Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada.
Chron Respir Dis. 2011;8(2):129-40. doi: 10.1177/1479972311404256.
The purpose of this review was to determine the impact of duration of pulmonary rehabilitation on measures of health-related quality of life and exercise tolerance in individuals with chronic obstructive pulmonary disease (COPD). Randomized controlled trials (RCTs) comparing different lengths of pulmonary rehabilitation in patients with COPD were identified after searches of six electronic databases (MEDLINE, PubMed, CINAHL, EMBASE, Physiotherapy Evidence Database [PEDro] and the Cochrane Library of clinical trials) and reference lists of pertinent articles. Two reviewers performed the searches and assessed trial quality using PEDro and Jadad scales. Five RCTs met inclusion criteria. The mean PEDro score was 6 (range 3-8) and mean Jadad was 2 (range 1-3). Three trials reported a difference in health-related quality of life in favour of the longer duration program; two trials reported a benefit in exercise capacity in favour of longer programs. A meta-analysis of results was not possible due to considerable heterogeneity in program duration and outcomes. Longer duration pulmonary rehabilitation programs appear to have a more favourable effect on health-related quality of life in individuals with COPD; results for exercise capacity are less clear. The limited literature prevents a more definitive conclusion on optimal duration of rehabilitation.
本次综述的目的是确定慢性阻塞性肺疾病（COPD）患者的肺康复持续时间对健康相关生活质量和运动耐量测量的影响。在对六个电子数据库（MEDLINE、PubMed、CINAHL、EMBASE、物理治疗证据数据库[PEDro]和 Cochrane 临床试验图书馆）和相关文章的参考文献进行检索后，确定了比较 COPD 患者不同肺康复持续时间的随机对照试验（RCT）。两名审查员使用 PEDro 和 Jadad 量表进行了搜索和试验质量评估。五项 RCT 符合纳入标准。平均 PEDro 评分为 6 分（范围 3-8 分），平均 Jadad 评分为 2 分（范围 1-3 分）。三项试验报告了较长持续时间方案对健康相关生活质量的有利差异；两项试验报告了较长方案对运动能力的益处。由于方案持续时间和结果存在很大的异质性，因此无法进行结果的荟萃分析。较长时间的肺康复方案似乎对 COPD 患者的健康相关生活质量有更有利的影响；运动能力的结果则不太明确。有限的文献无法得出关于最佳康复持续时间的更明确结论。
