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Meta-Analysis
. 2021 Dec 24:16:3525-3538.
doi: 10.2147/COPD.S338074. eCollection 2021.

Pulmonary Rehabilitation Programmes Within Three Days of Hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Dong Zhang  1   2   3 , Hailong Zhang  1   2   3 , Xuanlin Li  1   2   3 , Siyuan Lei  1   2   3 , Lu Wang  1   2   3 , Wen Guo  1   2   3 , Jiansheng Li  1   2   3
Affiliations
Meta-Analysis

Pulmonary Rehabilitation Programmes Within Three Days of Hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Dong Zhang et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Objective: To evaluate the efficacy and safety of early pulmonary rehabilitation (PR) (ie, <3 days of hospitalization) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods: Embase, Web of Science, PubMed and Cochrane Library were searched from their inception to 1 April 2021. Randomized controlled trials were included if they observed the efficacy of early PR in AECOPD patients. Study selection, data extraction, risk of bias and quality of evidence were assessed by two researchers independently. Assessment of the risk of bias and eidence quality were evaluated by the Cochrane Collaboration's tool and Grading of Recommendations, Assessment, Development and Evaluation system, respectively.

Results: Fourteen trials (829 participants) were identified. Significant improvement was found in the 6-minute walk distance (6MWD; mean difference (MD): 69.64; 95% CI: 40.26 to 99.01; Z = 4.65, P < 0.0001, low quality). In the subgroup analysis, the exercise-training group showed marked improvement (MD: 96.14; 95% CI: 20.24 to 172.04; Z = 2.48, P = 0.001). The Saint George's Respiratory Questionnaire (SGRQ) total score was low (MD: -12.77; 95% CI: -16.03 to -9.50; Z = 7.67, P < 0.0001, moderate quality). Significant effects were not found for the duration of hospital stay, quadriceps muscle strength or five times sit to stand test. Only one serious adverse event was reported in experimental group, which was not associated with early PR.

Conclusion: PR initiated <3 days of hospitalization may increase exercise capacity and improve quality of life, but the results should be interpreted prudently and dialectically, and the role of early PR in AECOPD needs further exploration.

Keywords: acute exacerbation; chronic obstructive pulmonary disease; meta-analysis; pulmonary rehabilitation.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study selection process for this review.
Figure 2
Figure 2
Continue.
Figure 2
Figure 2
(A) Risk of bias graph. (B) Risk of bias summary.
Figure 3
Figure 3
Experimental group versus control group, 6MWD.
Figure 4
Figure 4
Experimental group versus control group, SGRQ.
Figure 5
Figure 5
Experimental group versus control group, DoHS.
Figure 6
Figure 6
Experimental group versus control group, QMS.
Figure 7
Figure 7
Experimental group versus control group, 5 STS.
See this image and copyright information in PMC

References

    1. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736–1788. - PMC - PubMed
    1. GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017;5(9):691–706. - PMC - PubMed
    1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease (updated 2020). Available from: https://goldcopd.org/gold-reports/. Accessed December 8, 2021.
    1. Wang C, Xu J, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study[J]. Lancet. 2018;391(10131):1706–1717. - PubMed
    1. Wedzicha JA, Seemungal TA. COPD exacerbations: defining their cause and prevention. Lancet. 2007;370(9589):786–796. - PMC - PubMed