Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-Constructed by Henan Province & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, People's Republic of China.
Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, People's Republic of China.
Ther Adv Respir Dis. 2023 Jan-Dec;17:17534666231162250. doi: 10.1177/17534666231162250.
Pulmonary rehabilitation (PR) has been considered to be an effective treatment method for various respiratory diseases. However, the effects of exercise-based PR on patients with severe/very severe chronic obstructive pulmonary disease (COPD) are unclear. This review aimed to investigate the effects of exercise-based PR on patients with severe/very severe COPD.
PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases were searched from inception to December 23, 2022, without language restrictions. Randomized controlled trials (RCTs) investigating the effects of exercise-based PR on patients with severe/very severe COPD were included. Study selection, data extraction, and risk of bias assessment were conducted independently. RevMan software (version 5.3) was used for meta-analysis. The quality of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation system.
Six studies (263 patients) were identified. Compared with the control group, the 6-min walking distance [MD = 52.91, 95% CI (3.80, 102.03)], the St. George's Respiratory Questionnaire total scores [MD = -7.70, 95% CI (-14.32, -1.08)] and the Borg scale scores [MD = -0.68, 95% CI (-1.28, -0.08)] in the experimental group improved, respectively. The St. George's Respiratory Questionnaire and Borg scale scores were rated as 'moderate quality' and 'low quality', respectively, and the 6-min walking distance was rated as 'very low quality'.
Exercise-based PR may improve the exercise capacity, quality of life and dyspnea of patients with severe/very severe COPD, which can be regarded as an adjuvant treatment. High quality and large sample RCTs are needed.
This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (No. CRD42022294085).
肺康复（PR）被认为是治疗各种呼吸系统疾病的有效方法。然而，基于运动的 PR 对严重/极重度慢性阻塞性肺疾病（COPD）患者的效果尚不清楚。本综述旨在探讨基于运动的 PR 对严重/极重度 COPD 患者的影响。
从建库至 2022 年 12 月 23 日，检索了 PubMed、Embase、Cochrane 图书馆、Web of Science 和 ClinicalTrials.gov 数据库，无语言限制。纳入了评估基于运动的 PR 对严重/极重度 COPD 患者影响的随机对照试验（RCT）。独立进行了研究选择、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。使用推荐评估、制定与评价系统（Grading of Recommendations Assessment, Development and Evaluation system）对证据质量进行评级。
确定了 6 项研究（263 名患者）。与对照组相比，实验组的 6 分钟步行距离[MD=52.91，95%CI（3.80，102.03）]、圣乔治呼吸问卷总评分[MD=-7.70，95%CI（-14.32，-1.08）]和 Borg 量表评分[MD=-0.68，95%CI（-1.28，-0.08）]均有所改善。圣乔治呼吸问卷和 Borg 量表评分的质量被评为“中等质量”和“低质量”，6 分钟步行距离的质量被评为“极低质量”。
基于运动的 PR 可能改善严重/极重度 COPD 患者的运动能力、生活质量和呼吸困难，可作为辅助治疗。需要高质量和大样本的 RCT。
本系统评价和荟萃分析方案在 PROSPERO（编号：CRD42022294085）进行了前瞻性注册。
