Minimal equipment for aerobic training in COPD: A systematic review

Abstract

Background: There is a disparity between the demand for pulmonary rehabilitation and the availability of well-resourced programs. Aim: To determine whether pulmonary rehabilitation programs using minimal equipment can achieve improvements in exercise capacity and health-related quality of life in people with COPD. Method: Relevant randomised controlled trials (RCTs) were identified using a predefined search strategy of 5 databases: MEDLINE, CINAHL, AMED, Web of Science and SCOPUS. Minimal equipment programs were defined as home-based and facility-based exercise training using modes other than traditional gym equipment (e.g ground walking, elastic resistance bands). Results: 26 RCTs were identified that evaluated 1412 participants with COPD. Compared to usual care, minimal equipment programs (19 trials) demonstrated clinically significant improvements in six-minute walk distance (6MWD) (weighted mean difference (WMD) 34 metres, 95% CI 20 to 47), endurance shuttle walk test time (WMD 226 seconds, 95% CI 143 to 309), St George9s Respiratory Questionnaire total score (WMD -7 points, 95% CI -10 to -3) and Chronic Respiratory Disease Questionnaire (CRQ) dyspnoea domain (WMD 0.58 points, 95% CI 0.38 to 0.78). When compared to programs using well-resourced gym equipment (7 trials), there were no significant differences in 6MWD, CRQ total score or CRQ dyspnoea domain. Conclusion: Aerobic exercise training using minimal equipment improves functional exercise capacity, health-related quality of life and dyspnoea in people with COPD. Minimal equipment programs may provide an alternative where well-equipped facility-based pulmonary rehabilitation programs are not available.