Chest
Original ResearchCOPDSystematic Review of Supervised Exercise Programs After Pulmonary Rehabilitation in Individuals With COPD
Section snippets
Materials and Methods
The methodology is consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.17
Search Results
Of a possible 463 studies, seven were included (Fig 1).13, 14, 15, 16, 19, 20, 21 Two studies reported different outcomes from the same trial.13, 20 In total, 619 individuals were randomized to postrehabilitation supervised exercise or usual care following PR. Table 1 shows the study characteristics. Patients were elderly (mean, 67 years of age) with moderate to severe COPD (mean FEV1 32%-59% predicted).
There was consistent agreement between reviewers for study quality. All studies were judged
Discussion
This meta-analysis suggests that post-PR supervised exercise programs are superior to usual care for sustaining benefits in exercise capacity in the medium term for patients with moderate to severe COPD. However, this effect was not sustained at 12 months, and no between-group differences for HRQL were noted at any time. Our results should be interpreted with caution given the heterogeneity in interventions, follow-up intervals, and outcome measures.
Several factors may have accounted for the
Conclusions
The seven studies included in this review suggest that supervised postrehabilitation exercise conferred a medium-term benefit (6 months) in exercise capacity that was not sustained at 12 months in patients with moderate to severe COPD. No between-group differences in HRQL were noted at any time. Reaching more definitive conclusions is limited by the small number of studies and their methodologic shortcomings. The optimal postrehabilitation maintenance exercise program for individuals with COPD
Acknowledgments
Author contributions: Dr Brooks had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr. Beauchamp: contributed to the concept and design of the study; data acquisition, analysis, and interpretation; and drafting and revision of the manuscript.
Dr. Evans: contributed to the concept and design of the study, data acquisition and interpretation, and revision of the manuscript.
Dr. Janaudis-Ferreira: contributed
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For editorial comment see page 1091
Funding/Support: Dr Beauchamp is supported by a fellowship from the Canadian Institutes of Health Research, Dr Evans by a UK National Institute for Health Research clinical lectureship, Dr Goldstein by the National Sanitarium Association University of Toronto Chair in Respiratory Rehabilitation Research, and Dr Brooks by a Canada Research Chair.
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