Clinical effectiveness and components of Home-pulmonary rehabilitation for people with chronic respiratory diseases: a systematic review protocol

IntroductionChronic respiratory diseases (CRDs) are common and disabling conditions that can result in social isolation and economic hardship for patients and their families. Pulmonary rehabilitation (PR) improves functional exercise capacity and health-related quality of life (HRQoL) but practical barriers to attending centre-based sessions or the need for infection control limits accessibility. Home-PR offers a potential solution that may improve access. We aim to systematically review the clinical effectiveness, completion rates and components of Home-PR for people with CRDs compared with Centre-PR or Usual care.Methods and analysisWe will search PubMed, CINAHL, Cochrane, EMBASE, PeDRO and PsycInfo from January 1990 to date using a PICOS search strategy (Population: adults with CRDs; Intervention: Home-PR; Comparator: Centre-PR/Usual care; Outcomes: functional exercise capacity and HRQoL; Setting: any setting). The strategy is to search for ‘Chronic Respiratory Disease’ AND ‘Pulmonary Rehabilitation’ AND ‘Home-PR’, and identify relevant randomised controlled trials and controlled clinical trials. Six reviewers working in pairs will independently screen articles for eligibility and extract data from those fulfilling the inclusion criteria. We will use the Cochrane risk-of-bias tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the quality of evidence. We will perform meta-analysis or narrative synthesis as appropriate to answer our three research questions: (1) what is the effectiveness of Home-PR compared with Centre-PR or Usual care? (2) what components are used in effective Home-PR studies? and (3) what is the completion rate of Home-PR compared with Centre-PR?Ethics and disseminationResearch ethics approval is not required since the study will review only published data. The findings will be disseminated through publication in a peer-reviewed journal and presentation in conferences.PROSPERO registration numberCRD42020220137.

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Do supervised weekly exercise programs maintain functional exercise capacity and quality of life, twelve months after pulmonary rehabilitation in COPD?

BMC Pulmonary Medicine ◽

10.1186/1471-2466-7-7 ◽

2007 ◽

Vol 7 (1) ◽

Cited By ~ 5

Author(s):

Lissa M Spencer ◽

Jennifer A Alison ◽

Zoe J McKeough

Keyword(s):

Quality Of Life ◽

Exercise Capacity ◽

Pulmonary Rehabilitation ◽

Exercise Programs ◽

Functional Exercise ◽

Functional Exercise Capacity

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The Influence of Comorbidities on Outcomes of Pulmonary Rehabilitation Programs in Patients with COPD: A Systematic Review

BioMed Research International ◽

10.1155/2013/146148 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 19

Author(s):

Miek Hornikx ◽

Hans Van Remoortel ◽

Heleen Demeyer ◽

Carlos Augusto Marcal Camillo ◽

Marc Decramer ◽

...

Keyword(s):

Quality Of Life ◽

Cardiovascular Disease ◽

Exercise Capacity ◽

Pulmonary Rehabilitation ◽

Chronic Obstructive ◽

Rehabilitation Outcomes ◽

Rehabilitation Programs ◽

Functional Exercise ◽

Functional Exercise Capacity

Introduction. Chronic obstructive pulmonary disease (COPD) is associated with comorbidities such as cardiovascular disease, metabolic disease, osteoporosis, and anxiety and/or depression. Although pulmonary rehabilitation programs are proven to be beneficial in patients with COPD, it is unclear whether comorbidities influence pulmonary rehabilitation outcomes. The aim of the present review was to investigate to what extent the presence of comorbidities can affect pulmonary rehabilitation outcomes.Methods. The systematic literature search (Pubmed, EMBASE, and PEDro) resulted in 4 articles meeting the inclusion criteria. The odds ratios (95% confidence intervals) of the logistic regression analyses, with comorbidities as independent variables and pulmonary rehabilitation outcomes (dyspnea, functional exercise capacity, and quality of life) as dependent variables, were used for data extraction.Results. Patients with anxiety and/or depression less likely improve in dyspnea. Osteoporosis is associated with less improvements in functional exercise capacity, while cardiovascular disease does not seem to negatively impact on this outcome. Patients with cardiovascular comorbidity will experience less positive changes in quality of life.Conclusion. Evidence from literature suggests that comorbidities can have a negative influence on pulmonary rehabilitation outcomes. Screening for comorbidities in pulmonary rehabilitation settings seems useful to readdress the right patients for individually tailored pulmonary rehabilitation.

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Efficacy of an mHealth intervention to stimulate physical activity in COPD patients after pulmonary rehabilitation

European Respiratory Journal ◽

10.1183/13993003.00083-2016 ◽

2016 ◽

Vol 48 (4) ◽

pp. 1019-1029 ◽

Cited By ~ 40

Author(s):

Sigrid N.W. Vorrink ◽

Helianthe S.M. Kort ◽

Thierry Troosters ◽

Pieter Zanen ◽

Jan-Willem J. Lammers

Keyword(s):

Physical Activity ◽

Lung Function ◽

Usual Care ◽

Exercise Capacity ◽

Pulmonary Rehabilitation ◽

Mhealth Intervention ◽

Positive Effects ◽

Copd Patients ◽

Functional Exercise ◽

Functional Exercise Capacity

Physical inactivity in patients with chronic obstructive pulmonary disease (COPD) is associated with poor health status and increased disease burden. The present study aims to test the efficacy of a previously developed mobile (m)Health intervention to improve or maintain physical activity in patients with COPD after pulmonary rehabilitation.A randomised controlled trial was performed in 32 physiotherapy practices in the Netherlands. COPD patients were randomised into intervention or usual care groups. The intervention consisted of a smartphone application for the patients and a monitoring website for the physiotherapists. Measurements were performed at 0, 3, 6 and 12 months. Physical activity, functional exercise capacity, lung function, health-related quality of life and body mass index were assessed.157 patients started the study and 121 completed it. There were no significant positive effects of the intervention on physical activity (at 0 months: intervention 5824±3418 steps per weekday, usual care 5717±2870 steps per weekday; at 12 months: intervention 4819±2526 steps per weekday, usual care 4950±2634 steps per weekday; p=0.811) or on the secondary end-points. There was a significant decrease over time in physical activity (p<0.001), lung function (p<0.001) and mastery (p=0.017), but not in functional exercise capacity (p=0.585).Although functional exercise capacity did not deteriorate, our mHealth intervention did not improve or maintain physical activity in patients with COPD after a period of pulmonary rehabilitation.

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At home with pulmonary rehabilitation

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2010.559 ◽

2016 ◽

Vol 5 ◽

Author(s):

Richard ZuWallack

Keyword(s):

Quality Of Life ◽

Health Care ◽

Health Care Utilization ◽

Exercise Capacity ◽

Pulmonary Rehabilitation ◽

Respiratory Diseases ◽

Care Utilization ◽

Chronic Respiratory Diseases ◽

At Home

Pulmonary rehabilitation results in substantial and clinically meaningful improvements in dyspnea, exercise capacity and quality of life for patients with chronic respiratory diseases such as COPD. There is also evidence indicating that pulmonary re- habilitation reduces subsequent health care utilization and – perhaps – mortality, if the intervention is given in the post-exacerbation period.

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The Role of Inspiratory Muscle Training in Sickle Cell Anemia Related Pulmonary Damage due to Recurrent Acute Chest Syndrome Attacks

Case Reports in Hematology ◽

10.1155/2015/780159 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Burcu Camcıoğlu ◽

Meral Boşnak-Güçlü ◽

Müşerrefe Nur Karadallı ◽

Şahika Zeynep Akı ◽

Gülsan Türköz-Sucak

Keyword(s):

Quality Of Life ◽

Muscle Strength ◽

Exercise Capacity ◽

Respiratory Muscle ◽

Acute Chest Syndrome ◽

Respiratory Muscle Strength ◽

Muscle Training ◽

Functional Exercise ◽

Functional Exercise Capacity

Background. The sickling of red blood cells causes a constellation of musculoskeletal, cardiovascular, and pulmonary manifestations. A 32-year-old gentleman with sickle cell anemia (SCA) had been suffering from recurrent acute chest syndrome (ACS).Aim. To examine the effects of inspiratory muscle training (IMT) on pulmonary functions, respiratory and peripheral muscle strength, functional exercise capacity, and quality of life in this patient with SCA.Methods. Functional exercise capacity was evaluated using six-minute walk test, respiratory muscle strength using mouth pressure device, hand grip strength using hand-held dynamometer, pain using Visual Analogue Scale, fatigue using Fatigue Severity Scale, dyspnea using Modified Medical Research Council Scale, and health related quality of life using European Organization for Research and Treatment of Cancer QOL measurement.Results. A significant improvement has been demonstrated in respiratory muscle strength, functional exercise capacity, pain, fatigue, dyspnea, and quality of life. There was no admission to emergency department due to acute chest syndrome in the following 12 months after commencing regular erythrocytapheresis.Conclusion. This is the first report demonstrating the beneficial effects of inspiratory muscle training on functional exercise capacity, respiratory muscle strength, pain, fatigue, dyspnea, and quality of life in a patient with recurrent ACS.

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