Pulmonary rehabilitation outcomes in individuals with chronic obstructive pulmonary disease: a systematic review - 27/07/21

Doi : 10.1016/j.rehab.2021.101564

Sara Souto-Miranda, PT, MSc ^1,^2,³, Guilherme Rodrigues, PT ¹, Martijn A. Spruit, PhD ^3,⁴, Alda Marques, PhD ^1,^2,^⁎
¹ Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
² iBiMED: Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
³ Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
⁴ Department of Research and Development, CIRO, Horn, The Netherlands

^⁎Corresponding author: Alda Marques, Lab3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences and Institute of Biomedicine, University of Aveiro, Agras do Crasto - Campus Universitário de Santiago, Edifício 30, 3810-193 Aveiro, PortugalLab3R-Respiratory Research and Rehabilitation LaboratorySchool of Health Sciences and Institute of BiomedicineUniversity of AveiroAgras do Crasto - Campus Universitário de Santiago, Edifício 30Aveiro3810-193Portugal

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Abstract

Background

The magnitude of response to pulmonary rehabilitation (PR) is influenced by the selection of outcomes and measures.

Objectives

This systematic review aimed to review all outcomes and measures used in clinical trials of PR for individuals with chronic obstructive pulmonary disease (COPD).

Methods

The review involved a search of Scopus, Web of Knowledge, Cochrane Library, EBSCO, Science Direct and PubMed databases for studies of stable individuals with COPD undergoing PR. Frequency of reporting for each domain, outcome and measure was synthesized by using Microsoft Excel.

Results

We included 267 studies (43153 individuals with COPD). A broad range of domains (n=22), outcomes (n=163) and measures (n=217) were reported. Several measures were used for the same outcome. The most reported outcomes were exercise capacity (n=218) assessed with the 6-min walk test (n=140), health-related quality of life (n=204) assessed with the Saint George's respiratory questionnaire (n=99), and symptoms (n=158) assessed with the modified Medical Research Council dyspnea scale (n=56). The least reported outcomes were comorbidities, adverse events and knowledge.

Conclusions

This systematic review reinforces the need for a core outcome set for PR in individuals with COPD because of high heterogeneity in reported outcomes and measures. Future studies should assess the importance of each outcome for PR involving different stakeholders.