Effects of Exercise Training on Pulmonary Function in Adults With Chronic Lung Disease: A Meta-Analysis of Randomized Controlled Trials.

Abstract

To quantify the effect of exercise training on indices of pulmonary function in adults with chronic lung disease using meta-analytic techniques. Eligible trials were identified using a systematic search of MEDLINE, Web of Science, Physiotherapy Evidence Database, and GoogleScholar databases. Randomized controlled trials that evaluated pulmonary function before and after whole-body exercise training among adult patients (aged ≥19y) with chronic lung disease were included. Data were independently extracted from each study by 3 authors. Random-effects models were used to aggregate a mean effect size (Hedges' d; Δ) and 95% confidence interval (CI), and multilevel linear regression with robust maximum likelihood estimation was used to adjust for potential nesting effects. Among 2923 citations, a total of 105 weighted effects from 21 randomized controlled trials were included. After adjusting for nesting effects, exercise training resulted in a small (Δ=.18; 95% CI, .07-.30) and significant (P=.002) improvement in a composite measure of pulmonary function. Tests of heterogeneity of the mean effect size were nonsignificant. Contrary to prior assumptions, whole-body exercise training is effective for improving pulmonary function in adults with chronic lung disease, particularly spirometric indices. Subsequent studies are necessary to determine the optimal exercise training characteristics to maximize functional improvement.