Meharg David P, Gwynne Kylie, Gilroy John, Alison Jennifer A
Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia.
Poche Centre for Indigenous Health, The University of Sydney, Sydney, Australia.
J Thorac Dis. 2020 Dec;12(12):7442-7453. doi: 10.21037/jtd-20-1904.
Indigenous peoples in Australia, New Zealand, Canada, and the United States of America (USA) have a higher burden of chronic lung disease than non-Indigenous people. Exercised-based interventions, such as pulmonary rehabilitation, are highly effective to manage chronic lung disease. The outcomes of these interventions for Indigenous people require evaluation. The aim of this review was to critically appraise the literature on the impact of exercise-based interventions on quality of life, exercise capacity and health care utilisation in Indigenous adults with chronic lung disease in Australia, New Zealand, Canada, and USA. The Cochrane Library, Medline, Embase, CINAHL, Scopus, Psychinfo, APAIS-Aboriginal Health and PEDro databases were searched for peer-reviewed and grey literature that evaluated exercise-based interventions, such as pulmonary rehabilitation for Indigenous adults with chronic lung disease in Australia, New Zealand, Canada, and USA. Two authors independently screened and reviewed titles and abstract and full texts of potentially eligible studies for inclusion. An Indigenous decolonisation methodological framework was also applied to evaluate Indigenous governance, involvement, and engagement in the studies. A total of 3,598 records were screened, nine full papers were reviewed, and one was study included, which was a cardiopulmonary rehabilitation program for Indigenous people in Australia. Participants with chronic respiratory or heart disease significantly improved functional exercise capacity and quality of life [six-minute walk distance mean change (95% CI) 79 metres (47 to 111); Chronic Respiratory Questionnaire Dyspnoea 0.9 points (0.2 to 1.5)]. Several items of the decolonisation framework were addressed. Only one study was able to be included in the review, highlighting the paucity of research about culturally safe exercise-based interventions for Indigenous adults with chronic lung disease. There is a need for further research with strong Indigenous governance, involvement, and engagement.
澳大利亚、新西兰、加拿大和美利坚合众国（美国）的原住民比非原住民患有慢性肺病的负担更重。基于运动的干预措施，如肺康复，对管理慢性肺病非常有效。这些干预措施对原住民的效果需要评估。本综述的目的是批判性地评价关于基于运动的干预措施对澳大利亚、新西兰、加拿大和美国患有慢性肺病的原住民成年人的生活质量、运动能力和医疗保健利用影响的文献。检索了考克兰图书馆、医学数据库、荷兰医学文摘数据库、护理学与健康领域数据库、Scopus数据库、心理学文摘数据库、澳大利亚原住民健康数据库和循证医学数据库，以查找评估基于运动的干预措施的同行评审文献和灰色文献，例如针对澳大利亚、新西兰、加拿大和美国患有慢性肺病的原住民成年人的肺康复。两位作者独立筛选并审查了潜在合格研究的标题、摘要和全文以确定是否纳入。还应用了一个原住民去殖民化方法框架来评估研究中的原住民治理、参与和介入情况。共筛选了3598条记录，审查了9篇全文，并纳入了1项研究，该研究是澳大利亚一项针对原住民的心肺康复项目。患有慢性呼吸道或心脏病的参与者的功能性运动能力和生活质量有显著改善[六分钟步行距离平均变化（95%可信区间）79米（47至111）；慢性呼吸问卷呼吸困难评分0.9分（0.2至1.5）]。去殖民化框架的几个方面得到了探讨。本综述仅能纳入1项研究，这突出表明针对患有慢性肺病的原住民成年人的基于文化安全的运动干预措施的研究匮乏。需要在强有力的原住民治理、参与和介入下开展进一步研究。
