Document Detail


Exercise prescription for hospitalized people with chronic obstructive pulmonary disease and comorbidities: a synthesis of systematic reviews.
MedLine Citation:
PMID:  22665994     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The prescription of physical activity for hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can be complicated by the presence of comorbidities. The current research aimed to synthesize the relevant literature on the benefits of exercise for people with multimorbidities who experience an AECOPD, and ask: What are the parameters and outcomes of exercise in AECOPD and in conditions that are common comorbidities as reported by systematic reviews (SRs)?
METHODS: An SR was performed using the Cochrane Collaboration protocol. Nine electronic databases were searched up to July 2011. Articles were included if they (1) described participants with AECOPD, chronic obstructive pulmonary disease (COPD), or one of eleven common comorbidities, (2) were an SR, (3) examined aerobic training (AT), resistance training (RT), balance training (BT), or a combination thereof, (4) included at least one outcome of fitness, and (5) compared exercise training versus control/sham.
RESULTS: This synthesis examined 58 SRs of exercise training in people with AECOPD, COPD, or eleven chronic conditions commonly associated with COPD. Meta-analyses of endurance (aerobic or exercise capacity, 6-minute walk distance--6MWD) were shown to significantly improve in most conditions (except osteoarthritis, osteoporosis, and depression), whereas strength was shown to improve in five of the 13 conditions searched: COPD, older adults, heart failure, ischemic heart disease, and diabetes. Several studies of different conditions also reported improvements in quality of life, function, and control or prevention outcomes. Meta-analyses also demonstrate that exercise training decreases the risk of mortality in older adults, and those with COPD or ischemic heart disease. The most common types of training were AT and RT. BT and functional training were commonly applied in older adults. The quality of the SRs for most conditions was moderate to excellent (>65%) as evaluated by AMSTAR scores.
CONCLUSION: In summary, this synthesis showed evidence of significant benefits from exercise training in AECOPD, COPD, and conditions that are common comorbidities. A broader approach to exercise and activity prescription in pulmonary rehabilitation may induce therapeutic benefits to ameliorate clinical sequelae associated with AECOPD and comorbidities such as the inclusion of BT and functional training.
Authors:
W Darlene Reid; Cristiane Yamabayashi; Donna Goodridge; Frank Chung; Michael A Hunt; Darcy D Marciniuk; Dina Brooks; Yi-Wen Chen; Alison M Hoens; Pat G Camp
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Publication Detail:
Type:  Journal Article; Meta-Analysis     Date:  2012-05-14
Journal Detail:
Title:  International journal of chronic obstructive pulmonary disease     Volume:  7     ISSN:  1178-2005     ISO Abbreviation:  Int J Chron Obstruct Pulmon Dis     Publication Date:  2012  
Date Detail:
Created Date:  2012-06-05     Completed Date:  2012-09-25     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  101273481     Medline TA:  Int J Chron Obstruct Pulmon Dis     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  297-320     Citation Subset:  IM    
Affiliation:
Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada. darlene.reid@ubc.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Comorbidity
Databases as Topic
Diabetes Mellitus / epidemiology
Disease Progression
Exercise Therapy* / methods,  organization & administration
Exercise Tolerance*
Female
Heart Failure / epidemiology
Hospitalization
Humans
Male
Myocardial Ischemia / epidemiology
Outcome and Process Assessment (Health Care)
Physical Fitness*
Pulmonary Disease, Chronic Obstructive* / epidemiology,  physiopathology,  rehabilitation
Risk Assessment
Comments/Corrections

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