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基于网络的肺康复治疗:系统综述。

Web-based pulmonary telehabilitation: a systematic review.

机构信息

Centro de Investigación en Ciencias Humanas y de la Educación-CICHE, Facultad de Ingenierías, Ingeniería Industrial, Universidad Tecnológica Indoamérica, Ambato, Tungurahua, Ecuador.

Facultad de Ingeniería y Ciencias Aplicadas, Universidad de las Américas, Quito, Pichincha, Ecuador.

出版信息

NPJ Prim Care Respir Med. 2024 Nov 16;34(1):38. doi: 10.1038/s41533-024-00396-5.

Abstract

Web-based pulmonary telerehabilitation (WBPTR) can serve as a valuable tool when access to conventional care is limited. This review assesses a series of studies that explore pulmonary telerehabilitation programmes delivered via web-based platforms. The studies involved participants with moderate to severe chronic obstructive pulmonary disease (COPD). Of the 3190 participants, 1697 engaged in WBPTR platforms, while the remaining 1493 comprised the control groups. Sixteen studies were included in the meta-analysis. Web-based pulmonary telerehabilitation led to an increase in daily step count (MD 446.66, 95% CI 96.47 to 796.86), though this did not meet the minimum clinically important difference. Additionally, WBPTR did not yield significant improvements in the six-minute walking test (MD 5.01, 95% CI - 5.19 to 15.21), health-related quality of life as measured by the St. George's Respiratory Questionnaire (MD - 0.15, 95% CI - 2.24 to 1.95), or the Chronic Respiratory Disease Questionnaire (MD 0.17, 95% CI - 0.13 to 0.46). Moreover, there was no significant improvement in dyspnoea-related health status, as assessed by the Chronic Respiratory Disease Questionnaire (MD - 0.01, 95% CI - 0.29 to 0.27) or the modified Medical Research Council Dyspnoea Scale (MD - 0.14, 95% CI - 0.43 to 0.14). Based on these findings, this review concludes that WBPTR does not offer substantial advantages over traditional care. While slight improvements in exercise performance were observed, no meaningful enhancements were noted in dyspnoea or quality of life metrics. Overall, WBPTR remains a complementary and accessible option for managing and monitoring COPD patients. However, further research and innovation are required to improve its efficacy and adapt it to various clinical environments.

摘要

基于网络的肺远程康复(WBPTR)在常规治疗受限的情况下可以作为一种有价值的工具。本综述评估了一系列研究,这些研究探索了通过基于网络的平台提供的肺远程康复计划。研究对象为中重度慢性阻塞性肺疾病(COPD)患者。在 3190 名参与者中,有 1697 名参与了 WBPTR 平台,而其余 1493 名参与者为对照组。16 项研究纳入了荟萃分析。基于网络的肺远程康复可增加日常步数(MD 446.66,95%CI 96.47 至 796.86),但这未达到最小临床重要差异。此外,WBPTR 并未显著改善 6 分钟步行测试(MD 5.01,95%CI-5.19 至 15.21)、圣乔治呼吸问卷(MD-0.15,95%CI-2.24 至 1.95)或慢性呼吸疾病问卷(MD 0.17,95%CI-0.13 至 0.46)所评估的健康相关生活质量。此外,在通过慢性呼吸疾病问卷(MD-0.01,95%CI-0.29 至 0.27)或改良的医学研究委员会呼吸困难量表(MD-0.14,95%CI-0.43 至 0.14)评估的呼吸困难相关健康状况方面,也没有显著改善。基于这些发现,本综述得出结论,WBPTR 并未提供优于传统治疗的显著优势。虽然观察到运动表现略有改善,但在呼吸困难或生活质量指标方面没有明显的改善。总体而言,WBPTR 仍然是管理和监测 COPD 患者的一种补充和可及的选择。然而,需要进一步的研究和创新来提高其疗效并使其适应各种临床环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5339/11569176/3d871f4333a7/41533_2024_396_Fig1_HTML.jpg

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