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. 2022 Nov 17;17(11):e0277632. doi: 10.1371/journal.pone.0277632

Table 1. Characteristics of the included reviews.

First author and year Type and number of included studies Total number of participants Intervention Comparisons Outcomes Quality assessment tool Authors conclusions
Vieira (2010) [31] N = 12
12 RCTs
728 Exercise-based HPR: LLE, walking, cycling, stair climbing, endurance training, down a stair and sitting to standing from a chair Hospital-based PR, Standard medical care, No intervention 1) HRQoL: CRQ, SGRQ
2) Exercise capacity: 6MWD, SWT
3) Dyspnea: MRC, Borg
PEDro Home-based pulmonary rehabilitation can potentially improve HRQoL and exercise capacity compared to standard care.
Wang (2013) [32] N = 15
15 RCTs
518 Exercise-based HPR: LLE, ULE Usual care 1) HRQoL: CRQ
2) Exercise capacity: 6MWD
3) Dyspnea: CRQ-D
Not report Home pulmonary rehabilitation can improve exercise tolerance, dyspnea, and fatigue in patients with COPD.
Liu (2014) [33] N = 18
18 RCTs
733 Exercise-based HPR: LLE, ULE, walking, cycling, resistance exercise, endurance training Conventional community care without rehabilitation 1) HRQoL: CRQ, SGRQ
2) Exercise capacity: 6MWD
3) Dyspnea: Borg, CRQ-D
4) Pulmonary function: FEV1/FVC
Cochrane criteria Home-based pulmonary rehabilitation programs represent effective therapeutic intervention approaches for relieving dyspnea status and improving exercise capacity, pulmonary functions, and HRQoL among COPD populations.
Liu (2016) [34] N = 13
13 RCTs
464 Exercise-based HPR: LLE, ULE Conventional community care 1) HRQoL: CRQ, SGRQ
2) Exercise capacity: 6MWD
3) Dyspnea: Borg, CRQ-D
Cochrane criteria Home pulmonary rehabilitation can effectively improve health-related quality of life and physical function in COPD patients.
Neves (2016) [16] N = 23
23 RCTs
1258 Exercise-based HPR: LLE, ULE, walking, stretching
Exercise-based community PR: LLE, ULE, rowing machine, climbing stairs, swimming, skating, and bicycling
Standard medical care, Usual care, OPR 1) HRQoL: CRQ, SGRQ
2) Exercise capacity: 6MWT, ISWT
3) Dyspnea: MRC, CRQ-D
Cochrane criteria Compared to a control group, home or community-based PR improved functional capacity, decreased dyspnea sensation, and improved quality of life.
Li (2017) [35] N = 14
14 RCTs
495 Exercise-based HPR: LLE, ULE Usual care 1) HRQoL: CRQ, SGRQ
2) Exercise capacity: 6MWD, SWT
3) Dyspnea: Borg, MRC, CRQ-D
4) Pulmonary function: FEV1/FVC
Cochrane criteria Home pulmonary rehabilitation can effectively improve quality of life, exercise capacity, and dyspnea symptoms in stable COPD patients but has no significant improvement in lung function.
Wuytack (2018) [36] N = 10
10 RCTs
934 Exercise-based HPR/Exercise-based community PR: strength training, LLE, ULE, aerobic training, walking, cycling, resistance training, muscle strengthening exercises OPR 1) HRQoL: CRQ, SGRQ
2) Exercise capacity: 6MWD
3) Dyspnea: CRQ-D
Cochrane criteria There was low to moderate evidence that outpatient and home-based exercise are equally effective.
Chen (2020) [37] N = 9
9 RCTs
859 Exercise-based HPR Center-based PR 1) HRQoL: SGRQ, CRQ
2) Exercise capacity: 6MWT, ESWT
3) Dyspnea: mMRC, CRQ-D
Cochrane criteria Home and center-based pulmonary rehabilitation have similar effects on exercise capacity, quality of life, and dyspnoea scores in individuals with chronic obstructive pulmonary disease.
Fu (2021) [38] N = 23
23 RCTs
2352 Exercise-based HPR: endurance training, resistance/strength training, walking, gymnastics, jogging, cycling, Tai Chi, Ba Duan Jin, stair climbing Standard medical care 1) HRQoL: SGRQ
2) Exercise capacity: 6MWT
3) Pulmonary function: FEV1, FVC, FEV1/FVC
Jadad Community-based pulmonary rehabilitation for stable COPD patients can significantly improve their lung function and quality of life.
Mendes Xavier (2022) [39] N = 17
17 RCTs
898 Exercise-based HPR: LLE, ULE, walking, climbing, cycling, stretching, relaxation exercises, physical training, climbing up and down a ladder, resistance training, strengthening exercises, endurance training Conventional PR 1) HRQoL: SGRQ
2) Exercise capacity: 6MWT
3) Dyspnea: CRQ-D, MRC, mMRC
Cochrane criteria Home pulmonary rehabilitation reduced dyspnea levels, increased 6MWD, and improved HRQoL in COPD patients.
Paixão (2022) [40] N = 11
10 RCTs
1 non-RCT
1205 Exercise-based HPR: stair-climbing, LLE, ULE, walking, endurance training, HIIT, strength training, resistance training Usual care 1) HRQoL: SGRQ, CRQ
2) Exercise capacity: 6MWD, ISWD
3) Dyspnea: CRQ-D
Quality Assessment Tool for Quantitative Studies Unsupervised physical activity interventions benefit dyspnea and exercise capacity of people with COPD, are safe, and present a high adherence rate.

Abbreviations: RCTs: randomized controlled trials; HPR: home pulmonary rehabilitation; LLE: lower-limb endurance exercise training; PR: pulmonary rehabilitation; HRQoL: health-related quality of life; CRQ: chronic respiratory disease questionnaire; SGRQ: St George’s respiratory questionnaire; 6MWD: 6-minute walk distance; SWT: shuttle walk test; MRC: medical research council; Borg: Borg scale; PEDro: physiotherapy evidence database; ULE: upper-limb endurance exercise training; CRQ-D: the CRQ domains of dyspnea; FEV1: forced expiratory volume in 1 second; FVC: forced volume vital capacity; OPR: outpatient pulmonary rehabilitation; ISWT: incremental shuttle walk test; EWST: endurance shuttle walk test; mMRC: modified British Medical Research Council; Jadad: Jadad scale; HIIT: high-intensity interval training; ISWD: incremental shuttle walk distance.

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