Hospital Virgen de la Luz, C/ Hermandad de Donantes de Sangre, 1, 16002. Cuenca, Spain. Electronic address: https://twitter.com/susiprieJ.
Health and Social Research Center, University of Castilla La Mancha, Edificio Melchor Cano, Campus Universitario, s/n. 16071, Cuenca, Spain; Faculty of nursing, University of Castilla La Mancha, Edificio Melchor Cano, University of Castilla-La Mancha, Campus Universitario, s/n. 16071. Cuenca, Spain.
Ann Phys Rehabil Med. 2024 Nov;67(8):101875. doi: 10.1016/j.rehab.2024.101875. Epub 2024 Oct 30.
Although aerobic training leads to physiological improvements in people with chronic obstructive pulmonary disease (COPD), measured by the VO2 peak, there is no evidence as to which type of physical exercise intervention is the most effective in improving the VO peak or max.
A network meta-analysis (NMA) was performed to determine the effects of different physical interventions on oxygen uptake in people with COPD.
A literature search was performed from database inception to February 2024. Randomized controlled trials on the effectiveness of exercise programs on oxygen uptake with COPD were included. We assessed the risk of bias using the Cochrane Risk of Bias (RoB 2.0) tool and the quality of the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Pairwise meta-analyses and NMAs were performed for direct and indirect evidence.
A total of 22 studies were included in this NMA. The highest effects for improvement in oxygen uptake scores were for continuous, moderate-intensity endurance exercise versus a control (effect size [ES]: 1.17; 95% CI 0.59 to 1.74), followed by continuous, high-intensity endurance exercise versus a control (ES: 0.47; 95% CI 0.08 to 0.85), and combined exercise versus a control (ES: 0.41; 95% CI 0.18 to 0.64).
Continuous, moderate-intensity endurance exercise should be considered the most effective strategy to improve oxygen uptake in people with COPD, followed by continuous, high-intensity endurance exercise and combined exercise. Due to the importance of VO as a predictor of quality of life and mortality in people with COPD, it is essential to include its assessment in clinical guidelines and to include the most effective physical activity interventions to improve it.
PROSPERO database: CRD42023425893.
尽管有氧运动可通过 VO2 峰值衡量，改善慢性阻塞性肺疾病（COPD）患者的生理机能，但目前尚无证据表明哪种类型的体育锻炼干预措施对提高 VO 峰值或最大摄氧量最有效。
本项网络荟萃分析（NMA）旨在确定不同身体干预措施对 COPD 患者摄氧量的影响。
从数据库建立到 2024 年 2 月进行文献检索。纳入了关于运动方案对 COPD 患者摄氧量有效性的随机对照试验。我们使用 Cochrane 风险偏倚工具（RoB 2.0）评估偏倚风险，并使用推荐、评估、开发和评估分级工具（GRADE）评估证据质量。对于直接和间接证据，分别进行了成对荟萃分析和 NMA。
本 NMA 共纳入 22 项研究。在改善摄氧量评分方面，效果最高的是持续、中等强度耐力运动与对照组相比（效应量[ES]：1.17；95%置信区间 0.59 至 1.74），其次是持续、高强度耐力运动与对照组相比（ES：0.47；95%置信区间 0.08 至 0.85），以及综合运动与对照组相比（ES：0.41；95%置信区间 0.18 至 0.64）。
持续、中等强度耐力运动应该被视为改善 COPD 患者摄氧量的最有效策略，其次是持续、高强度耐力运动和综合运动。由于 VO 作为预测 COPD 患者生活质量和死亡率的重要指标，在临床指南中评估其重要性并纳入最有效的体育活动干预措施以改善其指标至关重要。
PROSPERO 数据库：CRD42023425893。
