The effectiveness, safety and compliance of Zheng’s supine rehabilitation exercise as a rehabilitation programme among elderly patients with AECOPD

Hu, Jie; Wang, Xinni; Li, Youxia; Song, Mali; Zhong, Li Hong; He, Wei; Chen, RongChang; Zheng, Zhong

doi:10.1111/crj.13164

Cited by 10 publications

(29 citation statements)

References 13 publications

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“…Twelve studies 42–47 , 49–54 identified the method of allocation concealment, and the outcome assessment was blinded in six studies. 42–45 , 52 , 54 A detailed assessment of risk of bias is provided in Figure 2A and B .…”

Section: Resultsmentioning

confidence: 99%

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Pulmonary Rehabilitation Programmes Within Three Days of Hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Zhang¹,

Zhang²,

Li³

et al. 2021

COPD

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Objective To evaluate the efficacy and safety of early pulmonary rehabilitation (PR) (ie, <3 days of hospitalization) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Embase, Web of Science, PubMed and Cochrane Library were searched from their inception to 1 April 2021. Randomized controlled trials were included if they observed the efficacy of early PR in AECOPD patients. Study selection, data extraction, risk of bias and quality of evidence were assessed by two researchers independently. Assessment of the risk of bias and eidence quality were evaluated by the Cochrane Collaboration’s tool and Grading of Recommendations, Assessment, Development and Evaluation system, respectively. Results Fourteen trials (829 participants) were identified. Significant improvement was found in the 6-minute walk distance (6MWD; mean difference (MD): 69.64; 95% CI: 40.26 to 99.01; Z = 4.65, P < 0.0001, low quality). In the subgroup analysis, the exercise-training group showed marked improvement (MD: 96.14; 95% CI: 20.24 to 172.04; Z = 2.48, P = 0.001). The Saint George’s Respiratory Questionnaire (SGRQ) total score was low (MD: −12.77; 95% CI: −16.03 to −9.50; Z = 7.67, P < 0.0001, moderate quality). Significant effects were not found for the duration of hospital stay, quadriceps muscle strength or five times sit to stand test. Only one serious adverse event was reported in experimental group, which was not associated with early PR. Conclusion PR initiated <3 days of hospitalization may increase exercise capacity and improve quality of life, but the results should be interpreted prudently and dialectically, and the role of early PR in AECOPD needs further exploration.

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Section: Resultsmentioning

confidence: 99%

“…Six studies 43 , 45 , 46 , 48 , 53 , 54 (319 participants) were included in this part of the meta-analysis. Significant heterogeneity was found (χ 2 = 44.24, P < 0.0001; I 2 = 89%), so a random-effects model was employed.…”

Section: Resultsmentioning

confidence: 99%

Pulmonary Rehabilitation Programmes Within Three Days of Hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Zhang¹,

Zhang²,

Li³

et al. 2021

COPD

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“…More than half of the studies (52%) were published in the last 5 years, 28,29,35,36,[38][39][40][41][42][43][44][45]50,52 and 37% were published in the previous 15 years. 27,[30][31][32][33]37,[47][48][49]51 Studies were conducted in 11 countries, with the biggest representation from Spain (30%), [39][40][41][42]44,[48][49][50] followed by China (19%), 33,36,38,43,52 and Germany (11%). 26,32,34 Six studies had multiple arms, comparing usual care to more than one intervention that met our criteria.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…The principle of specificity was adequately described by 19 studies, [26][27][28][29][30][31][32][33][34][35]37,39,41,42,[44][45][46][47]51 but seven studies were unclear, 36,38,40,43,[48][49][50] and one study did not describe this principle. 52 The application of progression was properly done by 13 studies, 28,[31][32][33]35,41,42,[45][46][47][48][49][50] but it was unclearly described in three trials, 27,39,51 and not reported in 11 studies.…”

Section: Application Of Exercise Principlesmentioning

confidence: 99%

A systematic review of exercise studies for individuals hospitalized with an acute exacerbation of chronic obstructive pulmonary disease: Focus on the principles of exercise training

Moecke,

Zhu,

Gill

et al. 2023

Chron Respir Dis

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Background For exercise interventions to be effectively reproduced or applied in a “real world” clinical setting, clinical trials must thoroughly document all components of the exercise prescription and ensure that participants adhere to each component. However, previous reviews have not critically examined the quality of exercise prescription of inpatient Pulmonary Rehabilitation (PR) programs. Objective The objectives of this review were to evaluate the (a) application of the principles of exercise training, (b) reporting of the frequency, intensity, time and type (FITT) components of exercise prescription, and (c) reporting of patient’s adherence to the FITT components in intervention studies for patients admitted to hospital for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Relevant scientific databases were searched for randomized controlled trials (RCTs) that compared in-hospital PR with usual care for people hospitalized with AECOPD. Title and abstract followed by full-text screening were conducted independently by two reviewers. Data were extracted and synthesized to evaluate the application of the principles of exercise training and the reporting/adherence of the FITT components. Results Twenty-seven RCTs were included. Only two applied all principles of exercise training. Specificity was applied by 70%, progression by 48%, overload by 37%, initial values by 89% and diminishing returns and reversibility by 37% of trials. Ten trials adequately reported all FITT components. Frequency and type were the components most reported (85% and 81%, respectively), while intensity was less frequently reported (52%). Only three trials reported on the patient's adherence to all four components. Conclusions Studies have not adequately reported the exercise prescription in accordance with the principles of exercise training nor reported all the FITT components of the exercise prescription and patient’s adherence to them. Therefore, interpretation of the current literature is limited and information for developing exercise prescriptions to individuals hospitalized with an AECOPD is lacking.

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“…Currently, neither the 6‐min walking distance (6MWD) nor the cardiopulmonary exercise test (CPET) can be completed for terminal or critically ill patients with severe exercise limitation, making it difficult to assess the rehabilitation effect. Our previous study found that ZSRE could be performed in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in GOLD stage IV without serious adverse events 3 . In view of the rehabilitation effectiveness and safety of ZSRE and the increase in simulated pedal motion per unit time as exercise endurance improves, we constructively suggest that simulated pedal motion can be used not only as a form of rehabilitation exercise for patients but also as an indicator of exercise endurance.…”

Section: Introductionmentioning

confidence: 99%

Exploration of the minimal clinically important difference value of the 3‐min simulated pedal motion in patients with chronic obstructive pulmonary disease: A self‐controlled prospective clinical trial

Zhang,

Liu,

Yang

et al. 2023

Clinical Respiratory J

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BackgroundTo help elderly patients with severe or very severe chronic obstructive pulmonary disease (COPD) with pulmonary rehabilitation, we have developed Zheng's supine rehabilitation exercise (ZSRE). Currently, none of the terminal or critically ill patients with severe exercise limitation can complete the 6‐min walking distance (6MWD) and cardiopulmonary exercise testing (CPET).MethodsIn this study, we discuss the definition of the standardized 3‐min simulated pedal motion (3MSPM) test and its operational specifications. Also, we evaluate the minimal clinically important difference (MCID) value of the 3MSPM.ResultsThe results showed that the mMRC score of COPD patients with acute exacerbation of dyspnea was progressively reduced from the second day of respiratory rehabilitation, and the difference between the first and seventh days was statistically significant (p < 0.000, χ2 = 176.664). 6MWD increased progressively, and the difference between 6MWD on day 1–7 was statistically significant (p = 0.024, F = 2.443). The difference between 3MSPM on day 1–7 was also statistically significant (p < 0.000, F = 4.481). Further analysis showed that 6MWD was negatively correlated with mMRC (p < 0.000, OR = −0.524). 3MSPM was positively correlated with 6MWD (p < 0.000, OR = 0.640) but negatively correlated with mMRC (p < 0.000, OR = −0.413). There is a linear regression relationship between 6MWD and 3MSPM, that is, 6MWD = 14.151 + 0.301 * 3MSPM, adjusted R2 = 0.401.ConclusionBased on the regression equation, 3MSPM can predict 6MWD, and it can be used as a simple exercise endurance method to evaluate patients with safety hazards in underground activities or who cannot complete the 6MWD test. The minimum clinically important difference value is increased by 23.

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The effectiveness, safety and compliance of Zheng’s supine rehabilitation exercise as a rehabilitation programme among elderly patients with AECOPD

Cited by 10 publications

References 13 publications

Pulmonary Rehabilitation Programmes Within Three Days of Hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Pulmonary Rehabilitation Programmes Within Three Days of Hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

A systematic review of exercise studies for individuals hospitalized with an acute exacerbation of chronic obstructive pulmonary disease: Focus on the principles of exercise training

Exploration of the minimal clinically important difference value of the 3‐min simulated pedal motion in patients with chronic obstructive pulmonary disease: A self‐controlled prospective clinical trial

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