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

  • Author Footnotes
    ∗ Salcedo and Lindheimer contributed equally to this work.
    Pablo A. Salcedo
    Footnotes
    ∗ Salcedo and Lindheimer contributed equally to this work.
    Affiliations
    War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ

    New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ
    Search for articles by this author
  • Author Footnotes
    ∗ Salcedo and Lindheimer contributed equally to this work.
    Jacob B. Lindheimer
    Footnotes
    ∗ Salcedo and Lindheimer contributed equally to this work.
    Affiliations
    War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ

    Department of Kinesiology, University of Wisconsin–Madison, Madison, WI
    Search for articles by this author
  • Jacquelyn C. Klein-Adams
    Affiliations
    War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ
    Search for articles by this author
  • Anays M. Sotolongo
    Affiliations
    War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ
    Search for articles by this author
  • Michael J. Falvo
    Correspondence
    Corresponding author Michael J. Falvo, PhD, VA NJ Health Care System–WRIISC, 385 Tremont Ave, Mail Stop 129, East Orange, NJ 07018.
    Affiliations
    War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ

    New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ
    Search for articles by this author
  • Author Footnotes
    ∗ Salcedo and Lindheimer contributed equally to this work.
Published:April 17, 2018DOI:https://doi.org/10.1016/j.apmr.2018.03.014

      Abstract

      Objective

      To quantify the effect of exercise training on indices of pulmonary function in adults with chronic lung disease using meta-analytic techniques.

      Data Sources

      Eligible trials were identified using a systematic search of MEDLINE, Web of Science, Physiotherapy Evidence Database, and GoogleScholar databases.

      Study Selection

      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 Extraction

      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.

      Data Synthesis

      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.

      Conclusions

      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.

      Keywords

      List of abbreviations:

      ATS (American Thoracic Society), CI (confidence interval), COPD (chronic obstructive pulmonary disease), FEV1 (forced expiratory volume in 1 second), FVC (forced vital capacity), PEDro (Physiotherapy Evidence Database)
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        • Webb K.A.
        • Preston M.E.
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