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.