Aerobic and Breathing Exercises Improve Dyspnea, Exercise Capacity and Quality of Life in Idiopathic Pulmonary Fibrosis Patients: Systematic Review and Meta-Analysis

Hanada, Masatoshi; Kasawara, Karina Tamy; Mathur, Sunita; Rozenberg, Dmitry; Kozu, Ryo; Reid, Darlene

doi:10.1183/13993003.congress-2019.pa1346

Cited by 16 publications

(19 citation statements)

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“…This is consistent with CT findings from other studies, which have reported that pulmonary fibrosis can persist for up to 7 years (26). Considering that pulmonary rehabilitation has shown positive results in patients with fibrosis, such intervention, if employed at an early stage, has the potential to improve outcomes long-term (39).…”

Section: Discussionsupporting

confidence: 91%

Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: A systematic review and meta-analysis

Ahmed¹,

Patel²,

Greenwood³

et al. 2020

J Rehabil Med

500

423

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Severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) are two previous viral infection outbreaks similar to the current COVID-19 pandemic. Studies that have looked at long-term health problems in survivors of these two outbreaks report reduced lung function and reduced ability to exercise in some survivors up to 6 months after discharge from hospital. Mental health problems including stress, anxiety and depression were observed in up to one-third of survivors at 6 months and beyond. The quality of life was observed to be low even 12 months after discharge from the hospital. Rehabilitation clinicians and services should anticipate similar health problems in survivors of COVID-19, investigate them accordingly and plan suitable and timely treatments to enable best possible recovery and quality of life for them. Objective: To determine long-term clinical outcomes in survivors of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus infections after hospitalization or intensive care unit admission. Data sources: Ovid MEDLINE, EMBASE, CINAHL Plus, and PsycINFO were searched. Study selection: Original studies reporting clinical outcomes of adult SARS and MERS survivors 3 months after admission or 2 months after discharge were included. Data extraction: Studies were graded using the Oxford Centre for Evidence-Based Medicine 2009 Level of Evidence Tool. Meta-analysis was used to derive pooled estimates for prevalence/severity of outcomes up to 6 months after hospital discharge, and beyond 6 months after discharge. Data synthesis: Of 1,169 identified studies, 28 were included in the analysis. Pooled analysis revealed that common complications up to 6 months after discharge were: impaired diffusing capacity for carbon monoxide (prevalence 27%, 95% confidence interval (CI) 15-45%); and reduced exercise capacity (mean 6-min walking distance 461 m, CI 450-473 m). The prevalences of post-traumatic stress disorder (39%, 95% CI 31-47%), depression (33%, 95% CI 20-50%) and anxiety (30%, 95% CI 10-61) beyond 6 months after discharge were considerable. Low scores on Short-Form 36 were identified beyond 6 months after discharge. Conclusion: Lung function abnormalities, psychological impairment and reduced exercise capacity were common in SARS and MERS survivors. Clinicians should anticipate and investigate similar longterm outcomes in COVID-19 survivors.

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Section: Discussionsupporting

confidence: 91%

Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: A systematic review and meta-analysis

Ahmed¹,

Patel²,

Greenwood³

et al. 2020

J Rehabil Med

500

423

View full text Add to dashboard Cite

show abstract

“…This is consistent with CT findings of other studies which have reported that pulmonary fibrosis can persist up to 7 years 29 . Pulmonary rehabilitation has been shown to improve QoL in other patients with fibrosis 43 but it is unknown whether this would be effective in COVID-19 survivors.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Clinical Outcomes in Survivors of Coronavirus Outbreaks After Hospitalisation or Icu Admission: A Systematic Review and Meta-Analysis of Follow-Up Studies

Ahmed

2020

Preprint

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Objective:To determine the long-term clinical problems in adult survivors of coronavirus (CoV) infection [Coronavirus disease 2019 (COVID-19), Severe Acute Respiratory Syndrome (SARS) andMiddle East Respiratory Syndrome (MERS)] after hospitalisation or Intensive Care Unit (ICU) admission.Design: Systematic review and meta-analysis of the literature. Data sources: Ovid MEDLINE, EMBASE, CINAHL Plus and PsycINFO were searched using the strategy: (Coronavirus OR Coronavirus Infections OR COVID OR SARS virus OR Severe acute respiratory syndrome OR MERS OR Middle east respiratory syndrome) AND (Follow-up OR Follow-up studies OR Prevalence). Original studies reporting the clinical outcomes of adult survivors of coronavirus outbreaks two months after discharge or three months after admission were included. The quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2009 Level of Evidence Tool. Meta-analysis was conducted to derive pooled estimates of prevalence and severity for different outcomes at time points up to 6 months follow-up and beyond 6 months follow-up. Results: The search yielded 1169 studies of which 28 were included in this review. There were 15 Level 1b, 8 Level 2b, 2 Level 3b and 3 Level 4 studies by OCEBM grading. Pooled analysis of studies revealed that complications commonly observed were impaired diffusing capacity for carbon monoxide (DLCO) [prevalence of 27.26%, 95% CI 14.87 to 44.57] and reduced exercise capacity [(6-minute walking distance (6MWD) mean 461m, 95% CI 449.66 to 472.71] at 6 months with limited improvement beyond 6 months. Coronavirus survivors had considerable prevalence of psychological disorders such as post-traumatic stress disorder (PTSD) [38.80%, CI 30.93 to 47.31], depression [33.20%, CI 19.80 to 50.02] and anxiety [30.04%, CI 10.44 to 61.26) beyond 6 months. These complications were accompanied by low Short Form 36 (SF-36) scores at 6 months and beyond indicating reduced quality of life which is present long-term. Conclusions: The long term clinical problems in survivors of CoV infections (SARS and MERS) after hospitalisation or Intensive Care Unit (ICU) admission include respiratory dysfunction, reduced exercise capacity, psychological problems such as PTSD, depression and anxiety, and reduced quality of life. Critical care, rehabilitation and mental health services should anticipate a high prevalence of these problems following COVID-19 and ensure their adequate and timely management with the aim of restoring premorbid quality of life. : medRxiv preprint Inclusion and Exclusion Criteria PopulationClinical studies involving adults with a confirmed diagnosis of coronavirus infection were included. ExposureStudies reporting patients with SARS, MERS or COVID-19 from current or previous outbreaks were included. Study DesignStudies had to follow-up patients for a minimum period of 2 months post-discharge or 3 months postadmission to be included in this review. Only primary research studies were included. Reviews, casereports and editoria...

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“…Meta-analysis revealed that PR has the same positive effect in patients with idiopathic pulmonary fibrosis and chronic obstructive pulmonary disease (COPD) in terms of dyspnea and quality of life parameters. Also, it was highlighted that breathing exercises added to aerobic programs are a complementary method to improve dyspnea [8]. The pulmonary rehabilitation programs are an effective treatment method for improving the cardiorespiratory functions and quality of life in moderate to severe COPD [9].…”

Section: Discussionmentioning

confidence: 99%

The effects of 6 weeks home rehabilitation program for non-ventilated COVID-19 patients after discharge: A case report

Aktürk¹,

Kılıç²,

Alğantekin³

2021

Journal of Surgery and Medicine

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COVID-19 disease is a pandemic that affects the cardio-respiratory system and causes other systemic problems. The effect of pulmonary rehabilitation (PR) programs for COVID-19 disease sequelae is not clear. The aim of this study was to investigate the effects of PR on COVID-19 sequelae. A 52-year-old patient was hospitalized for 8 days, and the complaints of fatigue and dyspnea continued after being discharged. For this reason, an exercise program was recommended. The patient underwent a 6-week PR that consisted of breathing, aerobic, and resistance exercises under supervision. After 6 weeks of the PR, complaints of dyspnea and fatigue decreased. There were also improvements in aerobic capacity and quality of life scores. The PR caused improvements in cardiorespiratory system complaints on a nonventilated COVID-19 patient.

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Aerobic and Breathing Exercises Improve Dyspnea, Exercise Capacity and Quality of Life in Idiopathic Pulmonary Fibrosis Patients: Systematic Review and Meta-Analysis

Cited by 16 publications

References 0 publications

Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: A systematic review and meta-analysis

Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: A systematic review and meta-analysis

Long-Term Clinical Outcomes in Survivors of Coronavirus Outbreaks After Hospitalisation or Icu Admission: A Systematic Review and Meta-Analysis of Follow-Up Studies

The effects of 6 weeks home rehabilitation program for non-ventilated COVID-19 patients after discharge: A case report

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