Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, 156 Jinshui East Road, Zhengzhou, 450046, China.
Respir Res. 2021 Jan 30;22(1):33. doi: 10.1186/s12931-021-01627-w.
Pulmonary rehabilitation (PR) has been proposed as an effective method for many respiratory diseases. However, the effects of exercise-based PR on asthma are currently inconclusive. This review aimed to investigate the effects of exercise-based PR on adults with asthma.
The PubMed, Embase, Cochrane Library, Web of Science, International Clinical Trials Registry Platform and ClinicalTrials.gov databases were searched from inception to 31 July 2019 without language restriction. Randomized controlled trials (RCTs) investigating the effects of exercise-based PR on adults with asthma were included. Study selection, data extraction and risk of bias assessment were performed by two investigators independently. Meta-analysis was conducted by RevMan software (version 5.3). Evidence quality was rated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.
Ten literatures from nine studies (n = 418 patients) were identified. Asthma quality of life questionnaire total scores (MD = 0.39, 95% CI: 0.02 to 0.76) improved significantly in the experimental group compared to control group, including activity domain scores (MD = 0.58, 95% CI: 0.21 to 0.94), symptom domain scores (MD = 0.52, 95% CI: 0.19 to 0.85), emotion domain scores (MD = 0.53, 95% CI: - 0.03 to 1.09) and environment domain scores (MD = 0.56, 95% CI: 0.00 to 1.11). Both the 6-min walk distance (MD = 34.09, 95% CI: 2.51 to 65.66) and maximum oxygen uptake (MD = 4.45, 95% CI: 3.32 to 5.58) significantly improved. However, improvements in asthma control questionnaire scores (MD = - 0.25, 95% CI: - 0.51 to 0.02) and asthma symptom-free days (MD = 3.35, 95% CI: - 0.21 to 6.90) were not significant. Moreover, there was no significant improvement (MD = 0.10, 95% CI: - 0.08 to 0.29) in forced expiratory volume in 1 s. Nonetheless, improvements in forced vital capacity (MD = 0.23, 95% CI: 0.08 to 0.38) and peak expiratory flow (MD = 0.39, 95% CI: 0.21 to 0.57) were significant.
Exercise-based PR may improve quality of life, exercise tolerance and some aspects of pulmonary function in adults with asthma and can be considered a supplementary therapy. RCTs of high quality and large sample sizes are required.
The review was registered with PROSPERO (The website is https://www.crd.york.ac.uk/prospero/ , and the ID is CRD42019147107).
肺康复（PR）已被提议作为许多呼吸系统疾病的有效治疗方法。然而，基于运动的 PR 对哮喘的影响目前尚无定论。本综述旨在研究基于运动的 PR 对成年哮喘患者的影响。
从建库到 2019 年 7 月 31 日，我们对 PubMed、Embase、Cochrane 图书馆、Web of Science、国际临床试验注册平台和 ClinicalTrials.gov 数据库进行了检索，无语言限制。纳入了评估基于运动的 PR 对哮喘成人影响的随机对照试验（RCT）。两名研究者独立进行研究选择、数据提取和偏倚风险评估。使用 RevMan 软件（版本 5.3）进行荟萃分析。通过 Grading of Recommendations, Assessment, Development and Evaluation（GRADE）系统对证据质量进行评级。
从 9 项研究的 10 篇文献中（n=418 名患者）确定了符合条件的研究。实验组的哮喘生活质量问卷总分（MD=0.39，95%CI：0.02 至 0.76）较对照组显著改善，包括活动领域评分（MD=0.58，95%CI：0.21 至 0.94）、症状领域评分（MD=0.52，95%CI：0.19 至 0.85）、情绪领域评分（MD=0.53，95%CI：-0.03 至 1.09）和环境领域评分（MD=0.56，95%CI：0.00 至 1.11）。6 分钟步行距离（MD=34.09，95%CI：2.51 至 65.66）和最大摄氧量（MD=4.45，95%CI：3.32 至 5.58）均显著改善。然而，哮喘控制问卷评分（MD=-0.25，95%CI：-0.51 至 0.02）和哮喘无症状天数（MD=3.35，95%CI：-0.21 至 6.90）的改善并不显著。此外，用力呼气量 1 秒率（FEV1）无显著改善（MD=0.10，95%CI：-0.08 至 0.29）。然而，用力肺活量（FVC）（MD=0.23，95%CI：0.08 至 0.38）和呼气峰流量（PEF）（MD=0.39，95%CI：0.21 至 0.57）的改善是显著的。
基于运动的 PR 可能改善成年哮喘患者的生活质量、运动耐量和某些肺功能方面，可以作为一种补充治疗。需要进行高质量、大样本量的 RCT。
本综述已在 PROSPERO 上注册（网址为 https://www.crd.york.ac.uk/prospero/ ，ID 为 CRD42019147107）。
