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Abstract
BACKGROUND: Community-based pulmonary rehabilitation (PR) programs can be offered to patients with COPD, but the literature on its effects is still not well summarized. Our purpose was to investigate the health-, physical-, and respiratory-related effects of community-based PR in individuals with COPD as compared to control groups.
METHODS: The PubMed and Embase databases were searched up to May 17, 2021. We included randomized control trials that compared the effects of community-based PR as compared to control groups in individuals with COPD. The risk of bias was judged using the Cochrane Risk of Bias 2 (RoB2). Meta-analysis was performed using a random-effects model to estimate the standardized mean difference (SMD) with 95% CI of the mean changes from baseline between groups. The Grading of Recommendations Assessment, Development, and Evaluation was used to interpret certainty of results.
RESULTS: We included 10 randomized control studies comprising a total of 9,350 participants with weighted mean age of 62.3 ± 2.38 y. The community-based interventions were based on exercise programs (resistance and/or endurance). All studies were judged as high risk and/or some concerns in one or more domains the risk of bias. All meta-analyses displayed very low certainty of evidence. The community-based PR interventions were significantly superior to control interventions in improving the St. George Respiratory Questionnaire Activity subscore (−0.40 [95% CI −0.72 to −0.08]; k = 5, n = 382) and total score (−0.73 [95% CI −1.29 to −0.18]; k = 4, n = 268) and the Chronic Respiratory Disease Questionnaire dyspnea subscore (0.36 [95% CI 0.03–0.69]; k = 6, n = 550). The mean changes from baseline were not different between the groups for all other outcomes.
CONCLUSIONS: Community-based PR tended to result in superior health-related quality of life and symptoms than control interventions, but the findings were inconsistent across outcomes and with very low certainty of evidence. Further studies are warranted for stronger conclusions.
Footnotes
- Correspondence: Marisela Barbosa MSc. E-mail: mariselabarbosa{at}gmail.com
Supplementary material related to this paper is available at http://rc.rcjournal.com.
The authors have disclosed no conflicts of interest.
This work was primarily performed at Faculty of Sports, University of Porto, Porto, Portugal.
- Copyright © 2022 by Daedalus Enterprises
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