Cochrane Database of Systematic Reviews
Pulmonary rehabilitation for chronic obstructive pulmonary
disease (Review)
McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y
McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y.
Pulmonary rehabilitation for chronic obstructive pulmonary disease.
Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No.: CD003793.
DOI: 10.1002/14651858.CD003793.pub3.
www.cochranelibrary.com
Pulmonary rehabilitation for chronic obstructive pulmonary disease (Review)
Copyright 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
http://www.cochranelibrary.com
T A B L E O F C O N T E N T S
1HEADER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2PLAIN LANGUAGE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4SUMMARY OF FINDINGS FOR THE MAIN COMPARISON . . . . . . . . . . . . . . . . . . .
7BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8METHODS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Figure 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Figure 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Figure 4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Figure 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
20DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22AUTHORS CONCLUSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
43CHARACTERISTICS OF STUDIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
144DATA AND ANALYSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 1.1. Comparison 1 Rehabilitation versus usual care, Outcome 1 QoL - Change in CRQ (Fatigue). . . . . 147
Analysis 1.2. Comparison 1 Rehabilitation versus usual care, Outcome 2 QoL - Change in CRQ (Emotional Function). 149
Analysis 1.3. Comparison 1 Rehabilitation versus usual care, Outcome 3 QoL - Change in CRQ (Mastery). . . . 150
Analysis 1.4. Comparison 1 Rehabilitation versus usual care, Outcome 4 QoL - Change in CRQ (Dyspnoea). . . . 151
Analysis 1.5. Comparison 1 Rehabilitation versus usual care, Outcome 5 QoL - Change in SGRQ (Total). . . . . 152
Analysis 1.6. Comparison 1 Rehabilitation versus usual care, Outcome 6 QoL - Change in SGRQ (Symptoms). . . 153
Analysis 1.7. Comparison 1 Rehabilitation versus usual care, Outcome 7 QoL - Change in SGRQ (Impacts). . . . 154
Analysis 1.8. Comparison 1 Rehabilitation versus usual care, Outcome 8 QoL - Change in SGRQ (Activity). . . . 155
Analysis 1.9. Comparison 1 Rehabilitation versus usual care, Outcome 9 Maximal Exercise (Incremental shuttle walk
test). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Analysis 1.10. Comparison 1 Rehabilitation versus usual care, Outcome 10 Maximal Exercise Capacity (cycle ergometer). 157
Analysis 1.11. Comparison 1 Rehabilitation versus usual care, Outcome 11 Functional Exercise Capacity (6MWT)). 158
Analysis 2.1. Comparison 2 Rehabilitation versus usual care (subgroup analysis hospital vs community), Outcome 1 QoL -
Change in CRQ (Fatigue). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
Analysis 2.2. Comparison 2 Rehabilitation versus usual care (subgroup analysis hospital vs community), Outcome 2 QoL -
Change in CRQ (Emotional Function). . . . . . . . . . . . . . . . . . . . . . . . . . 161
Analysis 2.3. Comparison 2 Rehabilitation versus usual care (subgroup analysis hospital vs community), Outcome 3 QoL -
Change in CRQ (Mastery). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Analysis 2.4. Comparison 2 Rehabilitation versus usual care (subgroup analysis hospital vs community), Outcome 4 QoL -
Change in CRQ (Dyspnoea). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
Analysis 2.5. Comparison 2 Rehabilitation versus usual care (subgroup analysis hospital vs community), Outcome 5 QoL -
Change in SGRQ (Total). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Analysis 2.6. Comparison 2 Rehabilitation versus usual care (subgroup analysis hospital vs community), Outcome 6 QoL -
Change in SGRQ (Symptoms). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Analysis 2.7. Comparison 2 Rehabilitation versus usual care (subgroup analysis hospital vs community), Outcome 7 QoL -
Change in SGRQ (Impacts). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Analysis 2.8. Comparison 2 Rehabilitation versus usual care (subgroup analysis hospital vs community), Outcome 8 QoL -
Change in SGRQ (Activity). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
Analysis 3.1. Comparison 3 Rehabilitation versus usual care (subgroup analysis exercise only vs exercise and other),
Outcome 1 QoL - Change in CRQ (Fatigue). . . . . . . . . . . . . . . . . . . . . . . . 172
Analysis 3.2. Comparison 3 Rehabilitation versus usual care (subgroup analysis exercise only vs exercise and other),
Outcome 2 QoL - Change in CRQ (Emotional Function). . . . . . . . . . . . . . . . . . . 173
iPulmonary rehabilitation for chronic obstructive pulmonary disease (Review)
Copyright 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Analysis 3.3. Comparison 3 Rehabilitation versus usual care (subgroup analysis exercise only vs exercise and other),
Outcome 3 QoL - Change in CRQ (Mastery). . . . . . . . . . . . . . . . . . . . . . . 175
Analysis 3.4. Comparison 3 Rehabilitation versus usual care (subgroup analysis exercise only vs exercise and other),
Outcome 4 QoL - Change in CRQ (Dyspnoea). . . . . . . . . . . . . . . . . . . . . . . 176
Analysis 3.5. Comparison 3 Rehabilitation versus usual care (subgroup analysis exercise only vs exercise and other),
Outcome 5 QoL - Change in SGRQ (Total). . . . . . . . . . . . . . . . . . . . . . . . 178
Analysis 3.6. Comparison 3 Rehabilitation versus usual care (subgroup analysis exercise only vs exercise and other),
Outcome 6 QoL - Change in SGRQ (Symptoms). . . . . . . . . . . . . . . . . . . . . . 179
Analysis 3.7. Comparison 3 Rehabilitation versus usual care (subgroup analysis exercise only vs exercise and other),
Outcome 7 QoL - Change in SGRQ (Impacts). . . . . . . . . . . . . . . . . . . . . . . 181
Analysis 3.8. Comparison 3 Rehabilitation versus usual care (subgroup analysis exercise only vs exercise and other),
Outcome 8 QoL - Change in SGRQ (Activity). . . . . . . . . . . . . . . . . . . . . . . 182
Analysis 4.1. Comparison 4 Rehabilitation versus usual care (sensitivity analysis by allocation concealment and incomplete
outcome), Outcome 1 QoL - Change in CRQ (Dyspnoea). . . . . . . . . . . . . . . . . . . 184
Analysis 4.2. Comparison 4 Rehabilitation versus usual care (sensitivity analysis by allocation concealment and incomplete
outcome), Outcome 2 QoL - Change in CRQ (Emotional Function). . . . . . . . . . . . . . . 185
Analysis 4.3. Comparison 4 Rehabilitation versus usual care (sensitivity analysis by allocation concealment and incomplete
outcome), Outcome 3 QoL - Low Risk CRQ (Fatigue). . . . . . . . . . . . . . . . . . . . 186
Analysis 4.4. Comparison 4 Rehabilitation versus usual care (sensitivity analysis by allocation concealment and incomplete
outcome), Outcome 4 QoL - Low Risk CRQ (Mastery). . . . . . . . . . . . . . . . . . . . 187
Analysis 4.5. Comparison 4 Rehabilitation versus usual care (sensitivity analysis by allocation concealment and incomplete
outcome), Outcome 5 QoL - Low Risk SGRQ (Total). . . . . . . . . . . . . . . . . . . . 188
Analysis 4.6. Comparison 4 Rehabilitation versus usual care (sensitivity analysis by allocation concealment and incomplete
outcome), Outcome 6 QoL - Low Risk SGRQ (Symptoms). . . . . . . . . . . . . . . . . . . 189
Analysis 4.7. Comparison 4 Rehabilitation versus usual care (sensitivity analysis by allocation concealment and incomplete
outcome), Outcome 7 QoL - Low Risk SGRQ (Impacts). . . . . . . . . . . . . . . . . . . 190
Analysis 4.8. Comparison 4 Rehabilitation versus usual care (sensitivity analysis by allocation concealment and incomplete
outcome), Outcome 8 QoL - Low Risk SGRQ (Activity). . . . . . . . . . . . . . . . . . . . 191
191ADDITIONAL TABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
201APPENDICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
206WHATS NEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
207HISTORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
207CONTRIBUTIONS OF AUTHORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
208DECLARATIONS OF INTEREST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
208DIFF