Zhengtong Qiao, Ziwei Kou, Jiazhen Zhang, Daozheng Lv, Xuefen Cui, Dongpan Li, Tao Jiang, Xinjuan Yu, Kai Liu
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The interventions were classified according to their intensity and type as high-intensity interval training (HIIT), high-intensity continuous training (HICT), moderate-intensity continuous training (MICT), and low-intensity continuous training (LICT). We assessed exercise capacity using peak work rate (Wpeak) and the 6-min walking test (6-MWT). Lung function was evaluated by measuring peak minute ventilation (VE) and the percentage of predicted FEV<sub>1</sub> (FEV<sub>1</sub>pred%). Dyspnea was assessed using the Modified Medical Research Council (mMRC) scale. Quality of life was measured with the Chronic Respiratory Questionnaire (CRQ).</p><p><strong>Results: </strong>Fifteen studies were identified (979 subjects). HIIT showed the greatest improvement in Wpeak, 6-MWT, VE, and mMRC compared to usual care (MD 18.48 (95% CI 12.35, 24.60), 67.73 (34.89, 100.57), 6.26 (2.81, 9.72), and -0.53 (-0.89, -0.17), respectively) and showed the improvement in CRQ (MD 10.80 (95% CI 1.65, 19.95)). MICT showed improvement in Wpeak and 6-MWT (MD 18.28 (95% CI 11.20, 25.22), 61.92 (28.34, 95.51)) similar to HICT (MD 16.08 (95% CI 8.19, 23.84), 64.64 (28.70, 100.57)) and showed the highest improvement in CRQ compared to usual care (MD 10.83 (95% CI 1.68, 19.98)). LICT significantly improved Wpeak compared to usual care (MD 13.47 (95% CI 4.77, 22.13)). The quality of evidence for outcomes varied from very low to moderate.</p><p><strong>Conclusion: </strong>HIIT and MICT might be optimal training approaches for patients with COPD. LICT exhibited limited clinical efficacy. 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引用次数: 0
摘要
背景：下肢有氧运动是慢性阻塞性肺疾病（COPD）患者肺部康复的核心组成部分。运动训练的最佳强度和类型（例如，间歇或连续）仍有待确定。目的：我们旨在评估COPD患者下肢有氧运动的最佳强度和类型。设计：随机对照试验的系统评价和网络荟萃分析。数据来源和方法：检索PubMed、Web of Science、Embase和Cochrane Central Register of Controlled Trials相关数据。干预措施根据强度和类型分为高强度间歇训练（HIIT）、高强度连续训练（HICT）、中强度连续训练（MICT）和低强度连续训练（LICT）。我们使用峰值工作率（Wpeak）和6分钟步行测试（6-MWT）来评估运动能力。通过测量峰值分钟通气量（VE）和预测FEV1百分比（FEV1pred%）来评估肺功能。呼吸困难采用改良医学研究委员会（mMRC）量表进行评估。用慢性呼吸问卷（CRQ）测量生活质量。结果：共纳入15项研究（979名受试者）。与常规治疗相比，HIIT在Wpeak、6-MWT、VE和mMRC方面的改善最大（MD分别为18.48 （95% CI 12.35, 24.60）、67.73（34.89,100.57）、6.26（2.81,9.72）和-0.53 (-0.89,-0.17)），CRQ方面的改善最大（MD为10.80 (95% CI 1.65, 19.95)）。MICT改善Wpeak和6-MWT (MD 18.28 （95% CI 11.20, 25.22), 61.92(28.34, 95.51)）与HICT相似(MD 16.08 (95% CI 8.19, 23.84), 64.64 (28.70, 100.57))， CRQ改善程度最高（MD 10.83 (95% CI 1.68, 19.98)）。与常规护理相比，LICT显著改善Wpeak （MD 13.47 (95% CI 4.77, 22.13)）。结果的证据质量从极低到中等不等。结论：HIIT和MICT可能是COPD患者的最佳训练方式。LICT的临床疗效有限。虽然HICT与MICT一样有效，但它引起的呼吸困难更多。试验注册：该系统评价和网络荟萃分析在普洛斯彼罗（PROSPERO）前瞻性注册。CRD 42024520134)。
Optimal intensity and type of lower limb aerobic training for patients with chronic obstructive pulmonary disease: a systematic review and network meta-analysis of RCTs.
Background: Lower limb aerobic exercise is the core component of pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) patients. The optimal intensity and type (e.g., interval or continuous) of exercise training remains to be determined.
Objectives: We aimed to evaluate the optimal intensities and types of lower limb aerobic exercise in patients with COPD.
Design: Systematic review and network meta-analysis of randomized controlled trials.
Data sources and methods: The PubMed, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant data. The interventions were classified according to their intensity and type as high-intensity interval training (HIIT), high-intensity continuous training (HICT), moderate-intensity continuous training (MICT), and low-intensity continuous training (LICT). We assessed exercise capacity using peak work rate (Wpeak) and the 6-min walking test (6-MWT). Lung function was evaluated by measuring peak minute ventilation (VE) and the percentage of predicted FEV1 (FEV1pred%). Dyspnea was assessed using the Modified Medical Research Council (mMRC) scale. Quality of life was measured with the Chronic Respiratory Questionnaire (CRQ).
Results: Fifteen studies were identified (979 subjects). HIIT showed the greatest improvement in Wpeak, 6-MWT, VE, and mMRC compared to usual care (MD 18.48 (95% CI 12.35, 24.60), 67.73 (34.89, 100.57), 6.26 (2.81, 9.72), and -0.53 (-0.89, -0.17), respectively) and showed the improvement in CRQ (MD 10.80 (95% CI 1.65, 19.95)). MICT showed improvement in Wpeak and 6-MWT (MD 18.28 (95% CI 11.20, 25.22), 61.92 (28.34, 95.51)) similar to HICT (MD 16.08 (95% CI 8.19, 23.84), 64.64 (28.70, 100.57)) and showed the highest improvement in CRQ compared to usual care (MD 10.83 (95% CI 1.68, 19.98)). LICT significantly improved Wpeak compared to usual care (MD 13.47 (95% CI 4.77, 22.13)). The quality of evidence for outcomes varied from very low to moderate.
Conclusion: HIIT and MICT might be optimal training approaches for patients with COPD. LICT exhibited limited clinical efficacy. While HICT was as effective as MICT, it caused more dyspnea.
Trial registration: This systematic review and network meta-analysis was prospectively registered with PROSPERO (No. CRD 42024520134).
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