Effect of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials

Zhang, Hong; Hu, Dandan; Xu, Yikai; Wu, Lixia; Lou, Liming

doi:10.1080/07853890.2021.1999494

Cited by 32 publications

(36 citation statements)

References 71 publications

(44 reference statements)

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“…Instead, we found an association between the endpoint occurrence and 6MWT which is commonly used as a measure of functional exercise capacity for the management of patients with moderate-to-severe pulmonary disease, capturing also manifestations of extra-pulmonary disorders, including cardiovascular disease, frailty, sarcopenia, cancer and others. 31 , 32 Although the 6MWT distance was consistently associated with symptoms and health-related quality of life across different disease groups, the relationships of this test with patient-reported outcomes were of weak to moderate strength. 33 Most of the studies in patients with chronic pulmonary diseases demonstrated that lower 6MWT distance is consistently associated with increased mortality, and – to a lesser extent – with hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Adverse Outcomes in Healthy Aging Adults: Coronary Artery Disease, Lower Educational Status and Higher P-Selectin Levels

Batko-Szwaczka¹,

Francuz²,

Kosowska³

et al. 2022

CIA

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Background Societal aging – as a global demographic phenomenon – shows no indication of abating. As a result, the problem of age-associated disability and related long-term care is emerging as a major public health challenge. It is important that methods for identifying older adults at risk of adverse outcomes are implemented early. Methods The study group consisted of 145 individuals, 44.1% women, who were randomized from community-dwelling 60–74-year-old adults. A comprehensive geriatric assessment was supplemented with Fried frailty phenotype evaluation and blood tests (including adhesion molecules, matrix metalloproteinases and neurotrophic factors). A follow-up by phone call was made for at least 3 years after the initial examination. Composite endpoint (CE) included falls, hospitalization, institutionalization and death. Results Mean study group age was 66.5 ± 4.1 years ( ) and mean number of diseases was 3.7 ± 2.2. Functional status of the subjects was good, as indicated by high Barthel Index scores of 99.1 ± 2.4, MMSE scores of 29.0 ±1.5 and no frailty case. During a three-year follow-up, 71 participants (49.0%) experienced any CE-events. The Wilcoxon-Gehan test indicates that a higher probability of three-year CE completion was associated with an age >65 years (P = 0.006), coronary artery disease (CAD) (P = 0.008), 6-Minute Walk Test <432 m (P = 0.034), serum glucose >120 mg/dL (P = 0.047), serum cortisol >10 μg/dL (P = 0.011), leptin ≥15 ng/mL (P = 0.018), P-selectin ≥23 ng/mL (P = 0.006) and GDNF ≥20 pg/mL (P = 0.004). CAD (OR = 3.64, 95% CI = 1.53−8.69, P = 0.004), educational status (OR = 0.87, 95% CI = 0.77−0.98, P = 0.022) and P-selectin levels (OR = 1.07, 95% CI = 1.02−1.13, P = 0.013) were independent measures predicting three-year CE occurrence in multivariate logistic regression analysis adjusted for clinical and functional measures, and blood tests. Conclusion Coronary artery disease, poorer lower educational status and higher P-selectin levels were predictive of adverse outcomes in the community-dwelling healthy-aging early-old adults during three-year follow-up.

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Section: Discussionmentioning

confidence: 99%

Predictors of Adverse Outcomes in Healthy Aging Adults: Coronary Artery Disease, Lower Educational Status and Higher P-Selectin Levels

Batko-Szwaczka¹,

Francuz²,

Kosowska³

et al. 2022

CIA

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“…Chronic lung diseases and COVID-19 are leading causes of disease, death and disability globally 1 – 4 which entail a substantial burden on the individual 5 – 7 and healthcare systems. 8 , 9 Pulmonary rehabilitation (PR) is defined by the “National Heart, Lung, And Blood Institute” as a “supervised program that includes exercise training, health education, and breathing techniques for people who have certain lung conditions or lung problems due to other conditions” 10 is widely recognized as an important treatment for patients suffering from chronic respiratory diseases, 11 , 12 and has been recommended as a potential beneficial intervention for post-COVID-19 patients. 13 PR has been shown to provide statistically and clinically significant improvements in physical activity, exercise capacity, self-efficacy, and health-related quality of life (HRQoL), and a decrease in healthcare use in patients with lung diseases.…”

Section: Introductionmentioning

confidence: 99%

Effect of telemonitoring and telerehabilitation on physical activity, exercise capacity, health-related quality of life and healthcare use in patients with chronic lung diseases or COVID-19: A scoping review

et al. 2022

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Background Telemonitoring and telerehabilitation can support home-based pulmonary rehabilitation (PR) and benefit patients with lung diseases or COVID-19. This study aimed to (1) identify which telemonitoring and telerehabilitation interventions (e.g. videoconferencing) are used to provide telehealth care for people with chronic respiratory conditions or COVID-19, and (2) provide an overview of the effects of telemonitoring and telerehabilitation on exercise capacity, physical activity, health-related QoL (HRQoL), and healthcare use in patients with lung diseases or COVID-19. Methods A search was performed in the electronic databases of Ovid MEDLINE, EMBASE, and Cinahl through 15 June 2021. Subject heading and keywords were used to reflect the concepts of telemonitoring, telerehabilitation, chronic lung diseases, and COVID-19. Studies that explored the effect of a telerehabilitation and/or telemonitoring intervention, in patients with a chronic lung disease such as asthma, chronic obstructive pulmonary diseases (COPD), or COVID-19, and reported the effect of the intervention in one or more of our outcomes of interest were included. Excluding criteria included evaluation of new technological components, teleconsultation or one-time patient assessment. Results This scoping review included 44 publications reporting the effect of telemonitoring (25 studies), telerehabilitation (8 studies) or both (11 studies) on patients with COPD (35 studies), asthma (5 studies), COPD and asthma (1 study), and COVID-19 (2 studies). Patients who received telemonitoring and/or telerehabilitation had improvements in exercise capacity in 9 out of 11 (82%) articles, better HRQoL in 21 out of 25 (84%), and fewer health care use in 3 out of 3 (100%) articles compared to pre-intervention. Compared to controls, no statistically significant differences were found in the intervention groups’ exercise capacity in 5 out 6 (83%) articles, physical activity in 3 out of 3 (100%) articles, HRQoL in 21 out of 25 (84%) articles, and healthcare use in 15 out of 20 (75%) articles. The main limitation of the study was the high variability between the characteristics of the studies, such as the number and age of the patients, the outcome measures, the duration of the intervention, the technological components involved, and the additional elements included in the interventions that may influence the generalization of the results. Conclusion Telemonitoring and telerehabilitation interventions had a positive effect on patient outcomes and appeared to be as effective as standard care. Therefore, they are promising alternatives to support remote home-based rehabilitation in patients with chronic lung diseases or COVID-19.

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“…According to the British Thoracic Society guideline on pulmonary rehabilitation in adults, a rehabilitation program should include supervised, individualized, progressive exercise training [ 6 ]. COPD patients might benefit from various exercises [ 10 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of exercise-based home pulmonary rehabilitation on patients with chronic obstructive pulmonary disease: An overview of systematic review

et al. 2022

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Background Clinical research on exercise-based home pulmonary rehabilitation (HPR) effectiveness in chronic obstructive pulmonary disease (COPD) treatment is rising, as are associated systematic reviews/meta-analyses (SRs/MAs). However, different SRs/MAs vary in outcome indicators, analysis methodologies, literature quality, and findings. This overview aimed to describe the findings of these SRs/MAs and assess their methodological quality. Methods From inception until April 2022, we searched PubMed, Web of Science, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), and Wan Fang. Two researchers searched these SRs/MAs separately, collected the data, and cross-checked it using predetermined rules. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) was used to evaluate the methodological quality of each contained SR/MA. The evidence was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 (PRISMA-2009). The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to determine the validity of the results. Results A total of 433 records were found, with 44 chosen for full-text review. There were 11 SRs/MAs that matched the inclusion criteria. Our overview included studies published from 2010 to 2022. According to the AMSTAR 2 tool, one had low methodological quality, while the other 10 SRs/MAs had very low quality. The PRISMA statement revealed a low rate of complete reporting for eight items. The GRADE tool, on the other hand, revealed that the evidence quality for most outcomes was very low to moderate. Conclusion According to current research, exercise-based HPR may benefit COPD patients. Nevertheless, this finding is restricted by the low quality of the included SRs/MAs. And more high-quality and large-sample studies are needed in the future. Prospero ID: CRD42022322768. https://www.crd.york.ac.uk/prospero/#recordDetails

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Effect of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials

Cited by 32 publications

References 71 publications

Predictors of Adverse Outcomes in Healthy Aging Adults: Coronary Artery Disease, Lower Educational Status and Higher P-Selectin Levels

Predictors of Adverse Outcomes in Healthy Aging Adults: Coronary Artery Disease, Lower Educational Status and Higher P-Selectin Levels

Effect of telemonitoring and telerehabilitation on physical activity, exercise capacity, health-related quality of life and healthcare use in patients with chronic lung diseases or COVID-19: A scoping review

Effects of exercise-based home pulmonary rehabilitation on patients with chronic obstructive pulmonary disease: An overview of systematic review

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