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KMID : 1022320190130010001
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Asian Nursing Research
2019 Volume.13 No. 1 p.1 ~ p.10
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Meta-analysis of the Effect of a Pulmonary Rehabilitation Program on Respiratory Muscle Strength in Patients with Chronic Obstructive Pulmonary Disease
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Lee Eun-Nam
Kim Moon-Ja
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Abstract
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Purpose: Pulmonary rehabilitation (PR) programs are important in the treatment of patients with chronic obstructive pulmonary disease (COPD) but vary widely in type, duration, and efficacy. This meta-analysis investigated the effect of PR programs on respiratory muscle strength in patients with COPD.
Methods: PubMed, Embase, and CINAHL were searched. The primary outcome variables were maximal expiratory pressure (MEP) and maximal inspiratory pressure (MIP). The secondary outcome variables were the modified Borg score after the 6-min walking test, percent predicted forced expiratory volume in 1 second (FEV1%pred), and percent FEV1/forced volume capacity (FVC). Comprehensive Meta-Analysis, version 3.0, was used to analyze the data. The effect size was calculated using the standardized mean difference (SMD) and 95% confidence interval (CI).
Results: Twenty randomized controlled trials (with 992 participants) were included in the analysis. The PR programs had a significant effect on the MEP (SMD, 0.87; 95% CI, 0.42?1.32; p < .001), MIP (SMD, 0.53; 95% CI, 0.13?0.93; p = .009), and modified Borg score (SMD, ?0.37; 95% CI, ?0.52 to ?0.22; p < .001) in patients with COPD. There was no effect on FEV1%pred (SMD, 0.09; 95% CI, ?0.12 to 0.30; p = .406) or FEV1/FVC% (SMD, 0.04; 95% CI, ?0.17 to 0.26; p = .702).
Conclusion: PR programs improve respiratory muscle strength in patients with COPD. Strategies for selecting a suitable PR program need to be developed, and future studies should evaluate the long-term effects of such programs on pulmonary function.
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KEYWORD
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meta-analysis, pulmonary disease, chronic obstructive, respiratory muscles
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