Non-invasive ventilation intervention during exercise training in individuals with chronic obstructive pulmonary disease: A systematic review and meta-analysis

Xiang, Guiling; Wu, Qiao; Wu, Xu; Hao, Shengyu; Xie, Liang; Li, Shanqun

doi:10.1016/j.rehab.2020.101460

Cited by 9 publications

(3 citation statements)

References 26 publications

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“…A heterogeneity test was first performed. Heterogeneity was evaluated by the I 2 statistic, which was classified as low, moderate, or high with I 2 < 25%, 25 − 50%, and > 50%, respectively [ 9 ]. If I 2 < 50% or P > 0.05, there was no significant heterogeneity among the included studies, and the fixed effect model was adopted.…”

Section: Methodsmentioning

confidence: 99%

Meta-analysis of the quantitative assessment of lower extremity motor function in elderly individuals based on objective detection

Liu,

Bai

2024

J NeuroEngineering Rehabil

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Objective To avoid deviation caused by the traditional scale method, the present study explored the accuracy, advantages, and disadvantages of different objective detection methods in evaluating lower extremity motor function in elderly individuals. Methods Studies on lower extremity motor function assessment in elderly individuals published in the PubMed, Web of Science, Cochrane Library and EMBASE databases in the past five years were searched. The methodological quality of the included trials was assessed using RevMan 5.4.1 and Stata, followed by statistical analyses. Results In total, 19 randomized controlled trials with a total of 2626 participants, were included. The results of the meta-analysis showed that inertial measurement units (IMUs), motion sensors, 3D motion capture systems, and observational gait analysis had statistical significance in evaluating the changes in step velocity and step length of lower extremity movement in elderly individuals (P < 0.00001), which can be used as a standardized basis for the assessment of motor function in elderly individuals. Subgroup analysis showed that there was significant heterogeneity in the assessment of step velocity [SMD=-0.98, 95%CI(-1.23, -0.72), I2 = 91.3%, P < 0.00001] and step length [SMD=-1.40, 95%CI(-1.77, -1.02), I2 = 86.4%, P < 0.00001] in elderly individuals. However, the sensors (I2 = 9%, I2 = 0%) and 3D motion capture systems (I2 = 0%) showed low heterogeneity in terms of step velocity and step length. The sensitivity analysis and publication bias test demonstrated that the results were stable and reliable. Conclusion observational gait analysis, motion sensors, 3D motion capture systems, and IMUs, as evaluation means, play a certain role in evaluating the characteristic parameters of step velocity and step length in lower extremity motor function of elderly individuals, which has good accuracy and clinical value in preventing motor injury. However, the high heterogeneity of observational gait analysis and IMUs suggested that different evaluation methods use different calculation formulas and indicators, resulting in the failure to obtain standardized indicators in clinical applications. Thus, multimodal quantitative evaluation should be integrated.

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Section: Methodsmentioning

confidence: 99%

Meta-analysis of the quantitative assessment of lower extremity motor function in elderly individuals based on objective detection

Liu,

Bai

2024

J NeuroEngineering Rehabil

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“…Noninvasive ventilation (NIV) using a nose or nose–mouth interface also reduces the work of breathing and acutely improves the exercise tolerance of patients with COPD. It allows for a slightly higher training intensity [ 50 ] and may render somewhat larger improvements in exercise tolerance after an exercise training programme [ 51 ], particularly in very severe patients. The application of NIV requires expertise and training, appropriate equipment and patients who are willing to get accustomed to the oronasal interfaces, making this not a mainstream technique for use in large amounts of patients [ 52 ] but an attractive option for those patients using nocturnal NIV to try.…”

Section: Reversing Physiological Problemsmentioning

confidence: 99%

Pulmonary rehabilitation and physical interventions

Troosters¹,

Janssens²,

Demeyer³

et al. 2023

Eur Respir Rev

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Pulmonary rehabilitation has established a status of evidence-based therapy for patients with symptomatic COPD in the stable phase and after acute exacerbations. Rehabilitation should have the possibility of including different disciplines and be offered in several formats and lines of healthcare. This review focusses on the cornerstone intervention, exercise training, and how training interventions can be adapted to the limitations of patients. These adaptations may lead to altered cardiovascular or muscular training effects and/or may improve movement efficiency. Optimising pharmacotherapy (not the focus of this review) and oxygen supplements, whole-body low- and high-intensity training or interval training, and resistance (or neuromuscular electrical stimulation) training are important training modalities for these patients in order to accommodate cardiovascular and ventilatory impairments. Inspiratory muscle training and whole-body vibration may also be worthwhile interventions in selected patients. Patients with stable but symptomatic COPD, those who have suffered exacerbations and patients waiting for or who have received lung volume reduction or lung transplantation are good candidates. The future surely holds promise to further personalise exercise training interventions and to tailor the format of rehabilitation to the individual patient's needs and preferences.

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“…Potential mechanisms by which NIV might improve exercise tolerance are respiratory muscle unloading, improving oxygenation due to better ventilation-perfusion ratio and reducing hyperinflation 16 17 . A recent meta-analysis included 15 randomized controlled trials (RCTs), which studied the effect of NIV during a training exercise programme of 4–12 weeks 18▪ , and concluded that after the training programme, the 6-min walking distance was higher in the group that trained with NIV and experienced lower fatigue during NIV use. However, there was no effect on dyspnoea.…”

Section: Non-invasive Ventilation During Exercise For Symptom Reliefmentioning

confidence: 99%

Home ventilation for patients with end-stage chronic obstructive pulmonary disease

Raveling,

Rantala,

Duiverman

2023

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of the review The number of patients with end-stage chronic obstructive pulmonary disease (COPD) treated with chronic non-invasive ventilation (NIV) has greatly increased. In this review, the authors summarize the evidence for nocturnal NIV and NIV during exercise. The authors discuss the multidisciplinary and advanced care of patients with end-stage COPD treated with NIV. Recent findings Nocturnal NIV improves gas exchange, health-related quality of life and survival in stable hypercapnic COPD patients. Improvements in care delivery have been achieved by relocating care from the hospital to home based; home initiation of chronic NIV is feasible, non-inferior regarding efficacy and cost-effective compared to in-hospital initiation. However, the effect of NIV on symptoms is variable, and applying optimal NIV for end-stage COPD is complex. While exercise-induced dyspnoea is a prominent complaint in end-stage COPD, nocturnal NIV will not change this. However, NIV applied solely during exercise might improve exercise tolerance and dyspnoea. While chronic NIV is often a long-standing treatment, patient expectations should be discussed early and be managed continuously during the treatment. Further, integration of advance care planning requires a multidisciplinary approach. Summary Although chronic NIV is an effective treatment in end-stage COPD with persistent hypercapnia, there are still important questions that need to be answered to improve care of these severely ill patients.

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Non-invasive ventilation intervention during exercise training in individuals with chronic obstructive pulmonary disease: A systematic review and meta-analysis

Cited by 9 publications

References 26 publications

Meta-analysis of the quantitative assessment of lower extremity motor function in elderly individuals based on objective detection

Meta-analysis of the quantitative assessment of lower extremity motor function in elderly individuals based on objective detection

Pulmonary rehabilitation and physical interventions

Home ventilation for patients with end-stage chronic obstructive pulmonary disease

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