Comparison of pulmonary rehabilitation and chest physiotherapy's outcomes among elder patients with chronic obstructive pulmonary disease: a meta-analysis

Abstract

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) has become the third foremost cause of mortality by 2020. Due to the high incidence rate of COPD among the population, it has become a major social and health burden. This meta-analysis was designed to appraise the long-term effect of the pulmonary rehabilitation (PR) program among elder COPD patients in terms of improvements in exercise capacity and quality of life.EVIDENCE ACQUISITION: Research papers were extracted from different databases including MEDLINE, Scopus, EMBASE, PubMed, ScienceDirect, and Resources Information Center. For data extraction, MeSH keywords of “Pulmonary Rehabilitation (PR)” “COPD elder patients” “Short term outcomes” “long-term outcomes” “improvements in quality of life” and “reduced physical activity” were used. The time duration of the study was limited from January 2010 to April 2022. PRISMA standards were followed in the meta-analysis.EVIDENCE SYNTHESIS: Approximately, 1852 elder COPD patients (66.8±7.8 years) were examined from 18 randomized control trials (RCT)-based studies. The standard mean difference of 7 RCT studies of Six-Minute Walk Test (6MWT) Score was 0.54 (0.39-0.70) at I2=71%, CI=95%, Z=6.83, (P<0.00001). Difference between the PR and without PR groups showed slight improvements in the 6MWT Score. The CRQ Score assessed through the questionnaire showed improvements from baseline values after receiving the PR program. The standard deviation measured was 0.30 (0.54-0.5) CI=95%, Z=2.36.CONCLUSIONS: There was a significant difference in 6MWT value when measured among COPD patients receiving PR as compared to patients without PR. PR has a significant role in the improvement of exercise capacity and quality of life. This intervention should be sustained long duration to avoid asthmatic attacks and airflow blockage.