Alison Jennifer A, McKeough Zoe J, Johnston Kylie, McNamara Renae J, Spencer Lissa M, Jenkins Sue C, Hill Catherine J, McDonald Vanessa M, Frith Peter, Cafarella Paul, Brooke Michelle, Cameron-Tucker Helen L, Candy Sarah, Cecins Nola, Chan Andrew S L, Dale Marita T, Dowman Leona M, Granger Catherine, Halloran Simon, Jung Peter, Lee Annemarie L, Leung Regina, Matulick Tamara, Osadnik Christian, Roberts Mary, Walsh James, Wootton Sally, Holland Anne E
Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
Allied Health Professorial Unit, Sydney Local Health District, Sydney, New South Wales, Australia.
Respirology. 2017 May;22(4):800-819. doi: 10.1111/resp.13025. Epub 2017 Mar 24.
The aim of the Pulmonary Rehabilitation Guidelines (Guidelines) is to provide evidence-based recommendations for the practice of pulmonary rehabilitation (PR) specific to Australian and New Zealand healthcare contexts.
The Guideline methodology adhered to the Appraisal of Guidelines for Research and Evaluation (AGREE) II criteria. Nine key questions were constructed in accordance with the PICO (Population, Intervention, Comparator, Outcome) format and reviewed by a COPD consumer group for appropriateness. Systematic reviews were undertaken for each question and recommendations made with the strength of each recommendation based on the GRADE (Gradings of Recommendations, Assessment, Development and Evaluation) criteria. The Guidelines were externally reviewed by a panel of experts.
The Guideline panel recommended that patients with mild-to-severe COPD should undergo PR to improve quality of life and exercise capacity and to reduce hospital admissions; that PR could be offered in hospital gyms, community centres or at home and could be provided irrespective of the availability of a structured education programme; that PR should be offered to patients with bronchiectasis, interstitial lung disease and pulmonary hypertension, with the latter in specialized centres. The Guideline panel was unable to make recommendations relating to PR programme length beyond 8 weeks, the optimal model for maintenance after PR, or the use of supplemental oxygen during exercise training. The strength of each recommendation and the quality of the evidence are presented in the summary.
The Australian and New Zealand Pulmonary Rehabilitation Guidelines present an evaluation of the evidence for nine PICO questions, with recommendations to provide guidance for clinicians and policymakers.
《肺康复指南》的目的是为澳大利亚和新西兰医疗环境下的肺康复（PR）实践提供循证建议。
该指南制定方法遵循《研究与评价指南评估（AGREE）II标准》。按照PICO（人群、干预措施、对照、结局）格式构建了九个关键问题，并由慢性阻塞性肺疾病（COPD）患者群体进行适宜性审查。对每个问题进行了系统评价，并根据GRADE（推荐分级、评估、制定和评价）标准给出了每项建议的力度。该指南由一个专家小组进行外部审查。
指南小组建议，轻至重度慢性阻塞性肺疾病患者应接受肺康复治疗，以提高生活质量和运动能力，并减少住院次数；肺康复可在医院健身房、社区中心或家中进行，且无论是否有结构化教育项目均可提供；支气管扩张症、间质性肺疾病和肺动脉高压患者也应接受肺康复治疗，后者应在专科中心进行。指南小组无法就超过8周的肺康复项目时长、肺康复后维持的最佳模式或运动训练期间补充氧气的使用提出建议。每项建议的力度和证据质量在总结中列出。
《澳大利亚和新西兰肺康复指南》对九个PICO问题的证据进行了评估，并给出了建议，为临床医生和政策制定者提供指导。
