Handgrip Strength in People With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Mackenzie Holden ◽  
Madeline Fyfe ◽  
Camille Poulin ◽  
Brianna Bethune ◽  
Chloe Church ◽  
...  

Abstract Objective The purpose of this study was to systematically review the association between handgrip strength (HGS) and mortality, morbidity, and health-related quality of life (HRQL) in individuals with chronic obstructive pulmonary disease (COPD). Methods The following databases were used: CENTRAL, CINAHL, EMBASE, MEDLINE Ovid, SPORTDiscus, and PsycINFO. Studies published between 2000 and 2020 in English, Portuguese, or French that examined the association of HGS with mortality, morbidity and HRQL in individuals with stable COPD. Two authors independently extracted data and assessed the quality of evidence using the GRADE framework. The studies effects were pooled using random effects meta-analysis models after assessing heterogeneity. The search generated 710 studies and 18 were included in the review. Studies evaluated a total of 12,046 individuals with stable COPD (mean percent of the predicted forced expiratory volume in one second = 34–80) using over 10 diverse protocols for HGS measurement. Statistically significant, small and negative relationships were found between HGS and mortality (r = −0.03; 95% CI = −0.05 to −0.02). Independently of the outcome measure used to assess morbidity, the estimate of the overall relationship was small to moderate and negative: Body mass index, airflow Obstruction, Dyspnea, and Exercise index Updated (BODEu) (r = −0.42; 95% CI = −0.61 to −0.03); exacerbations (r = −0.02; 95% CI = −0.04 to −0.00); and hospitalizations (r = −0.69; 95% CI = −1.70 to 0.32). Similarly, for HRQL, independently of the outcome measure, the estimate of the overall relationship was small to fair and negative: COPD Assessment Test (weighted r = −0.22; 95% CI = −0.32 to −0.12); CRQ domains (−0.24 < r < −0.14); EuroQol Five-Dimension Questionnaire (EQ-5D) (utility score) (r = −0.17; 95% CI = −0.26 to −0.07); EQ-5D domains (−0.32 < r < −0.06); and St George Respiratory Questionnaire total (r = −0.26; 95% CI = −0.33 to −0.17). The quality of the evidence ranged from low to very low across outcomes. Conclusions Although heterogeneity was present among HGS measurement protocols, small to moderate associations were found, indicating that those with lower HGS have increased likelihood of death, a higher risk of increased COPD morbidity (as assessed with BODE indexes), and poorer HRQL.

2016 ◽  
Vol 13 (11) ◽  
pp. 1275-1283 ◽  
Author(s):  
Travis Saunders ◽  
Nerissa Campbell ◽  
Timothy Jason ◽  
Gail Dechman ◽  
Paul Hernandez ◽  
...  

Background:Although individual studies have reported on the number of steps/day taken by individuals with chronic obstructive pulmonary disease (COPD), this evidence has not been systematically reviewed or synthesized.Methods:MEDLINE and PsycINFO were searched for studies reporting objectively-measured steps/day and percent predicted forced expiratory volume in 1 second (FEV1%) in patients with COPD. Meta-analyses were used to estimate steps/day across studies, while metaregression was used to estimate between-study variance based on clinical and demographic factors (year and location of study, activity monitor brand, number of days wearing the monitor, whether participants were about to enter pulmonary rehabilitation, 6-minute walk distance (6MWD), FEV1%, age, and sex).Results:38 studies including 2621 participants met inclusion criteria. The pooled mean estimate was 4579 steps/day (95% CI:4310 to 5208) for individuals with COPD. Only 6MWD, FEV1% and whether patients were about to undergo pulmonary rehabilitation explained a significant portion of the variance (P < 0.1) in univariate meta-regression. In a multivariate model including the above risk factors, only FEV1% was associated with steps/day after adjustment for other covariates.Conclusions:These results indicate that patients with COPD achieve extremely low levels of physical activity as assessed by steps/day, and that severity of airflow obstruction is associated with activity level.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e043377
Author(s):  
Kai Zhu ◽  
Jagdeep Gill ◽  
Ashley Kirkham ◽  
Joel Chen ◽  
Amy Ellis ◽  
...  

IntroductionPulmonary rehabilitation (PR) following an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) reduces the risk of hospital admissions, and improves physical function and health-related quality of life. However, the safety and efficacy of in-hospital PR during the most acute phase of an AECOPD is not well established. This paper describes the protocol for a systematic review with meta-analysis to determine the safety and efficacy of inpatient acute care PR during the hospitalisation phase.Methods and analysisMedical literature databases and registries MEDLINE, EMBASE, Physiotherapy Evidence Database, Cumulative Index to Nursing and Allied Health Literature, Canadian Agency for Drugs and Technologies in Health, CENTRAL, Allied and Complementary Medicine Database, WHO trials portal and ClinicalTrials.gov will be searched for articles from inception to June 2021 using a prespecified search strategy. We will identify randomised controlled trials that have a comparison of in-hospital PR with usual care. PR programmes had to commence during the hospitalisation and include a minimum of two sessions. Title and abstract followed by full-text screening will be conducted independently by two reviewers. A meta-analysis will be performed if there is sufficient homogeneity across selected studies or groups of studies. The Population, Intervention, Comparator, Outcomes and Study characteristics framework will be used to standardise the data collection process. The quality of the cumulative evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations framework.Ethics and disseminationAECOPD results in physical limitations which are amenable to PR. This review will assess the safety and efficacy of in-hospital PR for AECOPD. The results will be presented in a peer-reviewed publication and at research conferences. Ethical review is not required for this study.


2021 ◽  
Vol 10 (2) ◽  
pp. 269
Author(s):  
Elisabetta Zinellu ◽  
Alessandro G. Fois ◽  
Elisabetta Sotgiu ◽  
Sabrina Mellino ◽  
Arduino A. Mangoni ◽  
...  

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by chronic airway inflammation and lung parenchyma damage. Systemic inflammation and oxidative stress also play a role in the pathogenesis of COPD. Serum albumin is a negative acute-phase protein with antioxidant effects and an important marker of malnutrition. The aim of this meta-analysis was to investigate differences in serum albumin concentrations between patients with stable COPD and non-COPD subjects. Methods: A systematic search was conducted, using the terms “albumin” and “chronic obstructive pulmonary disease” or “COPD”, in the electronic databases PubMed and Web of Science, from inception to May 2020. Results: Twenty-six studies were identified on a total of 2554 COPD patients and 2055 non-COPD controls. Pooled results showed that serum albumin concentrations were significantly lower in COPD patients (standard mean difference, SMD = −0.50, 95% CI −0.67 to −0.32; p < 0.001). No significant differences were observed in SMD of serum albumin concentrations between COPD patients with forced expiratory volume in the 1st second (FEV1) < 50% and those with FEV1 > 50%. Conclusions: Our systematic review and meta-analysis showed that serum albumin concentrations are significantly lower in patients with stable COPD compared to non-COPD controls. This supports the presence of a deficit in systemic anti-inflammatory and antioxidant defense mechanisms in COPD.


2018 ◽  
Vol 28 (2) ◽  
pp. 52-57
Author(s):  
Md Nure Alom Siddiqui ◽  
Shahnaj Sultana ◽  
MMR Khan ◽  
PM Basak

Background: Acute exacerbations of chronic obstructive pulmonary disease (AE-COPD) impair quality of life (QOL), accelerate the decline in lung function and often require hospitalization, and thus, leading to increased healthcare burden. By identifying factors that may be associated with AE-COPD and managing them rationally, not only the hospital admissions could be avoided but progression of the disease may also be slowed.Objective. The aim of the present study was to determine the factors associated with hospital admissions among adults with AE-COPD.Methods. Seventy-three patients admitted with AE-COPD were administered a structured questionnaire during their hospital stay. Data on body mass index (BMI), smoking, symptoms, co-morbidities course of the disease, spirometry management and outcomes during the hospitalisation were obtained. Factors associated with hospital admissions were analyzed.Results. The hospitalization due to AE-COPD was significantly associated with the reduced forced expiratory volume in one second (FEV1), and peak expiratory flow rates, increasing sputum purulence, number of hospitalizations during previous year for COPD and presence of co-morbidities.Conclusions. The study shows that both disease and healthcare-related factors are predictors for hospitalisation. Identification of risk factors and appropriate management may reduce hospitalisation due to AE-COPD.TAJ 2015; 28(2): 52-57


2020 ◽  
Vol 41 (46) ◽  
pp. 4415-4422 ◽  
Author(s):  
Yan-Li Yang ◽  
Zi-Jian Xiang ◽  
Jing-Hua Yang ◽  
Wen-Jie Wang ◽  
Zhi-Chun Xu ◽  
...  

Abstract Aims The aim of this study was to clarify the effect of β-blockers (BBs) on respiratory function and survival in patients with chronic obstructive pulmonary disease with cardiovascular disease (CVD), as well as the difference between the effects of cardioselective and noncardioselective BBs. Methods and results We searched for relevant literature in four electronic databases, namely, PubMed, EMBASE, Cochrane Library, and Web of Science, and compared the differences in various survival indicators between patients with chronic obstructive pulmonary disease taking BBs and those not taking BBs. Forty-nine studies were included, with a total sample size of 670 594. Among these, 12 studies were randomized controlled trials (RCTs; seven crossover and five parallel RCTs) and 37 studies were observational (including four post hoc analyses of data from RCTs). The hazard ratios (HRs) of chronic obstructive pulmonary disease exacerbation between patients with chronic obstructive pulmonary disease who were not treated with BBs and those who were treated with BBs, cardioselective BBs, and noncardioselective BBs were 0.77 [95% confidence interval (CI) 0.67, 0.89], 0.72 [95% CI 0.56, 0.94], and 0.98 [95% CI 0.71, 1.34, respectively] (HRs &lt;1 indicate favouring BB therapy). The HRs of all-cause mortality between patients with chronic obstructive pulmonary disease who were not treated with BBs and those who were treated with BBs, cardioselective BBs, and noncardioselective BBs were 0.70 [95% CI 0.59, 0.83], 0.60 [95% CI 0.48, 0.76], and 0.74 [95% CI 0.60, 0.90], respectively (HRs &lt;1 indicate favouring BB therapy). Patients with Chronic obstructive pulmonary disease treated with cardioselective BBs showed no difference in ventilation effect after the use of an agonist, in comparison with placebo. The difference in mean change in forced expiratory volume in 1 s was 0.06 [95% CI −0.02, 0.14]. Conclusion The use of BBs in patients with chronic obstructive pulmonary disease is not only safe but also reduces their all-cause and in-hospital mortality. Cardioselective BBs may even reduce chronic obstructive pulmonary disease exacerbations. In addition, cardioselective BBs do not affect the action of bronchodilators. Importantly, BBs reduce the heart rate acceleration caused by bronchodilators. BBs should be prescribed freely when indicated in patients with chronic obstructive pulmonary disease and heart disease.


Author(s):  
Shi-Jie Liu ◽  
Zhanbing Ren ◽  
Lin Wang ◽  
Gao-Xia Wei ◽  
Liye Zou

Baduanjin exercise is a traditional Chinese health Qigong routine created by an ancient physician for health promotion. Its mild-to-moderate exercise intensity is suitable for individuals with medical conditions. Recently, a large number of trials have been conducted to investigate the effects of Baduanjin exercise in patients with chronic obstructive pulmonary disease (COPD). It remains to be determined whether Baduanjin exercise prescription is beneficial for the management of COPD patients. Thus, we conducted a systematic review to objectively evaluate the existing literature on this topic. We searched six databases (PubMed, Web of Science, Cochrane Library, Scopus, China National Knowledge Infrastructure, and Wanfang) from inception until early May 2018. The adapted Physical Therapy Evidence Database (PEDro) scale was used for study quality assessment of all randomized controlled trials (RCTs). Based on 95% confidence interval (CI), the pooled effect size (Hedge’s g) of exercise capability (6-Minute Walking Test, 6-MWT), lung function parameters (forced expiratory volume in one second, FEV1; forced volume vital capacity, FVC; FEV1/FVC ratio), and quality of life were calculated based on the random-effects model. Twenty RCTs (n = 1975 COPD patients) were included in this review, with sum scores of the adapted PEDro scale between 5 and 9. Study results of the meta-analysis indicate that Baduanjin is effective in improving exercise capability (Hedge’s g = 0.69, CI 0.44 to 0.94, p < 0.001, I2 = 66%), FEV1 (Hedge’s g = 0.47, CI 0.22 to 0.73, p < 0.001, I2 = 68.01%), FEV1% (Hedge’s g = 0.38, CI 0.21 to 0.56, p < 0.001, I2 = 54.74%), FVC (Hedge’s g = 0.39, CI 0.22 to 0.56, p < 0.001, I2 = 14.57%), FEV1/FVC (Hedge’s g = 0.5, CI 0.33 to 0.68, p < 0.001, I2 = 53.49%), and the quality of life of COPD patients (Hedge’s g = −0.45, CI −0.77 to −0.12, p < 0.05, I2 = 77.02%), as compared to control groups. Baduanjin exercise as an adjunctive treatment may potentially improve exercise capability and pulmonary function of COPD patients as well as quality of life. Baduanjin exercise could be tentatively prescribed for COPD in combination with the conventional rehabilitation program to quicken the process of recovery. To confirm the positive effects of Baduanjin exercise for COPD patients, future researchers need to consider our suggestions mentioned in this article.


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