Department of Physical Medicine and Rehabilitation, Division of Cardio-Pulmonary Rehabilitation, Faculty of Medicine, University of Kinshasa, Lemba, B-190, Kinshasa, Democratic Republic of the Congo.
Department Rehabilitation Sciences, Faculty Movement and Rehabilitation Sciences, Katholieke Universiteit of Leuven, University Hospitals Leuven, Leuven, Belgium.
Pan Afr Med J. 2022 May 27;42:78. doi: 10.11604/pamj.2022.42.78.31954. eCollection 2022.
Pulmonary rehabilitation (PR) is an integral part of the management of patients with chronic respiratory diseases. However, there is limited information available on the effectiveness and practice of PR in Africa. This study was conducted to examine the prevalence, structure, and organization of PR in Africa, as well as its substance and claimed efficacy. We conducted a multimethod study involving systematic review of PR studies (obtained from PubMed, Google Scholar, and Cochrane databases) and a web-based survey of African healthcare professionals engaged in PR (using a standardized questionnaire). The review included papers on at least one component of PR in Africa and excluded those on PR from other continents or assessing pulmonary disorders in general without PR, cardio-rehabilitation, or physiotherapy practice in general in Africa. The Cochrane risk of bias and the Newcastle Ottawa scale instruments were used to assess the quality of included studies. We narratively synthesised data across the studies to produce a holistic picture. Of the 14 studies included for qualitative synthesis, seven were randomized controlled trials on the effectiveness of PR treatments with a total number of 333 participants. Of the 39 surveys mailed to health professionals working in Africa, only 14 (35.8%) were returned. We found aerobic exercise and breathing exercises were the most used technique and that quality of life, exercise capacity, and lung function improved significantly after PR treatments. There were differences in the duration, frequency, and length of the programs across the continent. Half of the respondents indicated that their institutions had one or more PR programs for inpatient, outpatient, maintenance, and/or home-based programs. Additionally, aerobic activities, upper and lower extremity strength training were the most frequently used exercise modalities in PR programs, followed by breathing exercises. Pulmonary rehabilitation is understudied in Africa, but it has been linked to improved lung function, exercise capacity, and quality of life. There is a need to invest in techniques tailored to the continent to enhance the implementation of pulmonary rehabilitation in Africa.
肺康复（PR）是慢性呼吸系统疾病管理的重要组成部分。然而，关于 PR 在非洲的有效性和实践情况的信息有限。本研究旨在检查 PR 在非洲的流行情况、结构和组织，以及其物质和声称的疗效。我们进行了一项多方法研究，包括对 PR 研究的系统评价（从 PubMed、Google Scholar 和 Cochrane 数据库获得）以及对从事 PR 的非洲医疗保健专业人员的基于网络的调查（使用标准化问卷）。该综述包括至少有一个非洲 PR 组成部分的论文，排除了来自其他大陆的 PR 论文或评估非洲一般肺部疾病而无 PR、心脏康复或一般物理治疗的论文。使用 Cochrane 偏倚风险和纽卡斯尔-渥太华量表工具评估纳入研究的质量。我们对研究数据进行了叙述性综合，以形成整体图景。在纳入定性综合的 14 项研究中，有 7 项是关于 PR 治疗效果的随机对照试验，共有 333 名参与者。在寄给在非洲工作的卫生专业人员的 39 份调查中，只有 14 份（35.8%）被退回。我们发现有氧运动和呼吸练习是最常用的技术，并且 PR 治疗后生活质量、运动能力和肺功能显著改善。整个非洲大陆的项目持续时间、频率和长度存在差异。一半的受访者表示，他们的机构有一个或多个 PR 计划，用于住院、门诊、维持和/或家庭计划。此外，有氧运动、上下肢力量训练是 PR 计划中最常使用的运动方式，其次是呼吸练习。肺康复在非洲的研究不足，但已与改善肺功能、运动能力和生活质量相关。需要投资于针对该大陆的技术，以加强非洲肺康复的实施。
