Comparison of outpatient and home-based exercise training programmes for COPD: A systematic review and meta-analysis.
Respirology
; 23(3): 272-283, 2018 Mar.
Article
em En
| MEDLINE
| ID: mdl-29194864
ABSTRACT
Chronic obstructive pulmonary disease is a common, preventable and treatable disease. Exercise training programmes (ETPs) improve symptoms, health-related quality of life (HRQoL) and exercise capacity, but the optimal setting is unknown. In this review, we compared the effects of ETPs in different settings on HRQoL and exercise capacity. We searched (5 July 2016) the Cochrane Airways Group Specialised Register, ClinicalTrials.gov and World Health Organization trials portal. We selected studies, extracted data and assessed risk of bias with two independent reviewers. We calculated mean differences (MD) with 95% CI. We assessed the quality of evidence using Grades of Recommendation, Assessment, Development and Evaluation. Ten trials (934 participants) were included. Hospital (outpatient) and home-based ETPs (seven trials) were equally effective at improving HRQoL on the Chronic Respiratory Questionnaire (CRQ) (dyspnoea MD -0.09, 95% CI -0.28 to 0.10; fatigue MD -0.00, 95% CI -0.18 to 0.17; emotional MD 0.10, 95% CI -0.24 to 0.45; and mastery MD -0.02, 95% CI -0.28 to 0.25; moderate quality) and on the St George's Respiratory Questionnaire (SGRQ) (MD -0.82, 95% CI -7.47 to 5.83, low quality). Hospital (outpatient) and community-based ETPs (three trials) were equally effective at improving HRQoL (CRQ dyspnoea MD 0.29, 95% CI -0.05 to 0.62, moderate quality; fatigue MD -0.02, 95% CI -1.09 to 1.05, low quality; emotional MD 0.10, 95% CI -0.40 to 0.59, moderate quality; and mastery MD -0.08, 95% CI -0.45 to 0.28, moderate quality). There was no difference in exercise capacity. There was low to moderate evidence that outpatient and home-based ETPs are equally effective. See related Editorial.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pacientes Ambulatoriais
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Avaliação de Programas e Projetos de Saúde
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Doença Pulmonar Obstrutiva Crônica
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Terapia por Exercício
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Assistência Ambulatorial
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Serviços de Assistência Domiciliar
Tipo de estudo:
Evaluation_studies
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Guideline
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Systematic_reviews
Limite:
Humans
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article