Efficacy of unsupervised exercise in adults with obstructive lung disease: a systematic review and meta-analysis

Introduction The benefits of unsupervised exercise programmes in obstructive lung disease are unclear. aim this systematic review was to synthesise evidence regarding the efficacy versus non-exercise-based usual care patients with disease. Methods Electronic databases (MEDLINE, CINAHL, Embase, Allied and Complementary Medicine Database, Web Science, Cochrane Central Register Controlled Trials Physiotherapy Evidence Database) trial registers (ClinicalTrials.gov, Current Trials, UK Clinical Gateway WHO International Registry Platform) were searched from inception April 2020 for randomised trials comparing adults chronic pulmonary (COPD), non-cystic fibrosis bronchiectasis or asthma. Primary outcomes capacity, quality life, mortality, exacerbations respiratory cause hospitalisations. Results Sixteen (13 COPD, 2 asthma, 1 bronchitis: 1184 patients) met inclusion criteria. Only data on COPD populations available meta-analysis. Unsupervised resulted a statistically but not clinically significant improvement 6-Minute Walk Test (n=5, MD=22.0 m, 95% CI 4.4 39.6 p=0.01). However, did lead meaningful improvements St. George’s Respiratory Questionnaire (n=4, MD=−11.8 points, −21.2 −2.3 p=0.01) Chronic Disease domains (dyspnoea: n=4, MD=0.5 0.1 0.8 p<0.01; fatigue: MD=0.7 0.4 1.0 emotion: 0.2 0.7 mastery: unable perform meta-analysis) compared care. Discussion This demonstrates clinical interventions health-related life COPD. High-quality needed examine effectiveness prescription methods.