War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ; New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ.
War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ; Department of Kinesiology, University of Wisconsin-Madison, Madison, WI.
Arch Phys Med Rehabil. 2018 Dec;99(12):2561-2569.e7. doi: 10.1016/j.apmr.2018.03.014. Epub 2018 Apr 17.
To quantify the effect of exercise training on indices of pulmonary function in adults with chronic lung disease using meta-analytic techniques.
Eligible trials were identified using a systematic search of MEDLINE, Web of Science, Physiotherapy Evidence Database, and GoogleScholar databases.
Randomized controlled trials that evaluated pulmonary function before and after whole-body exercise training among adult patients (aged ≥19y) with chronic lung disease were included.
Data were independently extracted from each study by 3 authors. Random-effects models were used to aggregate a mean effect size (Hedges' d; Δ) and 95% confidence interval (CI), and multilevel linear regression with robust maximum likelihood estimation was used to adjust for potential nesting effects.
Among 2923 citations, a total of 105 weighted effects from 21 randomized controlled trials were included. After adjusting for nesting effects, exercise training resulted in a small (Δ=.18; 95% CI, .07-.30) and significant (P=.002) improvement in a composite measure of pulmonary function. Tests of heterogeneity of the mean effect size were nonsignificant.
Contrary to prior assumptions, whole-body exercise training is effective for improving pulmonary function in adults with chronic lung disease, particularly spirometric indices. Subsequent studies are necessary to determine the optimal exercise training characteristics to maximize functional improvement.
运用荟萃分析技术定量评估运动训练对慢性肺部疾病成人肺功能指标的影响。
通过系统检索 MEDLINE、Web of Science、物理治疗证据数据库和 Google Scholar 数据库，确定了符合条件的试验。
纳入了评估慢性肺部疾病成年患者（年龄≥19 岁）全身运动训练前后肺功能的随机对照试验。
由 3 位作者独立从每项研究中提取数据。采用随机效应模型汇总平均效应量（Hedges' d；Δ）和 95%置信区间（CI），采用多级线性回归结合稳健最大似然估计调整潜在的嵌套效应。
在 2923 条引文，共有 21 项随机对照试验的 105 个加权效应被纳入。调整嵌套效应后，运动训练使肺功能综合指标有较小（Δ=.18；95% CI，.07-.30）但显著（P=.002）的改善。平均效应量的异质性检验无统计学意义。
与先前的假设相反，全身运动训练对改善慢性肺部疾病成人的肺功能是有效的，特别是在肺功能指标方面。需要进一步的研究来确定最佳的运动训练特征，以最大限度地提高功能改善。
