer patients and facilitate support for future clinical trials and work.
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Özer Z, Bahçecioğlu Turan G, Aksoy M. The effects of yoga on dyspnea, sleep and fatigue in chronic respiratory diseases. Complement Ther Clin Pract 2021; 43:101306. [PMID: 33545575 DOI: 10.1016/j.ctcp.2021.101306] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/12/2020] [Accepted: 01/14/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE This study was carried out to find out the effects of yoga applied to chronic respiratory disease patients on dyspnea, sleep quality and fatigue. MATERIAL AND METHOD The study was conducted between May and August 2020 as a randomized controlled study. 'Personal Information Form', 'Respiratory Functions Monitoring Form', 'COPD and Asthma Fatigue Scale (CAFS), "Asthma and COPD Sleep Impact Scale (CASIS)" and Modified Medical Research Council Dyspnea Scale (mMRC) were used in data collection. RESULTS When the post-test mean scores of the patients in the experimental and control group were compared, it was found that CAFS, CASIS and mMRC mean scores of the patients in the experimental group decreased positively compared to the patients in the control group and the difference between was found to be statistically significant (p < 0.05). CONCLUSION Yoga has been found to reduce the severity of dyspnea and fatigue and improve sleep quality in chronic respiratory diseases.
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Affiliation(s)
- Zülfünaz Özer
- Department of Nursing, Faculty of Health Sciences, Istanbul Sabahattin Zaim University, Istanbul, Turkey.
| | | | - Meyreme Aksoy
- Department of Nursing, Faculty of Health Science Siirt University, Siirt, Turkey.
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Paneroni M, Vitacca M, Venturelli M, Simonelli C, Bertacchini L, Scalvini S, Schena F, Ambrosino N. The impact of exercise training on fatigue in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Pulmonology 2020; 26:304-313. [DOI: 10.1016/j.pulmoe.2020.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 12/13/2022] Open
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Schuler M, Wittmann M, Faller H, Schultz K. The interrelations among aspects of dyspnea and symptoms of depression in COPD patients - a network analysis. J Affect Disord 2018; 240:33-40. [PMID: 30048834 DOI: 10.1016/j.jad.2018.07.021] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/21/2018] [Accepted: 07/08/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Depression is a frequent comorbidity in COPD. COPD symptoms such as dyspnea may play an important role in the causal relationship between COPD and depression. We investigated the interrelations among different aspects of dyspnea and other COPD parameters and symptoms of depression in COPD patients. METHODS This is a secondary analysis of N = 590 COPD patients. At the beginning (T0) and the end (T1) of a 3-week inpatient pulmonary rehabilitation, dyspnea aspects intensity (BORG scale), frequency (2 CCQ items), functioning (CCQ-function) and cognitive/emotional response (2 SGRQ items) as well as cough (2 CCQ items), functional capacity (6MWD), lung function (FEV1) and symptoms of depression (PHQ-9) were assessed. Regression analyses with PHQ-9 sum score as dependent variable as well as network analysis using PHQ-9 single items were performed. Structural invariance over time was examined. RESULTS Dyspnea frequency, function, and cognitive/emotional response showed conditional independent relationships with PHQ-9 sum score. Network analysis showed that dyspnea frequency and dyspnea functioning were primarily associated with somatic depression symptoms (for example, sleep problems, loss of energy), while cognitive/emotional response was primarily related to cognitive-affective depression symptoms (for example, feeling down/depressed/hopeless). Regression parameters, network structure and network global strength did not differ between T0 and T1. LIMITATIONS Models are based on between-person relationships. Results should be confirmed using time-series data. CONCLUSIONS Dyspnea and depression seem to be interrelated through a variety of different and complex pathways in COPD patients. Results may be used to explain intervention effects and develop new intervention strategies to reduce depression in COPD.
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Affiliation(s)
- Michael Schuler
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Science, University of Würzburg, Würzburg, Germany.
| | - Michael Wittmann
- Klinik Bad Reichenhall, Center of Rehabilitation, Pulmonology and Orthopedics, Bad Reichenhall, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Science, University of Würzburg, Würzburg, Germany
| | - Konrad Schultz
- Klinik Bad Reichenhall, Center of Rehabilitation, Pulmonology and Orthopedics, Bad Reichenhall, Germany
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Yilmaz FT, Aydin HT. The effect of a regular walking program on dyspnoea severity and quality of life in normal weight, overweight, and obese patients with chronic obstructive pulmonary disease. Int J Nurs Pract 2018; 24:e12636. [PMID: 29498156 DOI: 10.1111/ijn.12636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/26/2018] [Accepted: 01/28/2018] [Indexed: 12/01/2022]
Abstract
AIM The objective was to determine the effect of a regular walking program on physical activity (the number of steps and walking duration), dyspnoea severity, and quality of life in normal weight, overweight, and obese patients with chronic obstructive pulmonary disease. METHOD An experimental study; 50 patients with chronic obstructive pulmonary disease admitted to the respiratory clinic of a public hospital in Turkey between November 2014 and July 2015 were included. All the patients underwent a regular walking program (at least 30 minutes every day) using a pedometer for 16 weeks under the supervision of a nurse. RESULTS After the regular walking program, the respiratory function test results of the obese patients were significantly improved. The walking duration, the number of steps taken per day, and the quality of life of all participants improved significantly, and dyspnoea severity was reduced in all participants. CONCLUSION The regular walking program reduced dyspnoea severity and improved quality of life in all participants. Nurses' efforts to increase activity levels in all patients with chronic obstructive pulmonary disease, and particularly those with obesity, through a regular walking program may contribute to reduce the severity of dyspnoea and improve quality of life.
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Affiliation(s)
- Feride Taskin Yilmaz
- Department of Internal Diseases Nursing, School of Susehri Health High, Cumhuriyet University, Sivas, Turkey
| | - Hatice Tel Aydin
- Department of Internal Diseases Nursing, Faculty of Healthy Science, Cumhuriyet University, Sivas, Turkey
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Al-Shair K, Kolsum U, Singh D, Vestbo J. The Effect of Fatigue and Fatigue Intensity on Exercise Tolerance in Moderate COPD. Lung 2016; 194:889-895. [PMID: 27549363 PMCID: PMC5093188 DOI: 10.1007/s00408-016-9931-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 08/07/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Fatigue is one of the most disabling symptoms in COPD, but little is known about the impact of fatigue on functional disability. We explored the impact of fatigue and fatigue intensity on exercise tolerance after adjusting for other factors using multivariate analysis and compared it to that of dyspnoea. METHODS A total of 119 patients with mainly moderate-severe stable COPD (38 % women, mean age 66 years) were enrolled. We used the Medical Research Council dyspnoea scores (MRC), Manchester COPD fatigue scale (MCFS) and its three dimensions, Borg scales for fatigue and dyspnoea, six-minute walk distance (6MWD), St George's Respiratory Questionnaire, the BODE index, and the Centre for Epidemiological Study on Depression scale (CES-D), and we measured spirometry, blood gases, systemic inflammatory markers and fat-free mass index (FFMI). RESULTS Fatigue measured using the MCFS was associated with 6MWD and explained 22 % of the variability in 6MWD (p < 0.001). Fatigue remained associated with 6MWD after adjusting for MRC dyspnoea, FFMI and FEV1, FVC, PaO2, PaCO2, CES-D, TNF-alpha, smoking status, age and gender. We found that 33, 50 and 23 % of patients reported an increase by 2 scores on Borg scales for fatigue, dyspnoea or both at the end of the 6MWT. Fatigue scores (both before and after the 6MWT) were negatively correlated with 6MWD after adjusting for FEV1, FFMI, CES-D score and age (p = 0.007 and 0.001, respectively). CONCLUSION In moderate stable COPD, fatigue may be a central driver of functional disability, to the same extent as dyspnoea.
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Affiliation(s)
- Khaled Al-Shair
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK.
- Respiratory Research Group, 2nd floor The Education and Research Centre, South Manchester University Hospitals Trust, Manchester, M23 9LT, UK.
| | - Umme Kolsum
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK
| | - Dave Singh
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK
| | - Jørgen Vestbo
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK
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