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23/1/2017 AerobicExerciseTraininginVerySevereChronicObstructivePulmonaryDisease:ASystematicReviewandMetaAnalysis.

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AmJPhysMedRehabil.2017Jan17.doi:10.1097/PHM.0000000000000667.[Epubaheadofprint]

AerobicExerciseTraininginVerySevereChronicObstructive
PulmonaryDisease:ASystematicReviewandMetaAnalysis.
PaneroniM1,SimonelliC,VitaccaM,AmbrosinoN.

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Abstract
OBJECTIVE: Toevaluatetheeffectivenessofexercisetraininginpatientswithveryseverechronic
obstructivepulmonarydisease(COPD).
DESIGN: WesearchedMEDLINE,EMBASE,CochraneCentralRegisterofControlledTrials,and
CumulativeIndextoNursingandAlliedHealthLiteraturedatabasesusingthefollowingassearch
terms:COPD,ChronicObstructivePulmonaryDisease,Exercise,andPulmonaryRehabilitation.
Weincludedrandomizedcontrolledtrials(RCTs)ofsubjectswithforcedexpiratoryvolumeinthe
firstsecondoflessthan35%ofthepredictednormalvalueenrolledininpatient,outpatient,or
homeorcommunitybasedtrainingprogramslastingatleast4weekswithrespecttousualcare.
WeincludedRCTswithoutcomemeasuresincludingthe6minutewalkingtestand/orhealth
relatedqualityoflifeassessedbytheSt.George'sRespiratoryQuestionnaire(SGRQ).
RESULTS: Of580articlesscreened,10wereincluded.Theprograms'durationrangedfrom4to
52weekswith1to5sessionsperweeklasting15to40minuteseach.Theinterventiongroup
improvedin6minutewalkingtest[weightedmeandifference,67.1(95%confidenceinterval[CI],
37.89798.927)standardizedmeandifference,3.86(95%CI,2.045.67)],andSt.George's
RespiratoryQuestionnaire[weightedmeandifference,8.041(95%CI,15.273to0.809)
standardizedmeandifference,1.23(95%CI,2.14to0.31)].
CONCLUSIONS: Exercisetrainingimprovesexercisetoleranceandhealthrelatedqualityoflifein
patientswithverysevereCOPD.However,becausefewstudiesonseverelyaffectedpatientsare
availableandthetrainingprogramsareHighlyheterogeneous,largerRCTsareneeded.

PMID:28099192 DOI:10.1097/PHM.0000000000000667
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