Tristan Bonnevie1, Pauline Smondack2, Mark Elkins3, Benoit Gouel4, Clément Medrinal5, Yann Combret6, Jean-François Muir7, Antoine Cuvelier7, Guillaume Prieur8, Francis-Edouard Gravier9. 1. ADIR Association, Rouen University Hospital, Rouen, France; Haute Normandie Research and Biomedical Innovation, Normandy University, Rouen, France. Electronic address: bonnevie.tristan@hotmail.fr. 2. ADIR Association, Rouen University Hospital, Rouen, France. 3. Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Centre for Education and Workforce Development, Sydney Local Health District, Sydney, Australia. 4. School of Physiotherapy Rouen University Hospital, Rouen, France. 5. Haute Normandie Research and Biomedical Innovation, Normandy University, Rouen, France; Intensive Care Unit Department, Le Havre Hospital, Le Havre, France. 6. Physiotherapy Department, Le Havre Hospital, Le Havre, France; Institute of Experimental and Clinical Research (IREC), Pole of Pulmonology, ORL and Dermatology, Catholic University of Louvain, Brussels, Belgium. 7. ADIR Association, Rouen University Hospital, Rouen, France; Haute Normandie Research and Biomedical Innovation, Normandy University, Rouen, France; Pulmonary, Thoracic Oncology and Respiratory Intensive Care Department, Rouen University Hospital, Rouen, France. 8. Haute Normandie Research and Biomedical Innovation, Normandy University, Rouen, France; Intensive Care Unit Department, Le Havre Hospital, Le Havre, France; Institute of Experimental and Clinical Research (IREC), Pole of Pulmonology, ORL and Dermatology, Catholic University of Louvain, Brussels, Belgium. 9. ADIR Association, Rouen University Hospital, Rouen, France; Haute Normandie Research and Biomedical Innovation, Normandy University, Rouen, France.
Abstract
QUESTIONS: How effective is home-based exercise therapy delivered using advanced telehealth technology (ATT-ET) for people with chronic obstructive pulmonary disease (COPD) compared with: no exercise therapy (ET), in/outpatient ET, and home-based ET without ATT? DESIGN: Systematic review and meta-analysis of randomised trials. PARTICIPANTS: People with stable COPD referred for ET. INTERVENTION: ATT-ET. OUTCOME MEASURES: Exercise capacity, quality of life, functional dyspnoea, cost-effectiveness and various secondary outcomes. RESULTS: Fifteen eligible trials involved 1,522 participants. Compared with no ET, ATT-ET improved exercise capacity (four studies, 6-minute walk test MD 15 m, 95% CI 5 to 24) and probably improved quality of life (four studies, SMD 0.22, 95% CI 0.00 to 0.43) and functional dyspnoea (two studies, Chronic Respiratory Questionnaire-Dyspnoea MD 2, 95% CI 0 to 4). ATT-ET had a similar effect as in/outpatient ET on functional dyspnoea (two studies, SMD -0.05, 95% CI -0.39 to 0.29) and a similar or better effect on quality of life (two studies, SMD 0.23, 95% CI -0.04 to 0.50) but its relative effect on exercise capacity was very uncertain (three studies, 6-minute walk test MD 6 m, 95% CI -26 to 37). ATT-ET had a similar effect as home-based ET without ATT on exercise capacity (three studies, 6-minute walk test MD 2 m, 95% CI -16 to 19) and similar or better effects on quality of life (three studies, SMD 0.79, 95% CI -0.04 to 1.62) and functional dyspnoea (two studies, Chronic Respiratory Questionnaire-Dyspnoea MD 2, 95% CI 0 to 4). ATT-ET had effects on most secondary outcomes that were similar to or better than each comparator. CONCLUSION: ATT-ET improves exercise capacity, functional dyspnoea and quality of life compared with no ET, although some benefits may be small. Its benefits are generally similar to in/outpatient ET and similar to or better than home-based ET without ATT. REGISTRATION: PROSPERO CRD42020165773.
QUESTIONS: How effective is home-based exercise therapy delivered using advanced telehealth technology (ATT-ET) for people with chronic obstructive pulmonary disease (COPD) compared with: no exercise therapy (ET), in/outpatient ET, and home-based ET without ATT? DESIGN: Systematic review and meta-analysis of randomised trials. PARTICIPANTS: People with stable COPD referred for ET. INTERVENTION: ATT-ET. OUTCOME MEASURES: Exercise capacity, quality of life, functional dyspnoea, cost-effectiveness and various secondary outcomes. RESULTS: Fifteen eligible trials involved 1,522 participants. Compared with no ET, ATT-ET improved exercise capacity (four studies, 6-minute walk test MD 15 m, 95% CI 5 to 24) and probably improved quality of life (four studies, SMD 0.22, 95% CI 0.00 to 0.43) and functional dyspnoea (two studies, Chronic Respiratory Questionnaire-Dyspnoea MD 2, 95% CI 0 to 4). ATT-ET had a similar effect as in/outpatient ET on functional dyspnoea (two studies, SMD -0.05, 95% CI -0.39 to 0.29) and a similar or better effect on quality of life (two studies, SMD 0.23, 95% CI -0.04 to 0.50) but its relative effect on exercise capacity was very uncertain (three studies, 6-minute walk test MD 6 m, 95% CI -26 to 37). ATT-ET had a similar effect as home-based ET without ATT on exercise capacity (three studies, 6-minute walk test MD 2 m, 95% CI -16 to 19) and similar or better effects on quality of life (three studies, SMD 0.79, 95% CI -0.04 to 1.62) and functional dyspnoea (two studies, Chronic Respiratory Questionnaire-Dyspnoea MD 2, 95% CI 0 to 4). ATT-ET had effects on most secondary outcomes that were similar to or better than each comparator. CONCLUSION: ATT-ET improves exercise capacity, functional dyspnoea and quality of life compared with no ET, although some benefits may be small. Its benefits are generally similar to in/outpatient ET and similar to or better than home-based ET without ATT. REGISTRATION: PROSPERO CRD42020165773.
Authors: Andrés Calvache-Mateo; Laura López-López; Alejandro Heredia-Ciuró; Javier Martín-Núñez; Janet Rodríguez-Torres; Araceli Ortiz-Rubio; Marie Carmen Valenza Journal: Int J Environ Res Public Health Date: 2021-12-02 Impact factor: 3.390
Authors: Lorenzo Lippi; Francesco D'Abrosca; Arianna Folli; Alberto Dal Molin; Stefano Moalli; Antonio Maconi; Antonio Ammendolia; Alessandro de Sire; Marco Invernizzi Journal: Int J Environ Res Public Health Date: 2022-07-27 Impact factor: 4.614