Chen Meng, Wang Yuchuan, Zhou Tiantian, He Jingjing, Zhang Min, Yan Zhenlong, Tao Junjie, Huang Ping
Department of Emergency, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
J Thorac Dis. 2024 Nov 30;16(11):7350-7360. doi: 10.21037/jtd-24-1017. Epub 2024 Nov 29.
Pulmonary embolism (PE) survivors frequently experience persistent dyspnea and diminished quality of life (QoL). Evidence suggests that rehabilitation exercise has a positive impact on QoL, physical fitness, and dyspnea in patients with heart disease and chronic obstructive pulmonary disease. However, the effects of exercise on patients with PE remain ambiguous. The purpose of our study was to systematically evaluate the impact of exercise on physical fitness and QoL in patients with PE.
PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science (WOS) databases were searched from their inception to May 21, 2024. Two reviewers independently extracted the data and evaluated the methodological quality and risk of bias in the included studies.
Two studies involving 348 participants were included. This meta-analysis showed that exercise did not significantly improve the outcomes of incremental shuttle walk test (ISWT) [mean difference (MD) =60.46; 95% confidence interval (CI): -5.51, 126.42; P=0.07] or the EuroQol-5 Dimensions questionnaire (EQ-5D) (MD =0.02; 95% CI: -0.01, 0.05; P=0.14), and it did not significantly reduce pulmonary embolism quality of life (PEmbQoL) (MD =0.00; 95% CI: -0.04, 0.04; P=0.93).
The potential benefits of exercise programs range from no improvement in ISWT and PEmb-QoL to significant improvements in both. Implementing exercises may be valuable for patients with PE. Future meticulously designed randomized controlled trials are needed to validate these findings.
肺栓塞（PE）幸存者经常会经历持续性呼吸困难和生活质量（QoL）下降。有证据表明，康复锻炼对心脏病和慢性阻塞性肺疾病患者的生活质量、身体素质和呼吸困难有积极影响。然而，运动对PE患者的影响仍不明确。我们研究的目的是系统评估运动对PE患者身体素质和生活质量的影响。
检索了PubMed、医学文献分析和在线检索系统（MEDLINE）、医学文摘数据库（EMBASE）、Scopus、护理及相关健康文献累积索引（CINAHL）、Cochrane对照试验中央登记库（CENTRAL）和科学网（WOS）数据库，检索时间从各数据库创建至2024年5月21日。两名 reviewers 独立提取数据，并评估纳入研究的方法学质量和偏倚风险。
纳入两项研究，共348名参与者。这项荟萃分析表明，运动并未显著改善递增式往返步行试验（ISWT）的结果[平均差（MD）=60.46；95%置信区间（CI）：-5.51，126.42；P=0.07]或欧洲五维健康量表问卷（EQ-5D）（MD =0.02；95%CI：-0.01，0.05；P=0.14），也未显著降低肺栓塞生活质量（PEmbQoL）（MD =0.00；95%CI：-0.04，0.04；P=0.93）。
运动计划的潜在益处从ISWT和PEmb-QoL无改善到两者都有显著改善不等。实施运动可能对PE患者有价值。未来需要精心设计的随机对照试验来验证这些发现。
