远程康复对新冠病毒肺炎患者肺功能、功能能力、体能、呼吸困难、疲劳及生活质量的影响:一项系统评价与Meta分析
Effect of Telerehabilitation on Pulmonary Function, Functional Capacity, Physical Fitness, Dyspnea, Fatigue, and Quality of Life in COVID-19 Patients: A Systematic Review and Metanalysis.
作者信息
Martins Renata de Lima, Monteiro Eduardo Dos Santos Soares, de Lima Anna Myrna Jaguaribe, Santos Amilton da Cruz, Brasileiro-Santos Maria do Socorro
机构信息
Laboratory of Physical Training Studies Applied to Health, Department of Physical Education, Federal University of Paraiba, João Pessoa, Paraíba, Brazil.
Graduate Program in Physiotherapy, Federal University of Paraiba, João Pessoa, Paraíba, Brazil.
出版信息
Telemed J E Health. 2024 Aug;30(8):e2256-e2286. doi: 10.1089/tmj.2023.0653. Epub 2024 Jun 26.
This study aimed to demonstrate the technological means used to offer telerehabilitation and to evaluate the effect of physical exercise on the population affected by COVID-19. Clinical trials were searched in the electronic databases Cochrane Library, PubMed/MEDLINE, EBSCO (CINAHL), PEDro, and Web of Science from January 16 to 19, 2023. The effect measure was estimated as mean difference (MD) or standard MD (SMD) with 95% confidence intervals (CI). Subgroup analysis was used to study potential moderating factors. Twenty-four articles, describing trials with a total of 1,344 individuals affected by COVID-19, were included in the qualitative synthesis and 14 articles in the meta-analysis. The pooled results revealed that telerehabilitation improves the functional capacity (MD 79.65 [63.57, 95.73]m, < 0.00001), agility (MD -0.69 [-1.33, -0.04] s, = 0.04), lower limb strength and endurance (SMD 0.74 [0.52, 0.96], < 0.00001), forced expiratory volume in 1 s (MD 0.22 [-0.04, 0.49] L, = 0.10), and dyspnea (SMD -0.94 [-1.64, -0.24], = 0.009). The dynamic muscular resistance training associated or not with other exercise modalities led to improvements in muscular strength (MD 4.69 [0.44, 8.94] kg, = 0.03) and fatigue (SMD -0.97 [-1.74, -0.20], = 0.01). In addition, telerehabilitation showed improvements in the quality of life in the contagious-phase COVID-19 patients. Although this intervention improved inspiratory muscle strength (MD 13.71 [5.41, 22.0] cmHO, = 0.001), it did not favor forced vital capacity. Telerehabilitation contributed to improving functional capacity, inspiratory muscle strength, physical fitness, and quality of life, and reducing dyspnea and fatigue in COVID-19 adult survivors.
本研究旨在展示用于提供远程康复的技术手段,并评估体育锻炼对受新冠疫情影响人群的效果。于2023年1月16日至19日在电子数据库考克兰图书馆、PubMed/MEDLINE、EBSCO(护理学与健康领域数据库)、PEDro和科学网中检索临床试验。效应量估计为均差(MD)或标准化均差(SMD),并带有95%置信区间(CI)。采用亚组分析来研究潜在的调节因素。定性综合分析纳入了24篇描述试验的文章,这些试验共有1344名受新冠疫情影响的个体,荟萃分析纳入了14篇文章。汇总结果显示,远程康复可改善功能能力(MD 79.65 [63.57, 95.73]m,< 0.00001)、敏捷性(MD -0.69 [-1.33, -0.04] s,P = 0.04)、下肢力量和耐力(SMD 0.74 [0.52, 0.96],< 0.00001)、一秒用力呼气量(MD 0.22 [-0.04, 0.49] L,P = 0.10)和呼吸困难(SMD -0.94 [-1.64, -0.24],P = 0.009)。与其他运动方式相关或不相关的动态肌肉抗阻训练可改善肌肉力量(MD 4.69 [0.44, 8.94] kg,P = 0.03)和疲劳(SMD -0.97 [-1.74, -0.20],P = 0.01)。此外,远程康复显示出对处于新冠疫情传染期患者生活质量的改善。尽管这种干预改善了吸气肌力量(MD 13.71 [5.41, 22.0] cmH₂O,P = 0.001),但对用力肺活量并无益处。远程康复有助于改善新冠疫情成年康复者的功能能力、吸气肌力量、身体素质和生活质量,并减轻呼吸困难和疲劳。