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Review Article   

Panminerva Medica 2022 Jul 29

DOI: 10.23736/S0031-0808.22.04757-7

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

An Overview of Cochrane Systematic Reviews for pulmonary rehabilitation interventions in people with COPD: a mapping synthesis

Elisabetta ZAMPOGNA 1, Giorgio FERRIERO 2, 3, Dina VISCA 1, 4, Michele PATRINI 5, Stefano NEGRINI 5, 6 , Chiara ARIENTI 7

1 Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Varese, Italy; 2 Physical and Rehabilitation Medicine Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Varese, Italy; 3 Department of Biotechnology and Life Sciences, University of Insubria, Varese-Como, Varese, Italy; 4 Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Varese, Italy; 5 IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; 6 Department of Biomedical, Surgical and Dental Sciences, University La Statale, Milan, Italy; 7 IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy



INTRODUCTION: There is a global unmet need for rehabilitation to meet which the World Health Organization, in collaboration with Cochrane Rehabilitation, is developing the Package of Interventions for Rehabilitation with the aim of identifying rehabilitation interventions relevant to a range of key health conditions, including chronic obstructive pulmonary disease (COPD). The purpose of this paper is to describe the best available evidence on pulmonary rehabilitation interventions for people with COPD.
EVIDENCE ACQUISITION: An Overview of Cochrane Systematic Reviews (CSRs). Through the search strategy, COPD-related systematic reviews published from January 2009 to November 2021 were identified. Data were extracted on each reported outcome related to an intervention and judgements about the quality of evidence were made, using the GRADE approach.
EVIDENCE SYNTHESIS: Seventeen reviews were analyzed, for a total of 314 primary studies that included 22206 participants. CSRs provided information on the effectiveness of rehabilitation on functioning, activity, quality of life, anxiety, depression, mortality, and health care resource utilization.
CONCLUSIONS: Our findings report that comprehensive pulmonary rehabilitation programs and water exercises improve the exercise capacity and quality of life (QoL) in people with COPD. Different exercise modalities, intensities, and settings for different muscle groups, breathing exercises, and counseling can improve exercise capacity, QoL, dyspnea, hospitalizations, and physical activity. It is uncertain whether breathing exercise, low-intensity exercise, neuromuscular electrical stimulation, and psychological intervention have an effect on exercise capacity, dyspnea, QoL, and physical activity. The protocol was registered on OSF (registration DOI: 10.17605/OSF.IO/8A26Q).


KEY WORDS: Rehabilitation; COPD; Exercise; Outcome

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