REVIEW   

Minerva Pediatrics 2023 August;75(4):604-13

DOI: 10.23736/S2724-5276.21.06656-8

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

The effect of pulmonary rehabilitation on childhood asthma: a systematic review and meta-analysis

Guoping JIN ¹, Yuan JIANG ², Hanqing SHAO ², Jihua ZHU ³ ✉

¹ Department of Endoscopy Center, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China; ² Department of Respiratory, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China; ³ Department of Nursing, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China

INTRODUCTION: Pulmonary rehabilitation (PR) is a comprehensive nursing intervention for lung function improvement in patients with respiratory diseases. This systematic review focused on further exploration of the unclear impacts of PR on childhood asthma.
EVIDENCE ACQUISITION: Web of Science, Cochrane Library, Embase, PubMed, and other databases were searched until May 2021. Randomized controlled trials (RCTs) comparing the effects of PR (including exercise training and education) and routine care on childhood asthma were included. Study selection, data extraction, and bias risk assessment were performed independently by two investigators.
EVIDENCE SYNTHESIS: Fourteen RCTs involving 1401 patients were included. Relative to the control group, the total scores of the asthma quality of life questionnaire were evidently improved in the experimental group, including motor domain scores (MD=0.88, 95% CI: 0.67-1.09), symptom domain scores (MD=1.23, 95% CI: 0.61-1.85), and affective domain scores (MD=1.38, 95% CI: 0.63-2.14). Besides, 6-min walk distance (MD=2.01, 95% CI: 0.86-3.15) and asthma control test (MD=0.31, 95% CI: 0.02-0.60) were prominently improved. However, the maximum oxygen uptake (MD=0.81, 95% CI: -0.2 to 1.82) was not markedly improved. The forced expiratory volume in 1 s (MD=0.42, 95% CI: -0.29 to 1.13), and forced vital capacity (MD=0.07, 95% CI: -0.14 to 0.28) were not remarkably improved. There was an evident improvement in the peak expiratory flow (MD=1.22, 95% CI: 0.15-2.30).
CONCLUSIONS: PR improves some lung functions, exercise tolerance and the quality of life of children with asthma, and it might work as a supplementary therapy for the treatment of childhood asthma. Moreover, more RCTs of high quality and in large sample size are needed for further confirmation.

KEY WORDS: Child; Asthma; Systematic review