Liu YiRan, Zhao Yan, Liu Fang, Liu Lin
School of Sport and Health, Nanjing Sport Institute, Nanjing 210014, Jiangsu, China.
Respiratory Medicine of Xuyi People's Hospital, Huaian 223001, Jiangsu, China.
Evid Based Complement Alternat Med. 2021 Dec 23;2021:5104102. doi: 10.1155/2021/5104102. eCollection 2021.
This study aimed to systematically evaluate the effect of exercise on pulmonary function, exercise capacity, and quality of life in children with bronchial asthma.
A comprehensive search was performed using PubMed, Cochrane Library, Web of Science, EBSCO, CNKI, and Wanfang Data Knowledge Service platform to identify any relevant randomized controlled trials (RCTs) published from inception to April 2021. The Cochrane risk of the bias tool was utilized to evaluate the methodological quality of the included studies, and RevMan 5.3 was applied to perform data analyses.
A total of 22 RCTs involving 1346 patients were included. The results of the meta-analysis showed that exercise had significant advantages in improving lung function and exercising capacity and quality of life in children with asthma compared with conventional treatment, such as the forced vital capacity to predicted value ratio (SMD = 0.27; 95% CI: 0.13, 0.40, and < 0.0001), the peak expiratory flow to predicted value ratio (MD = 4.53; 95% CI: 1.27, 7.80, and =0.007), the 6-minute walk test (MD = 110.65; 95% CI: 31.95, 189.34, and =0.006), rating of perceived effort (MD = -2.28; 95% CI: -3.21, -1.36, and < 0.0001), and peak power (MD = 0.94; 95% CI: 0.37, 1.52, and =0.001) on exercise capacity and pediatric asthma quality of life questionnaire (MD = 1.28; 95% CI: 0.60, 1.95, and =0.0002) on quality of life. However, no significant difference was observed in the forced expiratory flow between 25% and 75% of vital capacity (=0.25) and the forced expiratory volume at 1 second to predicted value ratio(=0.07).
Current evidence shows that exercise has a certain effect on improving pulmonary function recovery, exercise capacity, and quality of life in children with bronchial asthma. Given the limitation of the number and quality of included studies, further research and verification are needed to guide clinical application.
本研究旨在系统评价运动对支气管哮喘患儿肺功能、运动能力和生活质量的影响。
通过检索PubMed、Cochrane图书馆、Web of Science、EBSCO、中国知网和万方数据知识服务平台,全面查找从创刊至2021年4月发表的相关随机对照试验(RCT)。采用Cochrane偏倚风险工具评估纳入研究的方法学质量,并应用RevMan 5.3进行数据分析。
共纳入22项RCT,涉及1346例患者。荟萃分析结果显示,与传统治疗相比,运动在改善哮喘患儿肺功能、运动能力和生活质量方面具有显著优势,如用力肺活量与预测值比值(标准化均数差[SMD]=0.27;95%可信区间[CI]:0.13,0.40;P<0.0001)、呼气峰值流速与预测值比值(平均差[MD]=4.53;95%CI:1.27,7.80;P=0.007)、6分钟步行试验(MD=110.65;95%CI:31.95,189.34;P=0.006)、主观用力程度评分(MD=-2.28;95%CI:-3.21,-1.36;P<0.0001)以及运动能力方面的峰值功率(MD=0.94;95%CI:0.37,1.52;P=0.001)和儿童哮喘生活质量问卷评分(MD=1.28;95%CI:0.60,1.95;P=0.0002)。然而,在肺活量25%至75%时的用力呼气流量(P=0.25)和第1秒用力呼气容积与预测值比值(P=0.07)方面未观察到显著差异。
现有证据表明,运动对改善支气管哮喘患儿肺功能恢复、运动能力和生活质量有一定作用。鉴于纳入研究的数量和质量有限,需要进一步研究和验证以指导临床应用。