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. 2015 May;12(2):132–145. doi: 10.1177/1479972315575318

Table 2.

Summary of findings.a

Patient or population: Patients with COPD
Settings: Inpatient and outpatient
Intervention: Combined RT and ET (CT). Control: ET alone
Outcomes Illustrative comparative risksb (95% CI) Relative effect (95% CI) Number of participants (studies) Quality of the evidence (GRADE) Comments
Assumed risk Corresponding risk
Control CT versus ET alone for COPD
Quality of life-SGRQ  Training duration: mean 12 weeks The mean SGRQ in the intervention groups was 4.23 lower (17.22 lower to 8.75 higher) 48 (2 Studies) ⊕⊕⊖⊖ Low1,2,3
Quality of life-CRQ  Training duration: 8–12 weeks The mean CRQ in the intervention groups was 0.16 SDs lower (0.35 lower to 0.03 higher) 90 (3 Studies) ⊕⊕⊕⊖ Moderate1 Data from O’Shea et al.9 were re-meta-analysed to get overall result
Adverse events  Training duration: 6–12 weeks See comment See comment – 101 (4 Studies) ⊕⊕⊕⊖ Moderate4 Possible risk of low back pain with intervention.
6MWD  Training duration: 3–12 weeks The mean 6MWD in meters in the intervention groups was 13.29 lower (55.64 lower to 29.07 higher) 146 (7 Studies) ⊕⊖⊖⊖ Very low1,5,6
VO2max  Training duration: 8–12 weeks The mean VO2max in the intervention groups was 0.07 SDs lower (0.47 lower to 0.33 higher) 137 (5 Studies) ⊕⊕⊕⊖ Moderate4 SMD −0.07 (−0.47 to 0.33)
Max workload (watts)  Training duration: 8–12 weeks The mean max workload (watts) in the intervention groups was 0.38 higher (13.88 lower to 14.64 higher) 137 (5 Studies) ⊕⊖⊖⊖ Very low4,5,7
Leg muscle strength  Training duration: 8–12 weeks The mean leg muscle strength in the intervention groups was 0.69 SDs higher (0.39–0.98 higher) 194 (8 Studies) ⊕⊕⊕⊖ Moderate1 SMD 0.69 (0.39 to 0.98).
GRADE Working Group grades of evidence

  • High quality: Further research is very unlikely to change our confidence in the estimate of effect.

  • Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

  • Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.

  • Very low quality: We are very uncertain about the estimate.

  • 1. Lack of blinding and baseline differences.

  • 2. Lack of blinding.

  • 3. Only two studies, few patients and wide CI.

  • 4. No explanation for drop-outs was provided.

  • 5. Significant results of individual trials with point estimates in either direction. This difference may be explained with identified sources of bias.

  • 6. Wide confidence interval.

  • 7. I 2 = 61%, non-overlapping CIs with point estimates in either direction.

CRQ: Chronic Respiratory Questionnaire; CT: combined resistance and endurance training; ET: endurance training; GRADE: Grading of Recommendations Assessment, Development and Evaluation; COPD: chronic obstructive pulmonary disease; 6MWT: 6-minute walking test; SGRQ: St. George Respiratory Questionnaire; VO2max: maximal oxygen uptake; CI: confidence interval; RT: resistance training.

aCombined RT and ET versus ET alone for COPD.

bThe basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).