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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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Europa Medicophysica 2007 December;43(4):475-85

Copyright © 2007 EDIZIONI MINERVA MEDICA

lingua: Inglese

Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease. A Cochrane systematic review

Lacasse Y. 1, Martin S. 1, Lasserson T. J. 2, Goldstein R. S. 3

1 Research Center Laval Hospital Institute of Cardiology and Pneumology Laval University, Québec, Canada
2 Community Health Sciences St-George’s University of London London, UK
3 Division of Respirology University of Toronto, West Park Healthcare Centre Toronto, ON, Canada


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Background. The widespread application of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) should be preceded by demonstrable improvements in function attributable to the programs.
Objectives. To determine the impact of rehabilitation on health-related quality of life (QoL) and exercise capacity in patients with COPD.
Methods. We identified randomized controlled trials (RCTs) from the Cochrane Airways Group Specialised Register. We selected RCTs of rehabilitation in patients with COPD in which quality of life (QoL) and/or exercise capacity were measured. Rehabilitation was defined as exercise training for at least 4 weeks with or without education and/or psychological support. Control groups received conventional community care without rehabilitation.
Results. A total of 31 RCTs met the inclusion criteria. We found statistically significant improvements for all the outcomes. In 4 important domains of QoL (Chronic Respiratory Questionnaire scores for Dyspnea, Fatigue, Emotional function and Mastery), the effect was larger than the minimal clinically important difference. For exercise capacity, the effect was small and slightly below the threshold of clinical significance for the six-minute walking distance (WMD: 48 m; 95% CI: 32 to 65; n = 16 trials).
Conclusion. Rehabilitation relieves dyspnea and fatigue, improves emotional function and enhances patients’ control over their condition. These improvements are moderately large and clinically significant. Rehabilitation forms an important component of the management of COPD.

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