Exercise prescription for hospitalized people with chronic obstructive pulmonary disease and comorbidities: a synthesis of systematic reviews Full Text
International Journal of COPD, 05/25/2012
Evidence Based Medicine
Reid WD et al. – This synthesis showed evidence of significant benefits from exercise training in AECOPD, chronic obstructive pulmonary disease (COPD), and conditions that are common comorbidities. A broader approach to exercise and activity prescription in pulmonary rehabilitation may induce therapeutic benefits to ameliorate clinical sequelae associated with AECOPD and comorbidities such as the inclusion of BT and functional training.Methods
- An SR was performed using the Cochrane Collaboration protocol.
- Nine electronic databases were searched up to July 2011.
- Articles were included if they (1) described participants with AECOPD, chronic obstructive pulmonary disease (COPD), or one of eleven common comorbidities, (2) were an SR, (3) examined aerobic training (AT), resistance training (RT), balance training (BT), or a combination thereof, (4) included at least one outcome of fitness, and (5) compared exercise training versus control/sham.
- This synthesis examined 58 SRs of exercise training in people with AECOPD, COPD, or eleven chronic conditions commonly associated with COPD.
- Meta-analyses of endurance (aerobic or exercise capacity, 6-minute walk distance – 6MWD) were shown to significantly improve in most conditions (except osteoarthritis, osteoporosis, and depression), whereas strength was shown to improve in five of the 13 conditions searched: COPD, older adults, heart failure, ischemic heart disease, and diabetes.
- Several studies of different conditions also reported improvements in quality of life, function, and control or prevention outcomes.
- Meta-analyses also demonstrate that exercise training decreases the risk of mortality in older adults, and those with COPD or ischemic heart disease.
- The most common types of training were AT and RT.
- BT and functional training were commonly applied in older adults.
- The quality of the SRs for most conditions was moderate to excellent (>65%) as evaluated by AMSTAR scores.