F M Bickton1, C Fombe2, E Chisati3, J Rylance4. 1. Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre. 2. Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre. 3. Physiotherapy Department, College of Medicine, Blantyre, Malawi. 4. Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Abstract
BACKGROUND: Pulmonary rehabilitation (PR) is a highly effective non-pharmacological treatment for patients with chronic respiratory diseases. OBJECTIVE: To synthesise the evidence for PR practice and efficacy in sub-Saharan Africa. METHODS: We searched in PubMed and Scopus for relevant studies and scanned reference lists of relevant studies from these databases for additional studies. Articles meeting the inclusion criteria were included. Pre-determined data were extracted independently by two reviewers. A narrative synthesis approach was used in the interpretation of findings. RESULTS: Six studies were included, totalling 275 participants. Indications for PR were chronic obstructive pulmonary disease, asthma, pulmonary tuberculosis and post-tuberculosis lung disease. Programmes ran for 6-12 weeks, universally incorporated exercise, and variously used home-based and hospital-based delivery models. All were interventional studies, of which two were randomised controlled trials, and primarily reported pulmonary function and exercise tolerance endpoints. Evidence for individualising the exercise regimen was available in three studies. CONCLUSIONS: There is limited evidence on PR design and efficacy in sub-Saharan Africa, but available data support its use in a variety of chronic respiratory conditions. Future studies should report core outcome sets and their individualised exercise and education regimens.
BACKGROUND: Pulmonary rehabilitation (PR) is a highly effective non-pharmacological treatment for patients with chronic respiratory diseases. OBJECTIVE: To synthesise the evidence for PR practice and efficacy in sub-Saharan Africa. METHODS: We searched in PubMed and Scopus for relevant studies and scanned reference lists of relevant studies from these databases for additional studies. Articles meeting the inclusion criteria were included. Pre-determined data were extracted independently by two reviewers. A narrative synthesis approach was used in the interpretation of findings. RESULTS: Six studies were included, totalling 275 participants. Indications for PR were chronic obstructive pulmonary disease, asthma, pulmonary tuberculosis and post-tuberculosis lung disease. Programmes ran for 6-12 weeks, universally incorporated exercise, and variously used home-based and hospital-based delivery models. All were interventional studies, of which two were randomised controlled trials, and primarily reported pulmonary function and exercise tolerance endpoints. Evidence for individualising the exercise regimen was available in three studies. CONCLUSIONS: There is limited evidence on PR design and efficacy in sub-Saharan Africa, but available data support its use in a variety of chronic respiratory conditions. Future studies should report core outcome sets and their individualised exercise and education regimens.
Authors: Fanuel Meckson Bickton; Talumba Mankhokwe; Rebecca Nightingale; Cashon Fombe; Martha Mitengo; Langsfield Mwahimba; Wilfred Lipita; Laura Wilde; Ilaria Pina; Zainab K Yusuf; Zahira Ahmed; Martin Kamponda; Felix Limbani; Harriet Shannon; Enock Chisati; Andy Barton; Robert C Free; Michael Steiner; Jesse A Matheson; Adrian Manise; Sally J Singh; Jamie Rylance; Mark Orme Journal: BMJ Open Date: 2022-01-31 Impact factor: 2.692
Authors: Mark W Orme; Sally J Singh; A Chamilya H Perera; Akila R Jayamaha; Amy V Jones; Zainab K Yusuf; K D C Upendra Wijayasiri; Thamara Amarasekara; Anthony Seneviratne; Ruhme Miah; Andy Barton; Michael C Steiner; Savithri W Wimalasekara Journal: Int J Chron Obstruct Pulmon Dis Date: 2022-03-25