Recommendation of physical activity for patients with severe COPD: an integrative review

Abstract

Pulmonary rehabilitation programs are part of the gold standard in the treatment of COPD, in this strategy are important: medical followup, engagement in physical activity and habit changes by patients. Among the objectives of these programs are to reduce symptoms, increase exercise tolerance, and increase functionalcapacity. 3 Despite the numerous proven benefits on the effectiveness of rehabilitation programs for patients with COPD, approximately 50% of them refuse to participate and about 30-50% leave the program before itsconclusion. 4 The aim of this study was to describe the main benefits achieved by including high-intensity physical training in pulmonary rehabilitation programs for patients with severe COPD. MethodsIt is an integrative review of the literature, a method that allows the survey and analysis of subsidies present in scientific literature, in a broad and systematic way. It is a method that aims to synthesize results obtained from research on a theme or issue, in an orderly and comprehensivemanner. 5 The elaboration of this study had six stages: (1) definition of the problem; (2) database search in virtual libraries (Pub Med, Virtual Health Library -Bireme, Scielo) by means of descriptors in Portuguese and their correspondents in English; (3) individual reading of texts pertinent to randomized clinical studies, with complete methodologies for critical analysis in relation to their adherence to the objective of this research; (4) tabulation of the main findings of selected studies;(5) interpretation of results and; (6) synthesis of knowledge.This study included only articles of the randomized clinical trial type, published between 2015 and 2020, that approached patients with moderate to severe COPD and that were available in full on the search platforms surveyed. The descriptors severe COPD, pulmonary rehabilitation and physical exercise were used for the Portuguese and English languages. Among the exclusion criteria were: review articles, publication of protocols, articles not published between 2015 and 2020, works that were not related to the subject of this research, that were not available in full, or that did not clearly describe their methods (Figure 1).