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Cited by 821Chronic Obstructive Pulmonary Disease (COPD) ResearchCardiovascular and exercise physiologyRespiratory Support and Mechanisms

Pulmonary rehabilitation for chronic obstructive pulmonary disease

Lacasse, Yves, Goldstein, Roger, Lasserson, Toby J, Martin, Sylvie·2006·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd003793.pub2
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Abstract

BACKGROUND: The widespread application of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) should be preceded by demonstrable improvements in function attributable to the programs. This review updates that reported in 2001. OBJECTIVES: To determine the impact of rehabilitation on health-related quality of life (QoL) and exercise capacity in patients with COPD. SEARCH STRATEGY: We identified additional RCTs from the Cochrane Airways Group Specialised Register. Searches were current as of July 2004. SELECTION CRITERIA: We selected RCTs of rehabilitation in patients with COPD in which quality of life (QoL) and/or functional (FEC) or maximal (MEC) exercise capacity were measured. Rehabilitation was defined as exercise training for at least four weeks with or without education and/or psychological support. Control groups received conventional community care without rehabilitation. DATA COLLECTION AND ANALYSIS: We calculated weighted mean differences (WMD) using a random-effects model. We requested missing data from the authors of the primary study. MAIN RESULTS: We included the 23 randomized controlled trials (RCTs) in the 2001 Cochrane review. Eight additional RCTs (for a total of 31) met the inclusion criteria. We found statistically significant improvements for all the outcomes. In four important domains of QoL (Chronic Respiratory Questionnaire scores for Dyspnea, Fatigue, Emotional function and Mastery), the effect was larger than the minimal clinically important difference of 0.5 units (for example: Dyspnoea score: WMD 1.0 units; 95% confidence interval: 0.8 to 1.3 units; n = 12 trials). Statistically significant improvements were noted in two of the three domains of the St. Georges Respiratory Questionnaire. For FEC and MEC, the effect was small and slightly below the threshold of clinical significance for the six-minute walking distance (WMD: 48 meters; 95% CI: 32 to 65; n = 16 trials). AUTHORS' CONCLUSIONS: Rehabilitation relieves dyspnea and fatigue, improves emotional function and enhances patients' sense of control over their condition. These improvements are moderately large and clinically significant. Rehabilitation forms an important component of the management of COPD.

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Crossref · 10.1002/14651858.cd003793.pub2

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  • Only the pilot group surpassed all other estimates for the minimum clinically important difference, with a value of 54 m (95% CI 37-71 m).

    “but only the pilot group surpassed all other estimates for the minimum clinically important difference, 30,31 with a value of 54 m (95% CI 37-71 m).32”

    From Cognitive behavioral therapy for management of dyspnea: A pilot study (2015) · cites this paper as [30]

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Authors
Lacasse, Y., Goldstein, R., Lasserson, T. J., & Martin, S.
Affiliations
  • Institut universitaire de cardiologie et de pneumologie de Québec (CA)
  • West Park Hospital (GB)
  • St George's, University of London (GB)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
John Wiley & Sons, Ltd
Published
2006-10-18
Issue
4
Pages
CD003793-CD003793
ISSN
1361-6137 (ISSN-L)
DOI
10.1002/14651858.cd003793.pub2
OpenAlex
W4246117717
Cited by
821
References
9
Citations by year
2026: 2 · 2025: 8 · 2024: 13 · 2023: 13 · 2022: 20 · 2021: 11 · 2020: 12 · 2019: 24 · 2018: 29 · 2017: 29 · 2016: 38 · 2015: 63 · 2014: 81 · 2013: 84 · 2012: 72
Type
reference entry
Language
en
Update notices
new_version (2015-02-24)
Open access
closed
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords
pulmonary rehabilitation, chronic obstructive pulmonary disease, health-related quality of life, exercise capacity, dyspnea, fatigue, emotional functioning, 6-minute walk distance, Chronic Respiratory Questionnaire, St George's Respiratory Questionnaire, exercise training
MeSH terms
Dyspnea, Health Status, Humans, Quality of Life, Randomized Controlled Trials as Topic, Exercise Tolerance, Pulmonary Disease, Chronic Obstructive

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