Graduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas School of Medicine, Pelotas, Brazil.
J Bras Pneumol. 2011 Jul-Aug;37(4):544-55. doi: 10.1590/s1806-37132011000400017.
Pulmonary rehabilitation programs are aimed at providing benefits to COPD patients, in various aspects. Our objective was to review the literature on COPD patient rehabilitation. This systematic review involved articles written in English, Spanish, or Portuguese; published between 2005 and 2009; and indexed in national and international databases. Articles were classified in accordance with the Global Initiative for Chronic Obstructive Lung Disease criteria for the determination of the level of scientific evidence (grade of recommendation A, B, or C). The outcome measures were exercise, quality of life, symptoms, exacerbations, mortality, and pulmonary function. Treatments were classified as standard rehabilitation, partial rehabilitation, strength exercises, and resistance exercises. Of the 40 articles selected, 4, 18, and 18 were classified as grades A, B, and C, respectively. Of the 181 analyses made in these articles, 61, 50, 23, 23, 20, and 4, respectively, were related to the outcome measures quality of life, exercise, symptoms, exacerbations, pulmonary function, and mortality. The standard rehabilitation programs showed positive effects on all of the outcomes evaluated, except for mortality (because of the small number of analyses). However, we found no differences among the various rehabilitation programs regarding their effects on the outcomes studied. Rehabilitation programs can be considered important tools for the treatment of COPD. Therefore, health administrators should implement public policies including such programs in the routine of health care facilities.
肺康复计划旨在为 COPD 患者提供多方面的益处。我们的目的是对 COPD 患者康复的文献进行综述。这篇系统综述涉及到 2005 年至 2009 年间用英文、西班牙语或葡萄牙语发表的、被收录在国内外数据库中的文章。文章根据慢性阻塞性肺疾病全球倡议（GOLD）确定科学证据等级（推荐等级 A、B 或 C）的标准进行分类。结果测量指标包括运动、生活质量、症状、恶化、死亡率和肺功能。治疗方法分为标准康复、部分康复、力量锻炼和阻力锻炼。在选择的 40 篇文章中，分别有 4、18 和 18 篇被归类为 A、B 和 C 级。在这些文章中的 181 项分析中，分别有 61、50、23、23、20 和 4 项与生活质量、运动、症状、恶化、肺功能和死亡率的结果测量指标有关。标准康复计划对所有评估的结果都有积极影响，除了死亡率（因为分析数量较少）。然而，我们没有发现不同康复计划在对所研究结果的影响方面存在差异。康复计划可以被认为是 COPD 治疗的重要工具。因此，卫生行政部门应该在卫生保健机构的常规工作中实施包括这些计划在内的公共政策。
