PMID- 34992360 OWN - NLM STAT- MEDLINE DCOM- 20220322 LR - 20220429 IS - 1178-2005 (Electronic) IS - 1176-9106 (Print) IS - 1176-9106 (Linking) VI - 16 DP - 2021 TI - Pulmonary Rehabilitation Programmes Within Three Days of Hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. PG - 3525-3538 LID - 10.2147/COPD.S338074 [doi] AB - OBJECTIVE: To evaluate the efficacy and safety of early pulmonary rehabilitation (PR) (ie, <3 days of hospitalization) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Embase, Web of Science, PubMed and Cochrane Library were searched from their inception to 1 April 2021. Randomized controlled trials were included if they observed the efficacy of early PR in AECOPD patients. Study selection, data extraction, risk of bias and quality of evidence were assessed by two researchers independently. Assessment of the risk of bias and eidence quality were evaluated by the Cochrane Collaboration's tool and Grading of Recommendations, Assessment, Development and Evaluation system, respectively. RESULTS: Fourteen trials (829 participants) were identified. Significant improvement was found in the 6-minute walk distance (6MWD; mean difference (MD): 69.64; 95% CI: 40.26 to 99.01; Z = 4.65, P < 0.0001, low quality). In the subgroup analysis, the exercise-training group showed marked improvement (MD: 96.14; 95% CI: 20.24 to 172.04; Z = 2.48, P = 0.001). The Saint George's Respiratory Questionnaire (SGRQ) total score was low (MD: -12.77; 95% CI: -16.03 to -9.50; Z = 7.67, P < 0.0001, moderate quality). Significant effects were not found for the duration of hospital stay, quadriceps muscle strength or five times sit to stand test. Only one serious adverse event was reported in experimental group, which was not associated with early PR. CONCLUSION: PR initiated <3 days of hospitalization may increase exercise capacity and improve quality of life, but the results should be interpreted prudently and dialectically, and the role of early PR in AECOPD needs further exploration. CI - (c) 2021 Zhang et al. FAU - Zhang, Dong AU - Zhang D AUID- ORCID: 0000-0001-5780-5561 AD - Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, 450003, People's Republic of China. FAU - Zhang, Hailong AU - Zhang H AD - Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, 450003, People's Republic of China. FAU - Li, Xuanlin AU - Li X AD - Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, 450003, People's Republic of China. FAU - Lei, Siyuan AU - Lei S AD - Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, 450003, People's Republic of China. FAU - Wang, Lu AU - Wang L AD - Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, 450003, People's Republic of China. FAU - Guo, Wen AU - Guo W AD - Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, 450003, People's Republic of China. FAU - Li, Jiansheng AU - Li J AD - Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, People's Republic of China. AD - Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, 450003, People's Republic of China. LA - eng PT - Journal Article PT - Meta-Analysis PT - Review PT - Systematic Review DEP - 20211224 PL - New Zealand TA - Int J Chron Obstruct Pulmon Dis JT - International journal of chronic obstructive pulmonary disease JID - 101273481 SB - IM MH - Exercise MH - Exercise Tolerance MH - Hospitalization MH - Humans MH - *Pulmonary Disease, Chronic Obstructive/diagnosis/rehabilitation MH - *Quality of Life PMC - PMC8713718 OTO - NOTNLM OT - acute exacerbation OT - chronic obstructive pulmonary disease OT - meta-analysis OT - pulmonary rehabilitation COIS- The authors report no conflicts of interest in this work. EDAT- 2022/01/08 06:00 MHDA- 2022/03/23 06:00 PMCR- 2021/12/24 CRDT- 2022/01/07 06:19 PHST- 2021/09/16 00:00 [received] PHST- 2021/12/06 00:00 [accepted] PHST- 2022/01/07 06:19 [entrez] PHST- 2022/01/08 06:00 [pubmed] PHST- 2022/03/23 06:00 [medline] PHST- 2021/12/24 00:00 [pmc-release] AID - 338074 [pii] AID - 10.2147/COPD.S338074 [doi] PST - epublish SO - Int J Chron Obstruct Pulmon Dis. 2021 Dec 24;16:3525-3538. doi: 10.2147/COPD.S338074. eCollection 2021.