Abstract
Abstract Objective Chronic obstructive pulmonary disease (COPD) can be prevented and treated, although presenting with persistent airflow restriction; the airflow restriction caused by COPD is mostly progressive. In recent years, more attention has been paid to the home-based pulmonary rehabilitation (PR) and its influence on COPD. Exercise training is the basic constituent of PR. However, it is not clear which exercise trainings are the ideal ways to deliver home-based PR. Methods In this review, we focus on the effect of home-based exercise training on patients with COPD. We searched literature, which was necessarily required to be randomized controlled trails (RCTs) from the establishment of the four respective databases (Medline, PubMed, Web of Science, and China National Knowledge Infrastructure) from January 2008 to January 2018. We used the Cochrane collaborative “risk of bias” tool to assess the quality of evidence. A total of 21 trials (1694 participants) were included. Through the analysis of the literature, we find that a simple, low-cost, and low-intensity family-based lung-rehabilitation plan to adapt to the real life may lead to the improvement of the ability to exercise, the reduction of the difficulty in breathing, and the improvement of carrying out daily activities. Results In the exercise training of home-based PR, lower limb exercise (LLE) training demonstrated a more perceptible effect in improving the quality of life of patients with COPD. At the same time, the combination of LLE training, breathing training, and upper limb exercise training is more obvious than the simple LLE training. In addition, home-based low-intensity aerobic training may sometimes be no less than the outpatient or center intervention to improve dyspnea, health status, and exercise tolerance. In conclusion, the simple and easy home-based PR exercise program is useful. Long-term home-based PR may require an enhanced need for maintenance. Conclusions A simple, low-cost, and low-intensity high blood pressure response (HBPR) plan to adapt to the real life may lead to an augmentation in the ability to exercise, a reduction of the difficulty in breathing, and an improvement in carrying out day-to-day activities. HBPR strategies can benefit patients (elderly patients with COPD at home) in the long term.
Highlights
The results of some reviews show that home-based pulmonary rehabilitation (PR) program can be an effectual, easy, cheap, and effective program to reduce fatigue and improve abilities of daily living (ADL) and quality of life (QOL) in Chronic obstructive pulmonary disease (COPD) patients
Four of the trials compared home-based intervention with the usual care, and the results indicated that home-based lower limb exercise (LLE) with or without add-on intervention was more effective than the usual care
One trial showed that noninvasive intermittent positive pressure ventilation (NIPPV) in patients with COPD was significantly improved compared with routine treatment27 (Table 2)
Summary
According to the study published by the World Health Organization, chronic obstructive pulmonary disease (COPD) is expected to account for the fifth place in the world’s economic burden by 2020.1–3 COPD is a common disease with persistent airflow restriction that can be prevented and treated, and its airflow restriction is mostly progressive. The main symptoms of COPD are dyspnea, fatigue and reduced physical activity, progressive aggravation, and spiral of symptoms, which seriously affect the patient’s labor and quality of life. pulmonary rehabilitation (PR) has become an important part of the treatment of patients with COPD.. Regular visits to hospitals or clinics may result in a patient’s inability to comply with or reduce compliance, which is often a primary obstacle to the success of these programs Another approach, is to consider a home-based rehabilitation program, which may be an effective way of delivery. The results of some reviews show that home-based PR program can be an effectual, easy, cheap, and effective program to reduce fatigue and improve abilities of daily living (ADL) and quality of life (QOL) in COPD patients. Movement training is the basis of PR and is the effective method to improve the muscle function and chronic respiratory symptoms in patients with COPD.. Movement training is the basis of PR and is the effective method to improve the muscle function and chronic respiratory symptoms in patients with COPD.11,12 Those reviews did not focus on interventions of home-based exercise training. The innovation of this study is to: (i) discuss the current family movement training for patients with COPD from the aspects of intervention type, content, method, and results; and (ii) provide the basis for the direction of the future family rehabilitation research
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