Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane BS, Italy.
Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane BS, Italy.
Pulmonology. 2020 Sep-Oct;26(5):304-313. doi: 10.1016/j.pulmoe.2020.02.004. Epub 2020 Mar 14.
Fatigue can be divided in perceived fatigue, the feeling of exhaustion or lack of energy, and performance fatigue, the reduction in muscle force/activation during a given task. This meta-analysis evaluates the impact of exercise training on fatigue, compared with normal care in patients with COPD.
We searched randomised controlled trials on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and CINAHL databases from their inception to December, 31st 2019 using the terms COPD, Fatigue, Fatigability, Muscle activation, Muscle endurance, Muscle Performance, Voluntary Activation, Motoneuron excitability, Force Development, Exercise, AND Rehabilitation.
We evaluated 494 potential articles. Sixteen, all evaluating perceived fatigability, satisfied the inclusion criteria and were included. Twelve studies (463 patients) assessed fatigue by the Chronic Respiratory Questionnaire showing that intervention improved significantly more than the control group [SMD 0.708; 95% CI 0.510, 0.907; p < 0.001; I² = 34.3%; p = 0.116]. Two studies (68 patients) using the Fatigue Impact Scale, did not find any significant differences between groups [SMD -0.922; 95%CI -2.258, 0.413; p = 0.176; I² = 83.9%; p = 0.013]. Two studies (82 patients) assessed perceived fatigue by the Fatigue Severity Scale: the intervention improved significantly more than the control group [SMD -2.282; 95%CI -2.870, -1.699; p < 0.001; I² = 64.6%, p = 0.093]. No study evaluating performance fatigue was found.
This study provided low-quality evidence of a positive impact of different exercise training programs on perceived fatigue in patients with COPD. Further studies are needed to assess the effects of exercise training on fatigue and to test tailored programs.
疲劳可分为感知疲劳，即感到疲惫或缺乏能量，以及运动疲劳，即在完成给定任务时肌肉力量/激活的降低。本荟萃分析评估了与 COPD 患者的常规护理相比，运动训练对疲劳的影响。
我们使用术语 COPD、疲劳、疲劳性、肌肉激活、肌肉耐力、肌肉性能、自愿激活、运动神经元兴奋性、肌力发展、运动和康复，从其成立到 2019 年 12 月 31 日，在 MEDLINE、EMBASE、Cochrane 中央对照试验注册中心和 CINAHL 数据库中搜索随机对照试验。
我们评估了 494 篇潜在文章。16 篇全部评估感知疲劳的研究符合纳入标准并被纳入。12 项研究（463 名患者）通过慢性呼吸问卷评估疲劳，结果表明干预组的改善明显优于对照组[SMD 0.708；95%CI 0.510，0.907；p<0.001；I²=34.3%；p=0.116]。两项使用疲劳影响量表的研究[SMD -0.922；95%CI -2.258，0.413；p=0.176；I²=83.9%；p=0.013]未发现两组间存在任何显著差异。两项研究（82 名患者）通过疲劳严重程度量表评估感知疲劳：干预组的改善明显优于对照组[SMD -2.282；95%CI -2.870，-1.699；p<0.001；I²=64.6%，p=0.093]。没有发现评估运动疲劳的研究。
本研究提供了低质量证据，表明不同运动训练方案对 COPD 患者感知疲劳有积极影响。需要进一步研究评估运动训练对疲劳的影响，并测试针对性方案。
