Graduate School of Qinghai University, Xining, Qinghai, China.
Department of Respiratory Medicine, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China.
Ann Med. 2024 Dec;56(1):2392022. doi: 10.1080/07853890.2024.2392022. Epub 2024 Aug 28.
Skeletal muscle dysfunction is a significant factor contributing to exercise limitation in patients with chronic obstructive pulmonary disease (COPD). Although exercise training is often recommended to enhance patient outcomes, there continues to be ongoing debate regarding its exact effects.
The aim of this study is to evaluate the effectiveness of endurance exercise, strength training and combined exercise on cardiorespiratory fitness (including maximal oxygen uptake, maximal minute ventilation, and the 6-minute walk test), strength of lower limbs (measured by leg press), and quality of life (using the COPD Assessment Test) in patients with COPD. By conducting a systematic review and meta-analysis of randomized controlled trials (RCTs), our objective is to provide tailored training methods and intensity recommendations for patients with COPD in order to improve their quality of life.
The meta-analysis included 10 randomized controlled trials (RCTs) of exercise rehabilitation programs involving 180 patients with COPD that were retrieved from electronic databases (PubMed, Cochrane Library, and Embase). Two reviewers independently assessed the topical relevance, trial quality, and extracted data for the meta-analysis.
Meta-analysis showed that primary outcomes representing exercise endurance were elevated under different exercise interventions compared to pre-test, such as maximal oxygen uptake (VO2max (ml/kg/min)) [SMD = 0.40, 95% CI (0.15, 0.64)] and the 6-min walk test (6MWT) [MD = 33.90, 95% CI (25.25, 42.55)], and primary outcomes representing strength also increased, such as leg press (1RM) [MD = 24.59, 95% CI (16.08, 33.11)], while secondary outcomes such as assessments of life such as the COPD Assessment Test (CAT) recovered [MD = 2.51, 95% CI (2.01, 3.00)], with all differences being statistically significant ( < 0.05). However, Maximum minute ventilation (VEmax (L)) [MD = 0.91, 95%CI (3.61, 5.43)] was not statistically significant ( > 0.05) when compared with the post-test data. The sensitivity test data were stable, and the results were reliable. We subgrouped the data from different types of exercise interventions and found that different types of exercise affected the experimental results.
Exercise interventions have a positive effect on the treatment of patients with COPD, significantly improving functional capacity, aerobic capacity, and exercise tolerance, but they should be individualized and developed according to the patient's condition to achieve the best therapeutic effect.
骨骼肌功能障碍是导致慢性阻塞性肺疾病（COPD）患者运动受限的重要因素。尽管经常推荐运动训练来改善患者的预后，但对于其确切效果仍存在持续的争论。
本研究旨在评估耐力运动、力量训练和组合运动对 COPD 患者心肺功能（包括最大摄氧量、最大分钟通气量和 6 分钟步行试验）、下肢力量（通过腿推测量）和生活质量（使用 COPD 评估测试）的有效性。通过对随机对照试验（RCT）进行系统评价和荟萃分析，我们的目的是为 COPD 患者提供定制的训练方法和强度建议，以提高他们的生活质量。
荟萃分析纳入了 10 项涉及 180 例 COPD 患者的运动康复计划的随机对照试验（RCT），这些试验从电子数据库（PubMed、Cochrane 图书馆和 Embase）中检索而来。两位评审员独立评估了研究的主题相关性、试验质量，并提取了荟萃分析的数据。
荟萃分析显示，与基线相比，不同运动干预下的主要运动耐力结果得到提高，例如最大摄氧量（VO2max（ml/kg/min））[SMD=0.40，95%置信区间（0.15，0.64）]和 6 分钟步行试验（6MWT）[MD=33.90，95%置信区间（25.25，42.55）]，主要力量结果也得到提高，例如腿推（1RM）[MD=24.59，95%置信区间（16.08，33.11）]，而次要结果如 COPD 评估测试（CAT）等生活质量评估得到恢复[MD=2.51，95%置信区间（2.01，3.00）]，所有差异均具有统计学意义（ < 0.05）。然而，最大分钟通气量（VEmax（L））[MD=0.91，95%CI（3.61，5.43）]与测试后数据相比没有统计学意义（ > 0.05）。敏感性测试数据稳定，结果可靠。我们对不同类型的运动干预数据进行了分组，发现不同类型的运动对实验结果有影响。
运动干预对 COPD 患者的治疗有积极影响，显著改善了功能能力、有氧能力和运动耐量，但应根据患者病情进行个体化和制定，以达到最佳治疗效果。
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