Early Pulmonary Rehabilitation in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials

Du, Yanping; Lin, Jianhua; Wang, Xiaoxia; Zhang, Yan; Ge, Hua; Wang, Ye; Ma, Zhiyong; Zhang, Huaping; Liu, Jun; Wang, Zhiyong; Lin, Meixia; Ni, Fayu; Li, Xi; Tan, Hui; Tan, Shifan

doi:10.1080/15412555.2022.2029834

Cited by 11 publications

(4 citation statements)

References 31 publications

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“…In terms of pulmonary function, this study conducted subgroup analysis based on FEV1% predicted and FEV1/FVC (%) and included a total of 5 studies reporting changes in pulmonary function outcomes. The results indicated no statistically significant differences between the intervention and control groups, which is consistent with the findings of Du et al [ 41 ]. Given the possibility of insufficient sample sizes in the included studies, it is hoped that future research will involve long-term follow-up of these indicators to provide robust evidence for confirming the long-term effects of remote pulmonary rehabilitation.…”

Section: Discussionsupporting

confidence: 91%

The effects of telerehabilitation on physiological function and disease symptom for patients with chronic respiratory disease: a systematic review and meta-analysis

Dai,

Huang,

Zhang

et al. 2024

BMC Pulm Med

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Objective To compare the impact of telerehabilitation versus conventional rehabilitation on the recovery outcomes of patients with chronic respiratory disease (CRD). Methods The Cochrane Library, MEDLINE, Web of Science and Embase were searched to collect randomized controlled trials (RCTs) on telerehabilitation for the rehabilitation of patients with chronic respiratory system diseases since the establishment of the database to November 14, 2023. Two researchers independently screened the literature and extracted valid data according to the inclusion criteria. The quality assessment of included studies was conducted individually by using the RoB 2(Risk of Bias 2) tool, followed by meta-analysis using RevMan5.3 software. Results Based on inclusion and exclusion criteria, 21 RCTs were included, comprising 3030 participants, with 1509 in the telerehabilitation group and 1521 in the conventional rehabilitation group. Meta-analysis results indicated that compared to conventional rehabilitation, video conference-based telerehabilitation demonstrated significant improvements in short-term (≤ 6 months) outcomes, including 6-min walk distance (6MWD) (MD = 7.52, 95% CI: 2.09, 12.94), modified Medical Research Council Dyspnea Scale (mMRC) (MD = -0.29, 95% CI: -0.41, -0.18), COPD assessment test (CAT) (MD = -1.77, 95% CI: -3.52, -0.02), HADS (MD = -0.44, 95% CI: -0.86, -0.03), and St. George’s Respiratory Questionnaire (SGRQ’s) activity, impact, and symptom scores. In the long term (> 6 months), although improvements persisted in 6WMD [MD = 12.89, 95% CI (-0.37, 26.14)], mMRC [MD = -0.38, 95% CI (-0.56, -0.21)], CAT [MD = -1.39, 95% CI (-3.83, 1.05)], Hospital anxiety and depression scale (HADS) [MD = -0.34, 95% CI (-0.66, -0.03)], and SGRQ’s Activity, Impact, and Symptom scores between intervention and control groups, statistically significant differences were observed only for mMRC and HADS. Without considering time factors, the intervention group exhibited some improvement in FEV1% predicted and the forced expiratory volume in the first one second (FEV1)/ forced vital capacity (FVC) (%) without statistical significance compared to the control group. Conclusion Telerehabilitation therapy demonstrates short-term benefits in enhancing patients’ daily activity capacity, improving respiratory function, and enhancing mental health status, thereby improving patients’ quality of life. However, further high-quality, large-sample RCTs are required to ascertain its long-term effectiveness conclusively. Trial registration This study protocol was approved and registered in PROSPERO: CRD 42024509154.

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Section: Discussionsupporting

confidence: 91%

The effects of telerehabilitation on physiological function and disease symptom for patients with chronic respiratory disease: a systematic review and meta-analysis

Dai,

Huang,

Zhang

et al. 2024

BMC Pulm Med

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“…Traditional cardiopulmonary rehabilitation guidance is based on assessing the actual physiological condition of the patient, and care protocols are often developed in accordance with the experience of healthcare professionals, thus resulting in treatment outcomes that do not necessarily meet expectations and may be detrimental to the management of disease overall [18,19]. For many years, the value of cardiopulmonary exercise testing as a pulmonary function diagnostic tool has been studied in clinical practice, primarily to reflect metabolic gas capacity during exercise with increasing load, maximum exercise capacity, and to reveal cardiopulmonary pathology, as well as the interaction and reserve capacity of the circulatory system following comprehensive analysis of specific test parameters to guide cardiopulmonary rehabilitation [20].…”

Section: Discussionmentioning

confidence: 99%

The efficacy of different training programs guided by cardiopulmonary exercise test goals for the treatment of male patients with chronic obstructive pulmonary disease

2023

Journal of Men's Health

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To explore the therapeutic effect of aerobic exercise nursing plans based on target heart rate in cardiopulmonary exercise tests on male patients with chronic obstructive pulmonary disease. This study recruited 90 male patients with chronic obstructive pulmonary disease who met specific screening criteria and were evenly divided into a control group and an experimental group based on a random number table. The control group received respiratory training based on the target heart rate in the cardiopulmonary exercise test, while the experimental group received aerobic exercise based on the target heart rate in the cardiopulmonary exercise test. Both groups received 12 weeks of exercise each. Cardiopulmonary function tests showed that peak oxygen consumption (peak VO2), anaerobic threshold (AT), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and the FEV1/FVC ratio in the test group were significantly higher than those in the control group (p < 0.05); furthermore, the carbon dioxide ventilation equivalent (VE/VCO2) slope was significantly lower than that in the control group (p < 0.05). The 6MWT of the test group was significantly higher than that in the control group (p < 0.05). The CAT score, Borg score and scores related to the symptoms, activities, and impacts related to quality-of-life were significantly reduced after intervention (p < 0.05). Aerobic exercise based on cardiopulmonary exercise testing can improve the health status, quality of life and prognosis of COPD patients.

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“…PR has been proposed as a potential adjunct therapy for people with COPD in the postexacerbation period because it encompasses several interventions known to improve health status and prognosis ( 3 , 34 ). Previous reviews synthesizing evidence on PR after hospitalization for AECOPD have produced contrasting findings ( 8 , 89 – 93 ). These reviews have included PR programs initiated during the hospital admission itself, up to the point of discharge, and/or after hospital discharge.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Rehabilitation for Adults with Chronic Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline

Rochester¹,

Alison²,

Carlin³

et al. 2023

Am J Respir Crit Care Med

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Background Despite the known benefits of pulmonary rehabilitation (PR) for patients with chronic respiratory disease, this treatment is underused. Evidence-based guidelines should lead to greater knowledge of the proven benefits of PR, highlight the role of PR in evidence-based health care, and in turn foster referrals to and more effective delivery of PR for people with chronic respiratory disease. Methods The multidisciplinary panel formulated six research questions addressing PR for specific patient groups (chronic obstructive pulmonary disease [COPD], interstitial lung disease, and pulmonary hypertension) and models for PR delivery (telerehabilitation, maintenance PR). Treatment effects were quantified using systematic reviews. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to formulate clinical recommendations. Recommendations The panel made the following judgments: strong recommendations for PR for adults with stable COPD (moderate-quality evidence) and after hospitalization for COPD exacerbation (moderate-quality evidence), strong recommendation for PR for adults with interstitial lung disease (moderate-quality evidence), conditional recommendation for PR for adults with pulmonary hypertension (low-quality evidence), strong recommendation for offering the choice of center-based PR or telerehabilitation for patients with chronic respiratory disease (moderate-quality evidence), and conditional recommendation for offering either supervised maintenance PR or usual care after initial PR for adults with COPD (low-quality evidence). Conclusions These guidelines provide the basis for evidence-based delivery of PR for people with chronic respiratory disease.

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Early Pulmonary Rehabilitation in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials

Cited by 11 publications

References 31 publications

The effects of telerehabilitation on physiological function and disease symptom for patients with chronic respiratory disease: a systematic review and meta-analysis

The effects of telerehabilitation on physiological function and disease symptom for patients with chronic respiratory disease: a systematic review and meta-analysis

The efficacy of different training programs guided by cardiopulmonary exercise test goals for the treatment of male patients with chronic obstructive pulmonary disease

Pulmonary Rehabilitation for Adults with Chronic Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline

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