Effectiveness of home-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials
Article
Article Title | Effectiveness of home-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials |
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ERA Journal ID | 14161 |
Article Category | Article |
Authors | Liu, Xian-Liang, Tan, Jing-Yu, Wang, Tao, Zhang, Qi, Zhang, Min, Yao, Li-Qun and Chen, Jin-Xiu |
Journal Title | Rehabilitation Nursing |
Journal Citation | 39 (1), pp. 36-59 |
Number of Pages | 24 |
Year | 2014 |
Publisher | Lippincott Williams & Wilkins |
Place of Publication | United States |
ISSN | 0278-4807 |
Digital Object Identifier (DOI) | https://doi.org/10.1002/rnj.112 |
Web Address (URL) | https://journals.lww.com/rehabnursingjournal/fulltext/2014/01000/effectiveness_of_home_based_pulmonary.5.aspx |
Abstract | Purpose: The pulmonary rehabilitation program has become a cornerstone in the management of patients with chronic obstructive pulmonary disease (COPD). Programs based in hospital and treatment facilities, however, are inconvenient and underutilized. A home-based program is a promising alternative, but studies of its effectiveness have yielded inconsistent results. The purpose of this study is to evaluate the impact of home-based pulmonary rehabilitation programs on health-related quality of life (HRQoL) and other health outcomes in patients with COPD. Methods: Randomized controlled trials (RCTs) of home-based pulmonary rehabilitation programs published between February 1991 and February 2012 were retrieved from electronic databases (PubMed, Cochrane Library, Science Direct, China National Knowledge Infrastructure [CNKI], and Wanfang Database). Two reviewers independently assessed topical relevance and trial quality, extracted data for meta-analysis using the Review Manager v5.1 software, and contacted the original studies' authors for additional information. Findings: Eighteen trials, comprising 733 randomized patients, were included in the meta-analysis. COPD patients experienced significant relief in dyspnea status, measured by the Borg score (Fixed effects model, WMD = -0.92, 95% CI: -1.61∼-0.23, p =.009) and baseline dyspnea index (BDI) (Fixed effects model, WMD = -1.77, 95% CI: -2.65∼-0.89, p <.0001) after 12 weeks of home-based intervention. Home-based intervention also improved patients' HRQoL scores, measured by the Chronic Respiratory Questionnaire (CRQ) and St. George's Respiratory Questionnaire (SGRQ) (Fixed effects model, WMD = -11.33, 95% CI: -16.37∼-6.29, p <.0001, SGRQ total scores after 12 weeks of intervention); exercise capacity (measured by the 6-minute walking distance test (6MWD) (Fixed effects model, WMD = 35.88, 95% CI: 9.38∼62.38, p =.008, after 12 weeks of intervention); and pulmonary functions (measured by forced expiratory volume in one-second/forced vital capacity (FEV1/FVC) [Random effects model, WMD = -10.72, 95% CI: -15.86∼-5.58, p <.0001, after 12 weeks of intervention), as compared with the nonintervention control group; however, no statistically significant changes were seen in maximal workload, hospital admission, cost of care, or mortality between the two groups. Conclusions and Clinical Relevance: Home-based pulmonary rehabilitation programs represent effective therapeutic intervention approaches for relieving COPD-associated respiratory symptoms and improving HRQoL and exercise capacity. Rigorously designed, large-scale RCTs are still needed to identify an optimal standard home-based pulmonary rehabilitation program. © 2013 Association of Rehabilitation Nurses. |
Contains Sensitive Content | Does not contain sensitive content |
ANZSRC Field of Research 2020 | 420599. Nursing not elsewhere classified |
Public Notes | Files associated with this item cannot be displayed due to copyright restrictions. |
Byline Affiliations | Fujian University of Traditional Chinese Medicine, China |
Chongqing Medical University, China |
https://research.usq.edu.au/item/z7588/effectiveness-of-home-based-pulmonary-rehabilitation-for-patients-with-chronic-obstructive-pulmonary-disease-a-meta-analysis-of-randomized-controlled-trials
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