1
|
Gao Y, Li C, Li J, Li L. Causal relationships of physical activity and leisure sedentary behaviors with COPD: A Mendelian randomization study. Arch Gerontol Geriatr 2024; 121:105364. [PMID: 38430688 DOI: 10.1016/j.archger.2024.105364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/26/2024] [Accepted: 02/04/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Chronic diseases such as chronic obstructive pulmonary disease (COPD) have been linked to low levels of physical activity (PA) and higher frequency of leisure sedentary behavior (LSB). The main causes of COPD include respiratory and peripheral muscle dysfunction, low levels of PA, and LSB which are associated with a higher risk of developing COPD. The attribution relationship between PA or LSB and COPD risk or COPD respiratory insufficiency is unclear. To explore this further, we conducted a Mendelian randomization (MR) study using a genotype-simulated randomized trial group to systematically evaluate the causal relationships of PA/LSB on COPD risk and respiratory insufficiency. METHODS The exposure data were obtained from large-scale genome-wide association studies (GWAS), including the PA dataset (N = 729,373) and LSB dataset (N = 1,109,337). The outcome data were derived from the Finn-Gen COPD dataset (N = 381,392). The causal effects were estimated with IVW1, MR-Egger, and WM2. Sensitivity analysis was conducted using Cochran's Q test, MR-Egger intercept test, MR-PRESSO3, leave-one-out analysis, and funnel plot to estimate the robustness of our findings. RESULTS Genetically predicted leisure television (TV) watching significantly increased the risk of COPD (OR = 2.4895, 95 % CI: 1.85259 to 3.34536; P = 1.44 × 10-9) and COPD respiratory insufficiency (OR = 2.55, 95 % CI: 1.53 to 4.27; P = 3.54 × 10-4). No casual effect of other PA or LSB phenotypes on COPD risk or respiratory insufficiency was observed. CONCLUSION Our study provides evidence that TV watching may increase the risk of COPD and its related respiratory insufficiency. These findings emphasized the importance of promoting regular physical exercise and reducing leisure sedentary behavior to prevent COPD.
Collapse
Affiliation(s)
- Yixuan Gao
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Beijing 100084, China; Laboratory of Sports Stress and Adaptation of General Administration of Sports, 48 Xinxi Road, Beijing 100084, China
| | - Conghui Li
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Beijing 100084, China
| | - Junping Li
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Beijing 100084, China; Laboratory of Sports Stress and Adaptation of General Administration of Sports, 48 Xinxi Road, Beijing 100084, China.
| | - Ling Li
- Physical and Military Education, Jingdezhen Ceramic University, Jiangxi Province 333403, China
| |
Collapse
|
2
|
Cui S, Ji H, Li L, Zhu H, Li X, Gong Y, Song Y, Hu L, Wu X. Effects and long-term outcomes of endurance versus resistance training as an adjunct to standard medication in patients with stable COPD: a multicenter randomized trial. BMC Pulm Med 2024; 24:196. [PMID: 38649893 PMCID: PMC11036716 DOI: 10.1186/s12890-024-03010-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Comparisons between endurance training (ET) and resistance training (RT) have produced equivocal findings in chronic obstructive pulmonary disease (COPD) patients. The purpose of our study is to investigate the effectiveness and long-term outcomes of adding ET and RT to conventional medical treatment in patients with COPD. A secondary objective is to investigate the clinical improvements resulting from exercise training in patients with different disease severities. METHODS The study was a multicenter, prospective trial in people with stable COPD. The cohort was randomized to three groups: individualized medical treatment group (MT), MT + endurance training group (MT + ET) and MT + resistance training group (MT + RT). Exercise was performed 3 times weekly over a 12-week period. The endpoints of exercise capacity, health-related quality of life, COPD symptoms, lung function, and anxiety and depression questionnaires were re-evaluated at baseline, at the completion of the intervention and at 6 and 12-month follow-up. According to the COPD assessment tool offered by GOLD guidelines, patients were stratified into GOLD A and B groups and GOLD C and D groups for further subgroup analysis. RESULTS The intention-to-treat (ITT) population included 366 patients, 328 of them completed the study protocol over 12 months (the PP-population). There were no significant differences in the primary outcome, quality of life, between patients who underwent medical treatment (MT) alone, MT + endurance training (MT + ET), or MT + resistance training (MT + RT) at the completion of the intervention, 6-, or 12-month follow-up. Additionally, no significant differences were observed between MT, MT + RT, or MT + ET groups concerning the primary outcome, exercise capacity (3MWD), after initial 3 months of intervention. However, a small statistically significant difference was noted in favor of MT + ET compared to MT + RT at 12 months (ITT: Δ3MWD in ET vs RT = 5.53 m, 95% confidence interval: 0.87 to 13.84 m, P = 0.03) (PP: Δ3MWD in ET vs RT = 7.67 m, 95% confidence interval: 0.93 to 16.27 m, P = 0.04). For patients in the GOLD C and D groups, improvement in quality of life following ET or RT was significantly superior to medical intervention alone. Furthermore, upon completion of the exercise regimen, RT exhibited a greater improvement in anxiety compared to ET in these patients (ITT: ΔHAD-A at 3-month: RT = -1.63 ± 0.31 vs ET = -0.61 ± 0.33, p < 0.01) (PP: ΔHAD-A at 3-month: RT = -1.80 ± 0.36 vs ET = -0.75 ± 0.37, p < 0.01). CONCLUSIONS Our study presents evidence of the beneficial effects of ET and RT in combination with standard medical treatment, as well as the long-term effects over time after the intervention. While the statistically significant effect favoring ET over RT in terms of exercise capacity was observed, it should be interpreted cautiously. Patients in severe stages of COPD may derive greater benefits from either ET or RT and should be encouraged accordingly. These findings have implications for exercise prescription in patients with COPD. TRIAL REGISTRATION ChiCTR-INR-16009892 (17, Nov, 2016).
Collapse
Affiliation(s)
- Shilei Cui
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China
- Department of Pulmonary and Critical Care Medicine, Huadong Hospital, Fudan University, Shanghai, 200040, China
| | - Haiying Ji
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China
- Shanghai Respiratory Research Institute, Shanghai, 200032, China
| | - Li Li
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China
- Shanghai Respiratory Research Institute, Shanghai, 200032, China
| | - Huili Zhu
- Department of Pulmonary and Critical Care Medicine, Huadong Hospital, Fudan University, Shanghai, 200040, China
| | - Xiangyang Li
- Department of Pulmonary and Critical Care Medicine, Huadong Hospital, Fudan University, Shanghai, 200040, China
| | - Ying Gong
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China
- Shanghai Respiratory Research Institute, Shanghai, 200032, China
| | - Yuanlin Song
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China.
- Shanghai Respiratory Research Institute, Shanghai, 200032, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200032, China.
| | - Lijuan Hu
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China.
- Shanghai Respiratory Research Institute, Shanghai, 200032, China.
| | - Xu Wu
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China.
- Shanghai Respiratory Research Institute, Shanghai, 200032, China.
| |
Collapse
|
3
|
Zhu Z, Muhamad AS, Omar N, Ooi FK, Pan X, Ong MLY. Efficacy of exercise treatments for chronic obstructive pulmonary disease: A systematic review. J Bodyw Mov Ther 2024; 38:106-127. [PMID: 38763549 DOI: 10.1016/j.jbmt.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/24/2023] [Accepted: 01/13/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE To review the efficacy of exercise treatments on chronic obstructive pulmonary disease (COPD). DATA SOURCES PubMed, Scopus, Science Direct, Ebscohost, SPORTDiscus, ProQuest, Web of Science. REVIEW METHODS A systematic review was performed to identify the relevant studies published from 2011 to 2023. Studies were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 5170 articles were retrieved and assessed using the Physiotherapy Evidence Database (PEDro) scale. The risk of bias in individual studies was assessed with the Cochrane risk of bias tool. RESULTS A total of 38 eligible studies were included. Eight studies evaluated the effects of Tai Chi, followed by Liuzijue (five studies) and yoga (three studies). The duration of the exercise programmes ranged from 8 weeks to 3 years, and the frequency was between 2 and 7 times a week. Exercise sessions lasted between 20 and 90 min. Low-intensity exercise improved lung function after six months. Whole-body exercise improved dyspnea more than local exercise. Water-based exercise improved physical endurance more than land exercise, and quality of life was unaffected by long-term exercise. CONCLUSION This systematic review highlights the benefit of exercise treatments as a potential adjunct treatment for COPD patients.
Collapse
Affiliation(s)
- Zhenggang Zhu
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Ayu Suzailiana Muhamad
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Norsuhana Omar
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Foong Kiew Ooi
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Xiaoyan Pan
- School of Nursing, Hunan University of Chinese Medicine, Yuelu District, Changsha, Hunan, China
| | - Marilyn Li Yin Ong
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
| |
Collapse
|
4
|
Li J, Chen CT, Li P, Zhang X, Liu X, Wu W, Gu W. Lung transcriptomics reveals the underlying mechanism by which aerobic training enhances pulmonary function in chronic obstructive pulmonary disease. BMC Pulm Med 2024; 24:154. [PMID: 38532405 DOI: 10.1186/s12890-024-02967-1] [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: 11/20/2023] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Aerobic training is the primary method of rehabilitation for improving respiratory function in patients with chronic obstructive pulmonary disease (COPD) in remission. However, the mechanism underlying this improvement is not yet fully understood. The use of transcriptomics in rehabilitation medicine offers a promising strategy for uncovering the ways in which exercise training improves respiratory dysfunction in COPD patients. In this study, lung tissue was analyzed using transcriptomics to investigate the relationship between exercise and lung changes. METHODS Mice were exposed to cigarette smoke for 24 weeks, followed by nine weeks of moderate-intensity treadmill exercise, with a control group for comparison. Pulmonary function and structure were assessed at the end of the intervention and RNA sequencing was performed on the lung tissue. RESULTS Exercise training was found to improve airway resistance and lung ventilation indices in individuals exposed to cigarette smoke. However, the effect of this treatment on damaged alveoli was weak. The pair-to-pair comparison revealed numerous differentially expressed genes, that were closely linked to inflammation and metabolism. CONCLUSIONS Further research is necessary to confirm the cause-and-effect relationship between the identified biomarkers and the improvement in pulmonary function, as this was not examined in the present study.
Collapse
Affiliation(s)
- Jian Li
- Department of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University (Second Military Medical University), 200433, Shanghai, PR China
- Department of Sports Rehabilitation, Shanghai University of Sport, No. 399 Changhai Road, Yangpu District, 200438, Shanghai, PR China
| | - Cai-Tao Chen
- Department of Rehabilitation Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, 200434, Shanghai, PR China
| | - Peijun Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 201203, Shanghai, PR China
| | - Xiaoyun Zhang
- Laboratory Department of the 908th Hospital of the Joint Logistics Support Force, 330001, Nanchang, PR China
| | - Xiaodan Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 201203, Shanghai, PR China
| | - Weibing Wu
- Department of Sports Rehabilitation, Shanghai University of Sport, No. 399 Changhai Road, Yangpu District, 200438, Shanghai, PR China.
| | - Wei Gu
- Faculty of Traditional Chinese Medicine, Naval Medical University (Second Military Medical University), No. 800 Xiangyin Road, Yangpu District, 200433, Shanghai, PR China.
| |
Collapse
|
5
|
Chow R, So OW, Im JHB, Chapman KR, Orchanian-Cheff A, Gershon AS, Wu R. Predictors of Readmission, for Patients with Chronic Obstructive Pulmonary Disease (COPD) - A Systematic Review. Int J Chron Obstruct Pulmon Dis 2023; 18:2581-2617. [PMID: 38022828 PMCID: PMC10664718 DOI: 10.2147/copd.s418295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/08/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death globally and is responsible for over 3 million deaths annually. One of the factors contributing to the significant healthcare burden for these patients is readmission. The aim of this review is to describe significant predictors and prediction scores for all-cause and COPD-related readmission among patients with COPD. Methods A search was conducted in Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, from database inception to June 7, 2022. Studies were included if they reported on patients at least 40 years old with COPD, readmission data within 1 year, and predictors of readmission. Study quality was assessed. Significant predictors of readmission and the degree of significance, as noted by the p-value, were extracted for each study. This review was registered on PROSPERO (CRD42022337035). Results In total, 242 articles reporting on 16,471,096 patients were included. There was a low risk of bias across the literature. Of these, 153 studies were observational, reporting on predictors; 57 studies were observational studies reporting on interventions; and 32 were randomized controlled trials of interventions. Sixty-four significant predictors for all-cause readmission and 23 for COPD-related readmission were reported across the literature. Significant predictors included 1) pre-admission patient characteristics, such as male sex, prior hospitalization, poor performance status, number and type of comorbidities, and use of long-term oxygen; 2) hospitalization details, such as length of stay, use of corticosteroids, and use of ventilatory support; 3) results of investigations, including anemia, lower FEV1, and higher eosinophil count; and 4) discharge characteristics, including use of home oxygen and discharge to long-term care or a skilled nursing facility. Conclusion The findings from this review may enable better predictive modeling and can be used by clinicians to better inform their clinical gestalt of readmission risk.
Collapse
Affiliation(s)
- Ronald Chow
- University Health Network, University of Toronto, Toronto, ON, Canada
| | - Olivia W So
- University Health Network, University of Toronto, Toronto, ON, Canada
| | - James H B Im
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Kenneth R Chapman
- University Health Network, University of Toronto, Toronto, ON, Canada
| | | | - Andrea S Gershon
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Robert Wu
- University Health Network, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
6
|
Fernandes I, Santos A, Rodrigues G, Oliveira A, Marques A. Functional status following pulmonary rehabilitation in people with ECOPD: A systematic review and meta-analysis. Respir Med Res 2023; 84:101045. [PMID: 37625373 DOI: 10.1016/j.resmer.2023.101045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/20/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023]
Affiliation(s)
- Inês Fernandes
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health, University of Aveiro (ESSUA), Aveiro, Portugal
| | - André Santos
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Guilherme Rodrigues
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Ana Oliveira
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal; School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; West Park Healthcare Centre, Respiratory Medicine, Toronto, ON, Canada
| | - Alda Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal.
| |
Collapse
|
7
|
Chahdi M, Bruchhäuser A, von Gahlen-Hoops W, Nydahl P. [Interventions to reduce hospital readmission rates in patients with COPD: a systematic review]. Med Klin Intensivmed Notfmed 2023; 118:584-591. [PMID: 37099147 DOI: 10.1007/s00063-023-01003-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 04/27/2023]
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) have a high risk of hospital and intensive care unit readmission. Readmissions are a severe burden on patients, families, and the health care system. The aim of this study is to identify pedagogical-counseling interventions to reduce readmissions and other parameters in COPD patients. METHODS A systematic literature search was performed in March 2022 in the databases Medline, Cochrane Library, CINAHL, and LIVIVO. German‑, English‑, Arabic-, and French-language (cluster-) randomized, controlled studies were included. RESULTS In all, 21 studies with a total of 3894 COPD patients were included. The quality of included studies was moderate to good. Interventions were self-management programs, telemedical, and educational interventions. Five out of seven studies found a significant reduction in readmissions for self-management programs (p = 0.02-0.49). A positive effect of telemedicine interventions on outcome parameters was only reported in two studies (p < 0.05) and no significant effect in four studies. Educational interventions were examined in six studies: four found no difference between the study groups and two found a significant difference in favor of the intervention group (p = 0.01). Special care programs also showed a significant effect in two studies. CONCLUSION
Collapse
Affiliation(s)
- Mohamed Chahdi
- Gesundheits- und Krankenpfleger, Klinik für Neurologie, Station D110, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland, Arnold-Heller-Str. 3.
| | - Antje Bruchhäuser
- Gesundheits- und Krankenpflegerin, Weaning-Station, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland
| | - Wolfgang von Gahlen-Hoops
- Professur für Didaktik der Pflege und Gesundheitsberufe, Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland
| | - Peter Nydahl
- Arbeitsgruppe Didaktik in der Pflege, Pflegewissenschaft und -entwicklung, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| |
Collapse
|
8
|
Rochester CL, Alison JA, Carlin B, Jenkins AR, Cox NS, Bauldoff G, Bhatt SP, Bourbeau J, Burtin C, Camp PG, Cascino TM, Dorney Koppel GA, Garvey C, Goldstein R, Harris D, Houchen-Wolloff L, Limberg T, Lindenauer PK, Moy ML, Ryerson CJ, Singh SJ, Steiner M, Tappan RS, Yohannes AM, Holland AE. Pulmonary Rehabilitation for Adults with Chronic Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 2023; 208:e7-e26. [PMID: 37581410 PMCID: PMC10449064 DOI: 10.1164/rccm.202306-1066st] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
Background: Despite the known benefits of pulmonary rehabilitation (PR) for patients with chronic respiratory disease, this treatment is underused. Evidence-based guidelines should lead to greater knowledge of the proven benefits of PR, highlight the role of PR in evidence-based health care, and in turn foster referrals to and more effective delivery of PR for people with chronic respiratory disease. Methods: The multidisciplinary panel formulated six research questions addressing PR for specific patient groups (chronic obstructive pulmonary disease [COPD], interstitial lung disease, and pulmonary hypertension) and models for PR delivery (telerehabilitation, maintenance PR). Treatment effects were quantified using systematic reviews. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to formulate clinical recommendations. Recommendations: The panel made the following judgments: strong recommendations for PR for adults with stable COPD (moderate-quality evidence) and after hospitalization for COPD exacerbation (moderate-quality evidence), strong recommendation for PR for adults with interstitial lung disease (moderate-quality evidence), conditional recommendation for PR for adults with pulmonary hypertension (low-quality evidence), strong recommendation for offering the choice of center-based PR or telerehabilitation for patients with chronic respiratory disease (moderate-quality evidence), and conditional recommendation for offering either supervised maintenance PR or usual care after initial PR for adults with COPD (low-quality evidence). Conclusions: These guidelines provide the basis for evidence-based delivery of PR for people with chronic respiratory disease.
Collapse
|
9
|
Tao D, Awan-Scully R, Cole A, Gao Y, Ash GI, Gu Y, Dutheil F, Sun Y, Baker JS. Integration of exercise prescription into medical provision as a treatment for non-communicable diseases: A scoping review. Front Public Health 2023; 11:1126244. [PMID: 37501942 PMCID: PMC10369190 DOI: 10.3389/fpubh.2023.1126244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/22/2023] [Indexed: 07/29/2023] Open
Abstract
Background The purpose of this scoping review is to stimulate interest and to raise awareness, among researchers, healthcare practitioners, and policymakers regarding the current scientific literature related to exercise prescription for non-communicable diseases (NCDs). Exercise prescription is a safe and cost-effective method that enables physicians to use exercise as a complementary addition to NCDs management and treatment. Methods This scoping review followed the PRISMA Extension Guidelines for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Using this framework, we considered information from qualitative and quantitative studies to identify research gaps. We provide feasible suggestions to guide future research for the implementation of exercise prescription in the healthcare environment. The literature search was conducted using SPIDER and PICO tools for qualitative, quantitative, and mixed-study designs. Inclusion criteria included articles that investigated patients with NCDs and considered exercise interventions. Systematic searches of PubMed, Web of Science, MEDLINE, EMBASE, and ScienceDirect were undertaken on 26 July 2022 and all reference lists were manually searched. Data processing was performed using EndNote 2.0 software and data charts were used for numerical summary and thematic analysis. Results There were 10,951 articles retrieved, of which 28 met the inclusion criteria. Based on the evidence, exercise was a feasible, safe, and acceptable method to prevent and manage non-communicable diseases in inpatient and outpatient settings. Six research directions were identified and discussed. In addition, implementation evidence and suggestions for policy-reconfiguration are also provided. Conclusion This scoping review summarizes the current evidence for the effectiveness of exercise in the treatment of non-communicable diseases. The review provides key findings supporting exercise prescription for the inpatient and outpatient healthcare service. We suggest that governments and healthcare policymakers globally advocate the inclusion of structured exercise prescription within the NCDs treatment setting.
Collapse
Affiliation(s)
- Dan Tao
- Research Academy of Medicine Combining Sports, Ningbo No. 2 Hospital, Ningbo, China
- Department of Government and International Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Roger Awan-Scully
- Department of Government and International Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Alistair Cole
- Department of Government and International Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Yang Gao
- Centre for Health and Exercise Science Research, Population Health and Medical Informatics, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Garrett I. Ash
- Center for Medical Informatics, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Yaodong Gu
- Research Academy of Medicine Combining Sports, Ningbo No. 2 Hospital, Ningbo, China
| | - Frederic Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, University Clermont Auvergne, Clermont-Ferrand, France
| | - Yan Sun
- Centre for Health and Exercise Science Research, Population Health and Medical Informatics, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Population Health and Medical Informatics, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| |
Collapse
|
10
|
Lu HY, Chen CF, Lee DL, Tsai YJ, Lin PC. Effects of Early Pulmonary Rehabilitation on Hospitalized Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. Int J Chron Obstruct Pulmon Dis 2023; 18:881-893. [PMID: 37215744 PMCID: PMC10198174 DOI: 10.2147/copd.s397361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/30/2023] [Indexed: 05/24/2023] Open
Abstract
Background Pulmonary rehabilitation (PR) effectively improves symptoms and exercise ability in patients with stable chronic obstructive pulmonary disease (COPD). However, the effectiveness and timing of early PR on hospitalized patients with acute exacerbation of COPD (AECOPD) is still debated. Methods This study conducted a meta-analysis to compare the outcome benefits between early PR and usual care for patient hospitalized due to AECOPD. A systematic search was performed for retrieving randomized control trials (RCTs) from the PubMed, Embase, and Cochrane library until November 2021. RCTs reporting early PR for AECOPD with hospitalization, either during admission or within four weeks of discharge, were enrolled for systematic review and meta-analysis. Results Twenty RCTs (1274 participants) were included. Early PR showed significantly improved readmission rate (ten trials, risk ratio 0.68, 95% confidence interval (CI) 0.50-0.92), 6-minute walking distance (6MWD, twelve trials, MD 59.73, 95% CI 36.34-83.12), St George's Respiratory Questionnaire score (eight trials, MD -10.65, 95% CI -14.78 to -6.52), Borg score (eight trials, MD -0.79, 95% CI -1.26 to -0.32), and modified Medical Research Council dyspnea scale (eight trials, MD -0.38, 95% CI -0.5 to -0.25). However, the trend of mortality (six trials, risk ratio 0.72, 95% CI 0.39-1.34) benefit was not significant. The subgroup analysis showed non-significant trends of better effect in early PR during admission than those after discharge for outcomes of 6MWD, quality of life, and dyspnea. However, non-significant trends of less benefits on mortality and readmission rate were found in early PR during the admission. Conclusion Overall, early PR is beneficial for AECOPD with hospitalization, and there was no significant outcome difference between PR initiated during admission or within 4 weeks of discharge.
Collapse
Affiliation(s)
- Hsin- Yueh Lu
- Division of Respiratory Therapy, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chiu-Fan Chen
- Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Hsinchu City, Taiwan
| | - David Lin Lee
- Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Hsinchu City, Taiwan
| | - Yi-Ju Tsai
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Pei-Chin Lin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
11
|
Lu S, Zhang Q. Pilot testing the impact of an aerobic exercise plus rehabilitation training on respiratory function in older adults with COPD. Geriatr Nurs 2023; 51:238-244. [PMID: 37023683 DOI: 10.1016/j.gerinurse.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/08/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic intractable lung disease. To investigate the therapeutic effect, older adult patients were subjected to aerobic exercise and respiratory rehabilitation (diaphragmatic breathing) for six months. At the end of six-month intervention, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), 6-minute walking distance (6 MWD), and patient activation measure scores increased; St. George's respiratory questionnaire scores and disease impact score decreased; and PaCO2 and PaO2 were significantly improved in both groups, particularly in the experimental group. In addition, FEV1, FEV1/FVC, 6 MWD, blood gas levels, quality of life, and self-care ability in the experimental group were significantly improved compared with those in the control group, and the improvements were significantly greater in male, younger, and less diseased patients. Our study demonstrated that aerobic exercise combined with diaphragmatic breathing significantly improves respiratory function and quality of life in older adult patients.
Collapse
Affiliation(s)
- Shuangping Lu
- Department of Respiratory Medicine, The First People's Hospital of Fuyang District, Hangzhou, China
| | - Qundan Zhang
- Department of Respiratory Medicine, The First People's Hospital of Fuyang District, Hangzhou, China.
| |
Collapse
|
12
|
Qiu QX, Li WJ, Ma XM, Feng XH. Effect of continuous nursing combined with respiratory exercise nursing on pulmonary function of postoperative patients with lung cancer. World J Clin Cases 2023; 11:1330-1340. [PMID: 36926122 PMCID: PMC10013122 DOI: 10.12998/wjcc.v11.i6.1330] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/16/2023] [Accepted: 02/03/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Lung cancer is a malignant tumor with high morbidity and mortality among cancers. Surgery is currently one of the primary methods of treating lung cancer. Although it can slow down the progression of the disease by removing the lesion, this invasive surgery inevitably damages the integrity of the patient’s chest. Moreover, the patient’s pulmonary function may have a low compensatory capacity after surgery, causing various respiratory diseases such as atelectasis, respiratory function decline, and even serious cardiovascular disease. All of these have great negative impacts on the surgical effect and the prognosis of patients. With the continuous exploration and development of nursing, continuous nursing and respiratory exercise nursing have been gradually applied in the nursing of patients after lung cancer surgery, and have achieved good nursing results.
AIM To investigate the effect of continuous nursing combined with respiratory exercise nursing on the pulmonary function of postoperative patients with lung cancer.
METHODS A total of 80 patients with lung cancer who underwent surgery in our hospital from January 2021 to December 2021 were selected as the study subjects. All subjects were randomly divided into the control group (n = 40 cases) and the experimental group (n = 40 cases). Patients with lung cancer in the control group were given conventional nursing after surgery, while the experimental group was given continuous nursing combined with respiratory exercise nursing based on conventional nursing. The recovery of pulmonary function and respiratory symptoms was observed before and after 3 mo of intervention in both groups. The pulmonary function parameters, blood gas analysis, MD Anderson Symptom Inventory-lung cancer module (MDASI-LC) scores, incidence of pulmonary complications, and Morisky compliance scores were compared between the two groups before and after 3 mo of intervention.
RESULTS There was no significant difference in pulmonary function and blood gas analysis between the two groups before intervention (P > 0.05). 3 mo after the intervention, the pulmonary function parameters in the experimental group (SpO2, VC, MVV, FEV1, FEV1% pred, and FEV1/FVC) were higher than those in the control group, and the differences were statistically significant (P < 0.05). There was no significant difference in blood gas analysis between the two groups before intervention (P > 0.05). PaO2 in the experimental group was significantly higher than that in the control group, and PaCO2 was significantly lower than that in the control group 3 mo after the intervention. The difference had statistical significance (P < 0.05). 3 mo after the intervention, the MDASI score of respiratory symptoms in the experimental group was significantly lower than that in the control group (P < 0.05), and the incidence of pulmonary complications was lower than that in the control group (P < 0.05). In addition, the treatment compliance and nursing satisfaction of patients in the experimental group were higher than those in the control group, and the differences were statistically significant (P < 0.05).
CONCLUSION Continuous nursing combined with respiratory exercise nursing can significantly accelerate the recovery of respiratory function in postoperative lung cancer patients, reduce the incidence of postoperative complications of lung cancer as well as improve the treatment compliance of patients.
Collapse
Affiliation(s)
- Qiong-Xiang Qiu
- Department of Thoracic Surgery, Haikou People’s Hospital, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou 570208, Hainan Province, China
| | - Wen-Juan Li
- Department of Thoracic Surgery, Haikou People’s Hospital, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou 570208, Hainan Province, China
| | - Xi-Miao Ma
- Department of Thoracic Surgery, Haikou People’s Hospital, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou 570208, Hainan Province, China
| | - Xue-Hua Feng
- Department of Thoracic Surgery, Haikou People’s Hospital, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou 570208, Hainan Province, China
| |
Collapse
|
13
|
Reilly C, Sails J, Stavropoulos-Kalinoglou A, Birch RJ, McKenna J, Clifton IJ, Peckham D, Birch KM, Price OJ. Physical activity promotion interventions in chronic airways disease: a systematic review and meta-analysis. Eur Respir Rev 2023; 32:32/167/220109. [PMID: 36697208 PMCID: PMC9879326 DOI: 10.1183/16000617.0109-2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/02/2022] [Indexed: 01/27/2023] Open
Abstract
Physical inactivity is common in people with chronic airways disease (pwCAD) and associated with worse clinical outcomes and impaired quality of life. We conducted a systematic review and meta-analysis to characterise and evaluate the effectiveness of interventions promoting step-based physical activity (PA) in pwCAD. We searched for studies that included a form of PA promotion and step-count outcome measure. A random-effects model was used to determine the overall effect size using post-intervention values. 38 studies (n=32 COPD; n=5 asthma; n=1 bronchiectasis; study population: n=3777) were included. Overall, implementing a form of PA promotion resulted in a significant increase in step-count: median (IQR) 705 (183-1210) when compared with usual standard care: -64 (-597-229), standardised mean difference (SMD) 0.24 (95% CI: 0.12-0.36), p<0.01. To explore the impact of specific interventions, studies were stratified into subgroups: PA promotion+wearable activity monitor-based interventions (n=17) (SMD 0.37, p<0.01); PA promotion+step-count as an outcome measure (n=9) (SMD 0.18, p=0.09); technology-based interventions (n=12) (SMD 0.16, p=0.01). Interventions promoting PA, particularly those that incorporate wearable activity monitors, result in a significant and clinically meaningful improvement in daily step-count in pwCAD.
Collapse
Affiliation(s)
- Caroline Reilly
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Joe Sails
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | | | - Rebecca J. Birch
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
| | - Jim McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Ian J. Clifton
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK,Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Daniel Peckham
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK,Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Karen M. Birch
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - Oliver J. Price
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK,Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK,School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK,Corresponding author: Oliver J. Price ()
| |
Collapse
|
14
|
Zhang H, Hu D, Xu Y, Wu L, Lou L. Effect of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials. Ann Med 2022; 54:262-273. [PMID: 35037535 PMCID: PMC8765243 DOI: 10.1080/07853890.2021.1999494] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE The present systematic review and meta-analysis of randomized clinical trials (RCTs) aimed to investigate the effects of pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease (COPD). METHODS The RCTs of pulmonary rehabilitation programs published between 1999 and 2021 were retrieved from electronic databases (PubMed, Cochrane Library, and Embase). Two reviewers independently assessed the topical relevance and trial quality and extracted data for meta-analysis using the Stata software version 14.0. RESULTS A total of 39 trials involving 2,397 participants with COPD were evaluated. We found that patients who received pulmonary rehabilitation program had significant improvement in the 6-min walk test (6MWT), St. George Respiratory Questionnaire score, and the modified British Medical Research Council score as compared to those who received usual care. Yoga and Tai Chi showed significant improvement in the forced expiratory volume (FEV1)% in 1 s predicted value. However, no significant difference was detected in the modified Borg score, forced vital capacity (FVC), and FEV1/FVC predicted value between the pulmonary rehabilitation and usual care groups. CONCLUSION Yoga and Tai Chi showed a significant improvement in the FEV1% predicted value. Also, pulmonary rehabilitation program improved the exercise capacity, the quality of life, and dyspnoea in patients with COPD.Key messagesA total of 39 trials involving 2,397 participants with COPD were evaluated.We found that patients who received pulmonary rehabilitation program had significant improvement in the 6MWT, St. George Respiratory Questionnaire score, and the modified British Medical Research Council score as compared to those who received usual care.Yoga and Tai Chi showed significant improvement in the FEV1% predicted value.No significant difference was detected in the modified Borg score, FVC, and FEV1/FVC predicted value between the pulmonary rehabilitation and usual care groups.
Collapse
Affiliation(s)
- Hong Zhang
- Department of Respiratory Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Dandan Hu
- Department of Respiratory Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yikai Xu
- Department of Respiratory Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Lixia Wu
- Department of Respiratory Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Liming Lou
- Department of Respiratory Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| |
Collapse
|
15
|
Du Y, Lin J, Wang X, Zhang Y, Ge H, Wang Y, Ma Z, Zhang H, Liu J, Wang Z, Lin M, Ni F, Li X, Tan H, Tan S. Early Pulmonary Rehabilitation in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials. COPD 2022; 19:69-80. [PMID: 35099336 DOI: 10.1080/15412555.2022.2029834] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Pulmonary rehabilitation (PR) is an essential method for Acute exacerbation in chronic obstructive pulmonary disease (AECOPD) recovery. We perform a meta-analysis to compare early PR with usual care. A literature search was performed through these databases: PubMed, MEDLINE database, Google Scholar, Cochrane, Embase from inception to July 2021. Eligible trials were clinical randomized controlled trials comparing the effects of early PR and usual care in AECOPD patients. The primary endpoint of this meta-analysis was FEV1% predicted, 6-min walk test (6MWD), modified Medical Research Council (mMRC) and George Respiratory Questionnaire-total (SGRQ-total). The secondary outcomes were borg dyspnea score, short-form 36 health survey questionnaire physical (SF-36 physical) and SF-36 mental. We included 13 RCTs with a total of 866 patients. There were no significant effects of the PR group on measures of FEV1% predicted (MD = 0.50, 95%CI -1.43 to 2.44, Z = 0.51, p = 0.61), borg dyspnea score (MD = -0.88, 95%CI -1.89 to 0.13, Z = 1.71, p = 0.09) and SF-36 mental (MD = 4.34, 95%CI -1.64 to 10.32, Z = 1.42, p = 0.16) compared with usual care. PR group achieved better 6MWD (MD = 97.58, 95%CI 17.21 to 177.96, Z = 2.38, p = 0.02), mMRC (MD = -0.36, 95%CI -0.52 to -0.21, Z = 4.56, p ˂ 0.00001), SGRQ-total (MD= -9.67, 95%CI -16.23 to -3.11, Z = 2.89, p = 0.004) and SF-36 physical (MD = 4.98, 95%CI 0.60 to 9.35, Z = 2.23, p = 0.03) compared with usual care group. Early PR in AECOPD patients would lead to better 6MWD, mMRC, SGRQ-total and SF-36 physical. But there were no significant effects of the PR group on measures of FEV1% predicted, borg dyspnea score and SF-36 mental.
Collapse
Affiliation(s)
- Yanping Du
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Jun Lin
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Xiaoxia Wang
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Yan Zhang
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Hua Ge
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Ye Wang
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Zhiyi Ma
- Pulmonary and Critical Care Medicine, The First Hospital of Longyan Affiliated to Fujian Medical University, Longyan, Fujian, China
| | - Huaping Zhang
- Pulmonary and Critical Care Medicine, Second Affiliated Hospital of Fujian Medical University, Respiratory Medicine Center of Fujian Province, Quanzhou, Fujian, China
| | - Jun Liu
- Pulmonary and Critical Care Medicine, The Second Hospital of Longyan, Longyan, Fujian, China
| | - Zhiyong Wang
- Pulmonary and Critical Care Medicine, The First Hospital of Putian, Putian, Fujian, China
| | - Meixia Lin
- Pulmonary and Critical Care Medicine, The First Hospital of Putian, Putian, Fujian, China
| | - Fayu Ni
- Pulmonary and Critical Care Medicine, Fuqing Hospital, Fuqing, Fujian, China
| | - Xi Li
- Pulmonary and Critical Care Medicine, The Second People's Hospital Affiliated to Fujian Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Hui Tan
- Pulmonary and Critical Care Medicine, Chenzhou No. 1 People's Hospital, Chenzhou Hunan, China
| | - Shifan Tan
- Pulmonary and Critical Care Medicine, Chenzhou No. 1 People's Hospital, Chenzhou Hunan, China.,Pulmonary and Critical Care Medicine, Maoming People's Hospital, Maoming, Guangdong, Chian
| |
Collapse
|
16
|
Mendes Xavier D, Lanza Galvão E, Aliane Fonseca A, de Souza GM, Pereira Lima V. Effects of Home-Based Pulmonary Rehabilitation on Dyspnea, Exercise Capacity, Quality of Life and Impact of the Disease in COPD Patients: A Systematic Review. COPD 2022; 19:18-46. [PMID: 35000507 DOI: 10.1080/15412555.2021.2020234] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Conventional pulmonary rehabilitation programs are used as therapies for the treatment of chronic obstructive pulmonary disease (COPD). However, this modality presents barriers that make rehabilitation difficult. For this reason, home-based pulmonary rehabilitation (HBPR) has been used to overcome these barriers. The objective was to systematically compare a structured program with HBPR or a control group for participants with COPD. The primary outcome was an improvement in symptoms in the level of dyspnea and secondary outcomes were parameters in lung function, exercise capacity, health-related quality of life (HRQoL) and the impact of the disease on the individual. The Medline (via PubMed), Virtual Health Library and Cochrane Library databases were searched until May 10, 2021. Randomized controlled trials were included without restrictions on the year of publication or language. The risk of bias was evaluated using the Cochrane risk-of-bias tool for randomized trials (RoB). Our results showed that there was a significant decrease in the level of dyspnea, (MD: 5.46; 95% CI: 1.97 to 8.96), increased distance covered (MD: 61.75; 95% CI: 42, 94 to 80.56, significant improvement in HRQoL (MD: -11.30; 95% CI: -19.81 to -2.79) and reduction in the impact of the disease (DM: -4.71; 95% CI: -7.95 to -1.47). All results found were comparing the intervention group versus the control group. To conclude we found a reduction in the levels of dyspnea, an increase in the distance covered on the six-minute walk test, improving HRQoL and decreasing the impact of the disease in COPD patients in home-based pulmonary rehabilitation.Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2021.2020234 .
Collapse
Affiliation(s)
- Diêgo Mendes Xavier
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil Diamantina
| | - Endi Lanza Galvão
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Alenice Aliane Fonseca
- Department of Physiotherapy, Faculdade Verde - Norte, Montes Claros, Brazil.,Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Glaciele Maria de Souza
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Vanessa Pereira Lima
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil Diamantina.,Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| |
Collapse
|