Soh Imamura1, Takeshi Inagaki2, Jiro Terada3, Kengo Nagashima4, Hideki Katsura5, Koichiro Tatsumi6. 1. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan; Division of Rehabilitation, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan. 2. Division of Rehabilitation, Chiba University Hospital, Chiba, Japan. 3. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan. jirotera@chiba-u.jp. 4. Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tokyo, Japan. 5. Division of Respiratory Medicine, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan. 6. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Abstract
BACKGROUND: The short-term efficacy of pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD) has been established. Although continuous follow-up and sustained exercise training is important to maintain the effects, the long-term efficacy of PR without frequent supervised training remains unclear. The aim of this meta-analysis was to investigate the long-term efficacy of PR with home-based or low frequent maintenance program on exercise capacity and health related quality of life (HRQOL) in patients with COPD. METHODS: We identified randomized controlled trials (RCTs) comparing long-term efficacy of PR with home-based or low frequent maintenance and no maintenance program from PubMed and the Cochrane Library. Primary outcomes were exercise capacity [6-minute walking distance (6MWD), incremental shuttle walking test (ISWT)] and HRQOL [St. George's Respiratory Questionnaire (SGRQ)]. Outcomes were combined using a random-effects model. This study is registered with PROSPERO, number CRD42019109718. RESULTS: Seven RCTs with a total of 492 patients with COPD met the inclusion criteria. PR with maintenance significantly improved 6MWD [mean difference (MD) 27.00; 95% CI: 1.04-52.96; P=0.01] and ISWT (MD 44.48; 95% CI: 30.70-58.25; P<0.01), however no statistical evidence of improvement in HRQOL (MD -1.32; 95% CI: -7.71 to 5.08, P=0.69) was observed. CONCLUSIONS: PR with maintenance programs appears to be more effective than without maintenance for preserving exercise capacity in the long-term in patients with COPD. No long-term efficacy on HRQOL were noted. To maintain the efficacy of PR on exercise capacity and HRQOL over a long duration, it might be necessary to reexamine the contents and frequency of maintenance programs.
BACKGROUND: The short-term efficacy of pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD) has been established. Although continuous follow-up and sustained exercise training is important to maintain the effects, the long-term efficacy of PR without frequent supervised training remains unclear. The aim of this meta-analysis was to investigate the long-term efficacy of PR with home-based or low frequent maintenance program on exercise capacity and health related quality of life (HRQOL) in patients with COPD. METHODS: We identified randomized controlled trials (RCTs) comparing long-term efficacy of PR with home-based or low frequent maintenance and no maintenance program from PubMed and the Cochrane Library. Primary outcomes were exercise capacity [6-minute walking distance (6MWD), incremental shuttle walking test (ISWT)] and HRQOL [St. George's Respiratory Questionnaire (SGRQ)]. Outcomes were combined using a random-effects model. This study is registered with PROSPERO, number CRD42019109718. RESULTS: Seven RCTs with a total of 492 patients with COPD met the inclusion criteria. PR with maintenance significantly improved 6MWD [mean difference (MD) 27.00; 95% CI: 1.04-52.96; P=0.01] and ISWT (MD 44.48; 95% CI: 30.70-58.25; P<0.01), however no statistical evidence of improvement in HRQOL (MD -1.32; 95% CI: -7.71 to 5.08, P=0.69) was observed. CONCLUSIONS: PR with maintenance programs appears to be more effective than without maintenance for preserving exercise capacity in the long-term in patients with COPD. No long-term efficacy on HRQOL were noted. To maintain the efficacy of PR on exercise capacity and HRQOL over a long duration, it might be necessary to reexamine the contents and frequency of maintenance programs.
Authors: Xiaoyue Song; Cynthia Hallensleben; Weihong Zhang; Zongliang Jiang; Hongxia Shen; Robbert J J Gobbens; Rianne M J J Van Der Kleij; Niels H Chavannes; Anke Versluis Journal: J Med Internet Res Date: 2021-03-31 Impact factor: 5.428
Authors: Joana Berger-Estilita; José Miguel Padilha; Liliana Silva; Tiago Maricoto; Patrício Costa Journal: NPJ Prim Care Respir Med Date: 2022-10-03 Impact factor: 3.289