. 2012 May 14;7:297–320. doi: 10.2147/COPD.S29750

Table 4.

Generic and disease-specific outcomes from exercise interventions

Author	Condition and severity	Type of training:	Generic fitness, quality of life and functional outcomes # RCTs/n/difference [95% confidence intervals]	Disease specific fitness, control and prevention outcomes # trials/n/difference [95% confidence intervals]
Puhan et al³⁹	COPD after AECOPD	AT, RT	6MWD: 6/NR/WMD: 77.7 m [12.2, 143.2]; Shuttle walk test: 3/NR/WMD: 64.4 M [41.3, 87.4]; QoL: SGRQ: 3/NR/WMD: 9.88 [−14.40, −5.37]	Dyspnea: 5/NR/0.97 [0.35, 1.58]; Admission to hospital: 5/250/OR: 0.22 [0.08, 0.58]; Mortality: 3/110/OR: 0.28 [0.10, 0.84]
Lacasse et al⁴²	COPD	AT, RT	Maximal exercise capacity on cycle ergometer: 13/511/WMD: 8.4 watts [3.45, 13.41]; 6MWD: 16/669/WMD: 48.5 m [31.6, 65.3]; QoL: Fatigue of CRQ: 11/618/WMD: 0.92 [0.71, 1.13]	QoL: Change in dyspnea of CRQ: 11/618/WMD: 1.06 [0.85, 1.26]
O’ Shea et al⁴³	Mild to severe COPD	RT	Leg press strength: 4/77/SES: 0.96 [0.26, 1.66]; Knee extensor strength: 3/125/SES: 0.52 [0.30,0.74]; Cycling endurance: 2/52/SES: 0.87 [0.29, 1.44].
Salman et al⁴⁴	Mild to severe COPD	AT, RT	Walking distance: 20/979/SES: 0.71 [0.43, 0.99]	Shortness of breath: 12/723/SES: 0.62 [0.26, 0.91]
Chavannes et al⁴⁰	Mild to mod. COPD	AT, AT + RT,	Exercise tolerance: Limited evidence of improvement. SES NR
Vieira et al⁴⁵	COPD	Home based AT, RT	Exercise capacity: 2 of 2 studies show ↑ in 6MWD or constant work rate test; QoL: 3 of 6 studies showed ↑ compared to control
Janaudis-Ferreira et al⁴¹	Mod. to severe COPD	Arm AT, RT	Unsupported and supported arm exercise capacity: 2 (of 4) studies and 1 (of 2) showed ↑ compared to control
Liu and Latham⁵⁰	Elderly	RT	Lower limb strength: 73/3059/SES 0.84 [0.67, 1.00]; VO₂ max: 18/710/WMD 1.50 mL/kg/min [0.49, 2.51]; 6MWD: 11/325/WMD 52.37 m [17.38, 87.37]; Gait speed: 24/1179/WMD 0.08 m/s [0.04, 0.12]; Timed up-and-go: 12/691/WMD −0.69 s [−1.11, −0.27]; Time to stand from a chair: 11/384/SES −0.94 [−1.49, −0.38]; Stair climbing: 8/268/−1.44 s [−2.51, −0.37]; Vitality: (SF-36) 10/611/WMD 1.33 [−0.89, 3.55]; Main function: 33/2172/SES 0.14 [0.05, 0.22]	Death: 13/1125/RR 0.89 [0.52, 1.54]; Pain: 6/503/SES −0.30 [−0.48, −0.13]
Howe et al⁴⁹	Improving balance	Balance, gait, functional task	Single leg stance time, eyes open: 4/164/MD 0.33 s [0.02, 0.64]; Berg Balance Scale 3/126/MD 2.72 [0.94, 4.50]
Gillespie et al⁴⁸	Falls prevention	Balance, gait, functional		Rate of falls: 3/461/RR: 0.73 [0.54, 0.98] 0.036; Number of fallers: 17/2492/RR: 0.83 [0.72, 0.97] 0.018
Weening-Dijksterhuis et al⁵²	Institutionalized frail elderly	AT, RT, balance and functional training	Strength: ↑ in 8 of 9 studies; 6MWD: ↑ in 3 of 3 studies; Balance: ↑ in 10 of 10 studies; Psychological function/perceived health: some effect; Function: ↑ in 4 of 4 on depression and activity measures
Forster et al⁴⁷	Elderly in long term care	AT, RT and balance	Mobility (variety of tests): ↑ in 24 of 35 trials; Strength: ↑ in 18; Balance: ↑ in 12 of 16 studies
Chin et al⁴⁶	Frail, Elderly	AT, RT and balance	Physical Performance Test: ↑ in 3 of 4 studies; 6MWD: ↑ in 9 of 17 studies
Rydwik et al⁵¹	Institutionalized elderly, multiple diagnoses	AT, RT, balance, mobility, gait, ADL	Strength: ↑ in 6 of 9 studies; Mobility: ↑ in 8 of 12 studies; Range of motion: ↑ in 2 of 3 studies; Gait: ↑ in 4 of 8 studies; Activities of daily living: ↑ in 3 of 6 studies
Davies et al ⁵⁵	HF, severity not an inclusion criterion	AT, RT		Hospital admissions related to heart failure: 7/569/RR: 0.72 [0.52, −0.99]; QoL using Minnesota Living with Heart Failure Questionnaire: 6/700/WMD −10.3 [−15.9, −4.8]; QoL using all scales: 9/779/SMD: −0.57 [0–0.83, −0.31]
Hwang et al⁵⁴	HF, diagnosis based on clinical signs or LVEF < 40%	RT	6MWD: 2/40/52 m [19, 85]
Hwang and Marwick⁵⁷	HF	AT (15) or AT + RT (4)	VO₂ max: 16/733/2.86 mL/kg/min [1.43, 4.29]; Exercise duration: 7/241/2.00 min [1.43, 2.57]; 6MWD: 6/628/30.4 m [6.1, 54.7]
Chien et al⁵³	HF, diagnosis based on clinical signs or LVEF < 40%	Mostly AT, home-based. RT added in 3/10 studies	VO₂ max: 7/355/MD 2.71 mL/kg/min [0.67, 7.74]; 6MWD: 5/320/MD 41.09 m [19.12, 63.06]	Hospitalization due to cardiac events: 2/143/OR 0.75 [0.19, 2.92]
Haykowsky et al⁵⁶	HF, severity not a criterion, clinically stable	AT	VO₂ max: 9/538/WMD 2.98 mL/kg/min [2.47, 3.49]	Ejection fraction: 9/538/WMD 2.59% [1.44, 3.74]; End-diastolic volume: 5/371/WMD −11.49 mL [−19.95, −3.02]; End-systolic volume: 5/371/WMD −12.87 mL [−17.80, −7.93]
van Tol et al⁵⁸	HF, severity not a criterion for inclusion	AT, RT	VO₂ max: 31/1240/MD 2.06 mL/kg/min; Watts on maximal test: 19/715/MD 14.3 W; Anaerobic threshold: 13/511/MD 1.91 mL/kg/min; 6MWD: 15/599/MD 46.2 m; HR during maximal exercise: 18/683/MD 3.5 bpm; SBP during maximal exercise: 10/382/MD 5.4 mmHg; QoL: 9/463/MD −9.7 points	End-diastolic volume at rest: 9/527/WD −3.13 mL; Cardiac output during maximal exercise: 3/104/WD 2.51 L/min
Spruit et al⁶¹	HF, severity not a criterion for inclusion	RT	Mean peak isotonic strength of upper and lower body: 1/16/37% improvement; Muscle endurance: 1/16/299% improvement
Cahalin et al⁶⁰	HF, severity not a criterion	RT, with short or long bursts of AT	Muscle strength, muscle endurance, daily activity, forearm blood flow, performance of heel lift, and QoL increased and resting HR decreased, but no synthesis of data from more than one RCT was provided	Left ventricular ejection fraction, left ventricular fractional shortening, and insulin-stimulated glucose uptake improved, but no synthesis of data from more than one RCT was provided
Benton⁵⁹	HF, severity not a criterion	AT, RT	Muscle strength, muscle endurance, QoL, heart rate during exercise, and forearm blood flow improved, but no synthesis of data from more than one RCT was provided
Haykowsky et al⁶⁵	Post-MI	AT		Meta-regression analysis shows that exercise training had beneficial effects on LV remodeling in clinically stable post-MI patients with greatest benefits occurring when training starts earlier following MI (from one week) and lasts longer than 3 months Ejection fraction: Q = 25.48, df = 2, P < 0.01; End systolic volume: Q = 23.89, df = 2, P < 0.005; End diastolic volume: Q = 27.42, df = 2, P < 0.01
Valkeinen et al⁶⁸	Ischemic heart disease (MI, angina, CABG, PTCA, angioplasty, percutaneous intervention)	AT (majority), RT	VO₂ max for aerobic training: 15/807/SMD 0.67 mL/kg/min [0.39, 0.94]; Longer exercise training period (>6 months) starting soon after a cardiac event (<3 months) had a significant effect on VO₂ max in patients with CHD: 7/406/SMD 0.94 mL/kg/min [0.38, 1.50] and 11/647/SMD 0.77 mL/kg/min [0.44, 1.10, P < 0.001] respectively
Cortes et al⁶⁴	Acute myocardial infarction	In hospital early mobilization		Trend towards decreased total mortality and non-fatal re-infarction, but n.s
Jolliffe et al⁶⁶	Coronary heart disease	AT (majority), RT		Comprehensive cardiac rehabilitation: Total cardiac death: 22/2903/OR 0.75 [0.59, 0.97]; Total cholesterol: 9/1198, −0.65 mmol/L [−0.75, −0.55]; LDL cholesterol: 6/728, −0.61 mmol/L [−0.73, −0.50]; Triglycerides: Small but significant reduction (no numbers) Exercise only: Total cardiac death: 8/2312/OR 0.70 [0.51, 0.94]; Total mortality: 12/2582/OR 0.74 [0.56, 0.98]
Clark et al⁶²	Ischemic heart disease	AT, RT (no details)		Program with exercise: Recurrent MI: 12/3997/RR 0.62 [0.44, 0.87] Exercise only: Mortality: 11/2285/RR 0.72 [0.54, 0.95]
Cornish et al⁶³	Ischemic CAD (narrative review)	AT (interval training)	Exercise capacity: 2 studies (of 2) showed ↑ in either 6 MWD, cycle test time, VO₂ max, time to fatigue and HRrest, while both showed increase in workload
Oliveira et al⁶⁷	Post-MI, CABG (narrative review)	RT	Exercise capacity: 2 of 2 studies showed ↑ in 6MWD; Muscle strength: 2 studies (of 2) showed ↑ in muscle strength
Watson et al⁶⁹	PVD	AT, RT	Maximal walking time: 7/255/MD: 5.1 [4.5, 5.7]; Maximal walking distance: 6/391, MD: 113.20 M [95.0, 131.4]	Pain-free walking time time: 3/150, MD: 2.9 min [2.5, 3.3]; Pain-free walking distance: 6/322, MD: 82.2 M [71.7, 92.7]
Wind and Koelemay⁷⁰	PVD	AT	Walking distance: 9/499, WMD: 155.8 M [80.8, 230.7]	Pain free walking distance: 8/409, WMD: 81.3 M [35.5, 127.1]
Dickinson et al⁷³	Hypertension	AT	SBP: 21/1346/MD: −6.1 mmHg [−10.1, −2.1; I² = 87%]; DBP: 21/1346/MD: −3.0 mmHg [−4.9, −1.1; I² = 74%]
Cornelissen and Fagard⁷²	Hypertension	AT	VO₂ max: 17/279/WMD 4.4 mL/kg/min [3.7, 5.1]; HR: 23/340/WMD −4.5 bpm [−6.5; −2.6]; SBP: 30/492/WMD −6.9 mmHg [−9.1; −4.6]; DBP: 30/492/WMD −4.9 mmHg [−6.5; −3.3].
Whelton et al⁷⁴	Hypertension	AT	SBP: 15/NR/ES −4.94 mmHg [−7.17, −2.70]; DBP: 13/NR/ES −3.73 mmHg [−5.69, −1.77]
Kelley et al⁷¹	Hypertension	AT	SBP: −6 mmHg [−8, −3] (number of trials/subjects NR); DBP: −5 mmHg [−7, −3] (number of trials/subjects NR)
Shaw et al⁷⁶	Obesity	AT	DBP: 2/259/WMD −2.09 mmHg [−3.68, −0.51]	Triglycerides: 3/348/WMD −0.18 mmol/l [−0.31, −0.05]; Fasting glucose: 2/273/WMD −0.17 mmol/l [−0.30, −0.05]; HDL: 3/348/WMD 0.06 mmol/l [0.03, 0.09]
Witham and Avenell⁷⁵	Obese postmenopausal women	AT, RT	VO₂ max: increase by 11.7% in the intervention group and 0.7% in the control group at 12 months (P < 0.001)
Devos-Comby et al⁷⁹	OA	AT, RT, and balance	Direct measures of impairment (walking distance test, timed chair rise, time getting out of a car, balance tests, or gait): 11/740/SES 0.15 [0.08, 0.23]	Combined physical outcomes (Scales of physical disability, discomfort, pain, function, mobility ie, AIMS): 12/808/SES: 0.29 [0.23, 0.36].
Lange et al⁸⁰	Knee OA	RT	Strength: ↑ in 9 of 14 studies; Maximal gait speed: ↑ in 4 of 4 studies; Maximal stair climb/descent: ↑ in 3 of 5 studies	Pain: ↑ in 10 of 18 studies; Physical disability: ↑ in 11 of 14 studies; Physical self efficacy: ↑ in 2 of 2 studies
Ottawa Panel⁷⁷	OA	AT, RT	Strength, aerobic capacity, and functional status: different levels of evidence support various types of strengthening, mobility and flexibility exercises based on RCTs but no synthesis of data from more than one RCT was provided	Pain: different levels of evidence from RCTs show that different types of exercise decrease pain. No synthesis of data from more than one RCT was provided
Brosseau et al⁷⁸	OA	AT	Aerobic capacity, timed walk distance, walk velocity: ↑ in RCTs but no synthesis of data from more than one RCT was provided
Pelland et al⁸¹	OA – most knee or hip	Mainly RT	Strength, function and QoL: improves, but no synthesis of data from more than one RCT was provided	Pain: decreases, but no synthesis of data from more than one RCT was provided
Li et al⁸³	Osteoporosis or osteopenia; severity not an inclusion criteria	RT or combined stretch/strength/balance programs	QoL: All domains of SF36 were significantly improved for all 4 studies. Scores out of 100. Physical function: 5/288/WMD 2.77 [2.27, 3.37]; Pain: 5/288/WMD 4.95 [3.52, 8.70]; Role Physical: 2/78/WMD 12.41 [0.35, 24.46]; Vitality: 2/78/WMD 11.11 [3.99, 18.22] Subgroup analysis showed that programs that combined programs improved QoL physical function and pain scores more than strengthening alone
De Kam et al⁸²	Osteoporosis or osteopenia	AT, RT, Balance, Gait	Improvements in: TUG, standing up and walking around cones, U/E strength, posturagraphy; figure 8 walking; L/E strength; trunk strength; step test; lateral reach; walking velocity; balance performance	Improvements in: spine BMD, hip BMD, femur BMD, fall-related fractures; radius BMD, calcaneus BMD, fall risk reduction; tibia BMD, falls incidence; vertebral height
Chudyk and Petrella⁸⁵	Type 2 DM	AT 21 RCT AT + RT	SBP: AT: −6.1 mmHg [−10.8, −1.4]; AT + RT: −3.6 mmHg [−6.9, −0.2]	HbA_1c AT: WMD: −0.62% [−0.98, −0.27]; AT + RT: WMD: −0.67% [−0.93, −0.40]; Triglycerides AT: WMD: −0.29 mmol/L [−0.48, −0.11]; AT + RT: WMD: −0.30 mmol/L [−0.57, −0.02].
Umpierre et al⁹⁰	Type 2 DM	AT, RT, AT + RT		HbA_1c AT: 18/848/WMD: −0.73% [−1.06, −0.40]; RT: 4/261/WMD: −0.57% [−1.14, −0.01]; AT + RT: 7/404/WMD: −0.51% [−0.79, −0.23].
Irvine and Taylor⁸⁶	Type 2 DM	RT	Strength: 4/NR/SES: 0.95 [0.58, 1.31]	HbA_1c: 7/NR/SES: −0.25 [−0.47,−0.03]
Thomas et al⁸⁹	Type 2 DM	AT or RT	VO₂ max: 3/95/MD: 4.8 mL/kg/min [2.6, 7.1]	HbA_1c: 13/361/MD: −0.62% [−0.91,−0.33].
Kelley and Kelley⁸⁷	Type 2 DM	AT		Low density lipoprotein: WMD: −6.4 mg/dl [−11.8, −1.1]
Snowling and Hopkin⁸⁸	Type 2 DM	AT, RT, or A + RT	A + RT: SBP: 5/NR/WMD: −5.6 mmHg [−9.3, −1.8]; DBP: 5/NR/WMD: −5.5 mmHg [−9.9, −1.1].	HbA_1c: AT: 17/NR/WMD: −0.7% [−1.0, −0.4]; RT: 6/NR/WMD: −0.5% [−1.0, −0.1]; A + RT: 5/NR/WMD: −0.8% [−1.3, −0.2].
Boulé et al⁸⁴	Type 2 DM	AT	VO₂ max: 9/266/SES: 0.53 [0.18, 0.88]	HbA_1c: 8/NR/WMD: −0.71 [−1.1, −0.32]
O’Brien et al⁹¹	HIV – range of severity	AT	VO₂ max: 5/276/WMD: 2.6 mL/kg/min [1.2, 4.1]; Strength: ↑ in 5 of 6 studies	Interval AT: CD4 cell counts: 2/45/WMD: 69.6 cells/mm³ [14.1, 125.1]; AT: Profile of moods: 2/65/WMD: −7.7 [−13.5, −1.9].
Krogh et al⁹³	Depression	9 AT; 3 RT; 1 A + RT		Depressive symptoms: 13/272/SES: −0.40 [−0.66, −0.14]
Herring et al⁹⁴	Anxiety and chronic illness	AT, RT, balance		Anxiety symptoms: 38/NR/SES: 0.29 [0.23, 0.36]
Mead et al⁹⁶	Depression	AT, RT, A + RT		Depression symptoms AT: 17/640/SES: −0.63 [−0.95, −0.30]; RT: 2/69/SES: −1.34 [−2.07, −0.61]; A + RT: 4/198/SES: −1.47 [−2.56, −0.37]
Rethorst et al⁹⁵	Depression	AT, RT, AT + RT		Depression scores: 58/2982/ES: −0.80 [0.92, 0.67].
Lawlor and Hopker⁹²	Depression	AT		Depressive symptoms: 9/461/SES: −1.1 [−1.5 to −0.6]; Beck depression: 9/461/WMD: −7.3 [−10.0, −4.6]

Notes: WMD (weighted mean difference) is a calculation that provides an average mean difference of studies by weighting the means more highly when the n is larger and the variance is smaller. If the WMD is provided, the unit value for the measure is shown. SES (standardized effect size) is usually calculated by determining the difference between the pre-post values for the intervention and control groups and dividing this difference by the respective standard deviation of differences for the intervention group or the average SD of the differences for both groups.

Abbreviations: AT, aerobic training; BMD, bone mineral density; DBP, diastolic blood pressure; HbA_1c, glycosylated hemoglobin; MD, mean difference; OR, odds ratio; QoL, quality of life; RR, rate ratio; RT, resistance training; SES, standardized effect size; 6 MWD, six-minute walking distance; SBP, systolic blood pressure; TUG: timed up-and-go; WMD, weighted mean difference.