Home versus centre-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis

摘要

Background: To evaluate the effects of home versus centre-based pulmonary rehabilitation on exercise capacity, quality of life, and dyspnoea scores in patients with chronic obstructive pulmonary disease by meta-analysis. Methods: We searched the Cochrane library, Embase, PubMed and CINAHL (EBSCO) up to April 2020 without language restriction to collect randomized controlled trials of home versus centre-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease. Literatures screening, risk of bias assessment and data extraction for the included studies were conducted by two reviewers independently. The data analysis was carried out by RevMan 5.3 software. Results: A total of 9 studies, which comprised a total of 859 participants were included in the meta-analysis. Centre and home-based pulmonary rehabilitation were equally effective at improving exercise capacity (MD = 2.30, 95% CI: 12.02 to 7.42, P > 0.05) and dyspnoea scores (MD = 0.15, 95% CI: 0.46 to 0.17, P > 0.05). They were also equally effective at improving health-related quality of life on the chronic respiratory questionnaire (dyspnea: MD = 0.08, 95% CI: 0.30 to 0.13, P > 0.05;fatigue: MD = 0.19, 95% CI: 0.45 to 0.07, P > 0.05;emotional function: MD = 0.18, 95% CI, 0.40 to 0.40, P > 0.05 and mastery: MD = 0.13, 95% CI: 0.38 to 0.11, P > 0.05), and on the St George''s respiratory questionnaire (MD = 1.77, 95% CI: 4.54 to 0.99, P > 0.05). Conclusion: Home and centre-based pulmonary rehabilitation has similar effects on exercise capacity, quality of life, and dyspnoea scores in individuals with chronic obstructive pulmonary disease. Home-based pulmonary rehabilitation has the potential to be an alternative to centre-based pulmonary rehabilitation.