Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 May 4;103(5):pzad013.
doi: 10.1093/ptj/pzad013.

Pulmonary Rehabilitation Using Minimal Equipment for People With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Sonia Wing Mei Cheng  1 , Zoe J McKeough  1 , Renae J McNamara  2   3 , Jennifer A Alison  1   4
Affiliations
Meta-Analysis

Pulmonary Rehabilitation Using Minimal Equipment for People With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Sonia Wing Mei Cheng et al. Phys Ther. .

Abstract

Objective: Pulmonary rehabilitation programs that use minimal equipment for exercise training, rather than gymnasium equipment, would enable delivery of pulmonary rehabilitation to a greater number of people with chronic obstructive pulmonary disease (COPD). The effectiveness of minimal equipment programs in people with COPD is unclear. This systematic review and meta-analysis aimed to determine the effects of pulmonary rehabilitation using minimal equipment for aerobic and/or resistance training in people with COPD.

Methods: Literature databases were searched up to September 2022 for randomized controlled trials (RCTs) comparing the effect of minimal equipment programs with usual care or with exercise equipment-based programs for exercise capacity, health-related quality of life (HRQoL), and strength.

Results: Nineteen RCTs were included in the review and 14 RCTs were included in the meta-analyses, which reported low to moderate certainty of evidence. Compared with usual care, minimal equipment programs increased 6-minute walk distance (6MWD) by 85 m (95% CI = 37 to 132 m). No difference in 6MWD was observed between minimal equipment and exercise equipment-based programs (14 m, 95% CI = -27 to 56 m). Minimal equipment programs were more effective than usual care for improving HRQoL (standardized mean difference = 0.99, 95% CI = 0.31 to 1.67) and were not different from exercise equipment-based programs for improving upper limb strength (6 N, 95% CI = -2 to 13 N) or lower limb strength (20 N, 95% CI = -30 to 71 N).

Conclusion: In people with COPD, pulmonary rehabilitation programs using minimal equipment elicit clinically significant improvements in 6MWD and HRQoL and are comparable with exercise equipment-based programs for improving 6MWD and strength.

Impact: Pulmonary rehabilitation programs using minimal equipment may be a suitable alternative in settings where access to gymnasium equipment is limited. Delivery of pulmonary rehabilitation programs using minimal equipment may improve access to pulmonary rehabilitation worldwide, particularly in rural and remote areas and in developing countries.

Keywords: Chronic Obstructive Pulmonary Disease; Equipment and Supplies; Exercise; Pulmonary Rehabilitation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
PRISMA flow diagram of screening, selection process, and inclusion of studies.
Figure 2
Figure 2
Risk of bias summary.
Figure 3
Figure 3
Meta-analysis of the effects of minimal equipment programs on post intervention 6-minute walk distance (6MWD). (A) Minimal equipment programs versus usual care. (B) Minimal equipment programs compared with equipment-based programs.
Figure 4
Figure 4
Meta-analysis of the effects of minimal equipment programs on postintervention disease-specific health-related quality of life (HRQoL). (A) Effects of minimal equipment programs versus usual care on disease-specific HRQoL total score. (B) Effects of minimal equipment programs versus equipment-based programs on Chronic Respiratory Disease Questionnaire (CRQ) dyspnea. (C) Effects of minimal equipment programs versus equipment-based programs on CRQ fatigue.
Figure 5
Figure 5
Meta-analysis of the effects of minimal equipment programs compared with equipment-based programs on postintervention knee extensor strength.
See this image and copyright information in PMC

References

    1. McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015;2:CD003793. 10.1002/14651858.CD003793.pub3. - DOI - PMC - PubMed
    1. Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2016;12:CD005305. 10.1002/14651858.CD005305.pub4. - DOI - PMC - PubMed
    1. O'Shea SD, Taylor NF, Paratz J. Peripheral muscle strength training in COPD: a systematic review. Chest. 2004;126:903–914. - PubMed
    1. Bolton CE, Bevan-Smith EF, Blakey JD et al. British Thoracic Society pulmonary rehabilitation guideline development group; British Thoracic Society standards of care committee. British Thoracic Society guideline on pulmonary rehabilitation in adults. Thorax. 2013;68:ii1–ii30. - PubMed
    1. Nici L, Donner C, Wouters E et al. ATS/ERS pulmonary rehabilitation writing committee. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med. 2006;173:1390–1413. - PubMed