Effectiveness of pulmonary rehabilitation performed through exercise training for patients with stable COPD: A meta-analysis of randomized controlled trials

1Barnes PJ. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol. 2016;138(1):16–27. doi: 10.1016/j.jaci.2016.05.011. Barnes PJ Inflammatory mechanisms in patients with chronic obstructive pulmonary disease J Allergy Clin Immunol 2016138116–27 10.1016/j.jaci.2016.05.01127373322Open DOISearch in Google Scholar

2Müllerova H, Agusti A, Erqou S, Mapel DW. Cardiovascular comorbidity in COPD. Chest. 2013;144(4):1163–78. Müllerova H Agusti A Erqou S Mapel DW Cardiovascular comorbidity in COPD Chest 201314441163 7810.1378/chest.12-284723722528Search in Google Scholar

3World Health Organisation. Chronic obstructive pulmonary disease (COPD). Accessed Spetember 1st, 2022 at: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd) World Health Organisation Chronic obstructive pulmonary disease (COPD). Accessed Spetember 1st 2022 at https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)Search in Google Scholar

4Global initiative for chronic obstructive lung disease: global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease 2019 report. Accessed February 23th, 2021 at: https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-v1.7-FINAL-14Nov2018-WMS.pdf Global initiative for chronic obstructive lung disease: global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease 2019 report Accessed February 23th, 2021 at https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-v1.7-FINAL-14Nov2018-WMS.pdfSearch in Google Scholar

5Adeloye D, Chua S, Lee C, Basquill C, Papana A, Theodoratou E, et al. Global and regional estimates of COPD prevalence: systematic review and meta-analysis. J Glob Health. 2015;5(2):020415. doi: 10.7189/ jogh.05-020415. Adeloye D Chua S Lee C Basquill C Papana A Theodoratou E et al Global and regional estimates of COPD prevalence: systematic review and meta-analysis J Glob Health 201552020415 10.7189/jogh.05-020415Open DOISearch in Google Scholar

6World Health Organisation. COPD predicted to be third leading cause of death in 2030. Accessed February 23, 2021 at: https://www.who.int/respiratory/copd/World_Health_Statistics_2008/en/ World Health Organisation COPD predicted to be third leading cause of death in 2030 Accessed February 23 2021 at https://www.who.int/respiratory/copd/World_Health_Statistics_2008/en/Search in Google Scholar

7Wouters EF, Posthuma R, Koopman M, Liu W-Y, Sillen MJ, Hajian B, et al. An update on pulmonary rehabilitation techniques for patients with chronic obstructive pulmonary disease. Expert Rev Respir Med. 2020;14(2):149–61. doi: 10.1080/17476348.2020.1700796. Wouters EF Posthuma R Koopman M Liu W-Y Sillen MJ Hajian B et al An update on pulmonary rehabilitation techniques for patients with chronic obstructive pulmonary disease Expert Rev Respir Med 2020142149 61 10.1080/17476348.2020.170079631931636Open DOISearch in Google Scholar

8Škrgat S, Triller N, Košnik M, Poplas Susič T, Petek D, Vodopivec Jamšek V, et al. Priporočila za obravnavo bolnika s kronično obstruktivno pljučno boleznijo na primarni in specialistični pulmološki ravni v Sloveniji. Zdrav Vest. 2017;86(1–2):65-75. doi: 10.6016/ ZdravVestn.2471. Škrgat S Triller N Košnik M Poplas Susič T Petek D Vodopivec Jamšek V et al Priporočila za obravnavo bolnika s kronično obstruktivno pljučno boleznijo na primarni in specialistični pulmološki ravni v Sloveniji Zdrav Vest 2017861–265 75 10.6016/ZdravVestn.2471Open DOISearch in Google Scholar

9Maltais F, Decramer M, Casaburi R, Barreiro E, Burelle Y, Debigaré R, et al. An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2014;189(9):e15-62. doi: 10.1164/rccm.201402-0373ST. Maltais F Decramer M Casaburi R Barreiro E Burelle Y Debigaré R et al An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease Am J Respir Crit Care Med 20141899e15 62 10.1164/rccm.201402-0373ST409811224787074Open DOISearch in Google Scholar

10Zamzam MA, Azab NY, El Wahsh RA, Ragab AZ, Allam EM. Quality of life in COPD patients. Egypt J Chest Dis Tuberculosis. 2012;61(4):281–9. doi: 10.1016/j.ejcdt.2012.08.012. Zamzam MA Azab NY El Wahsh RA Ragab AZ Allam EM Quality of life in COPD patients Egypt J Chest Dis Tuberculosis 2012614281 9 10.1016/j.ejcdt.2012.08.012Open DOISearch in Google Scholar

11Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A self-complete measure of health status for chronic airflow limitation: the St. George’s Respiratory Questionnaire. Am Rev Respir Dis. 1992;145(6):1321–7. doi: 10.1164/ajrccm/145.6.1321. Jones PW Quirk FH Baveystock CM Littlejohns P A self-complete measure of health status for chronic airflow limitation: the St George’s Respiratory Questionnaire. Am Rev Respir Dis 199214561321 7 10.1164/ajrccm/145.6.13211595997Open DOISearch in Google Scholar

12Jones PW. Quality of life, symptoms and pulmonary function in asthma: long-term treatment with nedocromil sodium examined in a controlled multicentre trial: Nedocromil Sodium Quality of Life Study Group. Eur Respir J. 1994;7(1):55–2. doi: 10.1183/09031936.94.07010055. Jones PW Quality of life, symptoms and pulmonary function in asthma: long-term treatment with nedocromil sodium examined in a controlled multicentre trial: Nedocromil Sodium Quality of Life Study Group Eur Respir J 19947155 2 10.1183/09031936.94.070100558143833Open DOISearch in Google Scholar

13Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188(8):e13-64. doi: 10.1164/ rccm.201309-1634ST. Spruit MA Singh SJ Garvey C ZuWallack R Nici L Rochester C et al An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation Am J Respir Crit Care Med 20131888e13 64 10.1164/rccm.201309-1634ST24127811Open DOISearch in Google Scholar

14Sievi N, Franzen D, Kohler M, Clarenbach C. Physical inactivity and arterial stiffness in COPD. Int J Chron Obstruct Pulmon Dis. 2015;10:1891-7. doi: 10.2147/COPD.S90943. Sievi N Franzen D Kohler M Clarenbach C Physical inactivity and arterial stiffness in COPD Int J Chron Obstruct Pulmon Dis 2015101891 7 10.2147/COPD.S90943457307826392763Open DOISearch in Google Scholar

15Reis LFF, Guimarães FS, Fernandes SJ, Cantanhede LA, Dias CM, Lopes AJ, et al. A long-term pulmonary rehabilitation program progressively improves exercise tolerance, quality of life and cardiovascular risk factors in patients with COPD. Eur J Phys Rehabil Med. 2013;49(4):491–7. Reis LFF Guimarães FS Fernandes SJ Cantanhede LA Dias CM Lopes AJ et al A long-term pulmonary rehabilitation program progressively improves exercise tolerance, quality of life and cardiovascular risk factors in patients with COPD Eur J Phys Rehabil Med 2013494491–7Search in Google Scholar

16Polverino F, Celli BR, Owen CA. COPD as an endothelial disorder: endothelial injury linking lesions in the lungs and other organs? (2017 Grover Conference Series). Pulm Circ. 2018;8(1):1–18. doi: 10.1177/2045894018758528. Polverino F Celli BR Owen CA COPD as an endothelial disorder: endothelial injury linking lesions in the lungs and other organs? (2017 Grover Conference Series) Pulm Circ 2018811 18 10.1177/2045894018758528582601529468936Open DOISearch in Google Scholar

17Clarenbach CF, Senn O, Sievi NA, Camen G, van Gestel AJR, Rossi VA, et al. Determinants of endothelial function in patients with COPD. Eur Respir J. 2013;42(5):1194–204. doi: 10.1183/09031936.00144612. Clarenbach CF Senn O Sievi NA Camen G van Gestel AJR Rossi VA et al Determinants of endothelial function in patients with COPD Eur Respir J 20134251194 204 10.1183/09031936.0014461223429917Open DOISearch in Google Scholar

18ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111–7. doi: 10.1164/ ajrccm.166.1.at1102. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories ATS statement: guidelines for the six-minute walk test Am J Respir Crit Care Med 20021661111 7 10.1164/ajrccm.166.1.at110212091180Open DOISearch in Google Scholar

19Porszasz J, Emtner M, Goto S, Somfay A, Whipp BJ, Casaburi R. Exercise training decreases ventilatory requirements and exercise-induced hyperinflation at submaximal intensities in patients with COPD. Chest. 2005;128(4):2025–34. doi: 10.1378/chest.128.4.2025. Porszasz J Emtner M Goto S Somfay A Whipp BJ Casaburi R Exercise training decreases ventilatory requirements and exercise-induced hyperinflation at submaximal intensities in patients with COPD Chest 200512842025 34 10.1378/chest.128.4.202516236851Open DOISearch in Google Scholar

20American College of Sports Medicine. General Principles of Exercise Prescription. In: Pescatello LS, Arena R, Riebe D, Thompson PD, editors. ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013: 162-193. American College of Sports Medicine General Principles of Exercise Prescription. In: Pescatello LS, Arena R, Riebe D, Thompson PD, editors. ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed Philadelphia Wolters Kluwer Health/Lippincott Williams & Wilkins 2013 162 193Search in Google Scholar

21Spruit MA, Gosselink R, Troosters T, De Paepe K, Decramer M. Resistance versus endurance training in patients with COPD and peripheral muscle weakness. Eur Respir J. 2002;19(6):1072–8. doi: 10.1183/09031936.02.00287102. Spruit MA Gosselink R Troosters T De Paepe K Decramer M Resistance versus endurance training in patients with COPD and peripheral muscle weakness Eur Respir J 20021961072 8 10.1183/09031936.02.0028710212108859Open DOISearch in Google Scholar

22Garvey C, Bayles MP, Hamm LF, Hill K, Holland A, Limberg TM, et al. Pulmonary rehabilitation exercise prescription in chronic obstructive pulmonary disease: review of selected guidelines: an official statement from the American Association of Cardiovascular and Pulmonary Rehabilitation. J Cardiopulm Rehabil Prev. 2016;36(2):75–83. doi: 10.1097/HCR.0000000000000171. Garvey C Bayles MP Hamm LF Hill K Holland A Limberg TM et al Pulmonary rehabilitation exercise prescription in chronic obstructive pulmonary disease: review of selected guidelines: an official statement from the American Association of Cardiovascular and Pulmonary Rehabilitation J Cardiopulm Rehabil Prev 201636275–83 10.1097/HCR.000000000000017126906147Open DOISearch in Google Scholar

23Mänttäri A, Suni J, Sievänen H, Husu P, Vähä-Ypyä H, Valkeinen H, et al. Six-minute walk test: a tool for predicting maximal aerobic power (VO 2 max) in healthy adults. Clin Physiol Funct Imaging. 2018;38(6):1038–45. doi: 10.1111/cpf.12525. Mänttäri A Suni J Sievänen H Husu P Vähä-Ypyä H Valkeinen H et al Six-minute walk test: a tool for predicting maximal aerobic power (VO 2 max) in healthy adults Clin Physiol Funct Imaging 20183861038 45 10.1111/cpf.1252529851229Open DOISearch in Google Scholar

24Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1428–46. doi: 10.1183/09031936.00150314. Holland AE Spruit MA Troosters T Puhan MA Pepin V Saey D et al An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease Eur Respir J 20144461428 46 10.1183/09031936.0015031425359355Open DOISearch in Google Scholar

25Malamud AL, Ricard PEH. Feasibility of the six-minute walk test for patients who have cystic fibrosis, are ambulatory, and require mechanical ventilation before lung transplantation. Phys Ther. 2016;96(9):1468–76. doi: 10.2522/ptj.20150235. Malamud AL Ricard PEH Feasibility of the six-minute walk test for patients who have cystic fibrosis, are ambulatory, and require mechanical ventilation before lung transplantation Phys Ther 20169691468 76 10.2522/ptj.2015023526916926Open DOISearch in Google Scholar

26Seoane L, Alex S, Pirtle C, Gupta M, Taylor DE, Valentine VG, et al. Utility of the 6-minute walk test following lung transplantation. Ochsner J. 2010;10(4):227–30. Seoane L Alex S Pirtle C Gupta M Taylor DE Valentine VG et al Utility of the 6-minute walk test following lung transplantation Ochsner J 2010104227 30Search in Google Scholar

27Brooks D, Solway S, Weinacht K, Wang D, Thomas S. Comparison between an indoor and an outdoor 6-minute walk test among individuals with chronic obstructive pulmonary. Arch Phys Med Rehabil. 2003;84(6):873–6. doi: 10.1016/S0003-9993(03)00011-X. Brooks D Solway S Weinacht K Wang D Thomas S Comparison between an indoor and an outdoor 6-minute walk test among individuals with chronic obstructive pulmonary Arch Phys Med Rehabil 2003846873 6 10.1016/S0003-9993(03)00011-XOpen DOISearch in Google Scholar

28Valeiro B, Hernández C, Barberán-Garcia A, Rodríguez DA, Aibar J, Llop L, et al. Viabilidad de la evaluación domiciliaria del estado funcional de pacientes con enfermedad pulmonar obstructiva crónica en fase de recuperación de una exacerbación. Arch Bronconeumolog. 2016;52(5):256–61. doi: 10.1016/j.arbres.2015.10.010. Valeiro B Hernández C Barberán-Garcia A Rodríguez DA Aibar J Llop L et al Viabilidad de la evaluación domiciliaria del estado funcional de pacientes con enfermedad pulmonar obstructiva crónica en fase de recuperación de una exacerbación Arch Bronconeumolog 2016525256 61 10.1016/j.arbres.2015.10.010Open DOISearch in Google Scholar

29Physiotherapy Evidence Database. PEDro scale. Accessed February 15, 2021 at: https://staging-pedro.neura.edu.au/english/resources/pedro-scale/ Physiotherapy Evidence Database PEDro scale. Accessed February 15 2021 at https://staging-pedro.neura.edu.au/english/resources/pedro-scale/Search in Google Scholar

30de Morton NA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother. 2009;55(2):129–33. doi: 10.1016/S0004-9514(09)70043-1. de Morton NA The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study Aust J Physiother 2009552129 33 10.1016/S0004-9514(09)70043-1Open DOISearch in Google Scholar

31Cashin AG, McAuley JH. Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale. J Physiother. 2020;66(1):59. doi: 10.1016/j. jphys.2019.08.005. Cashin AG McAuley JH Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale J Physiother 202066159 10.1016/j.jphys.2019.08.00531521549Open DOISearch in Google Scholar

32Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687–8. doi: 10.1136/bmj.g1687. Hoffmann TC Glasziou PP Boutron I Milne R Perera R Moher D et al Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide BMJ 2014348g1687 8 10.1136/bmj.g168724609605Open DOISearch in Google Scholar

33Austin TM, Richter RR, Sebelski CA. Introduction to the GRADE approach for guideline development: considerations for physical therapist practice. Phys Ther. 2014;94(11):1652–9. doi: 10.2522/ ptj.20130627. Austin TM Richter RR Sebelski CA Introduction to the GRADE approach for guideline development: considerations for physical therapist practice Phys Ther 201494111652 9 10.2522/ptj.2013062725035268Open DOISearch in Google Scholar

34GRADEpro GDT: GRADEpro guideline development tool. McMaster University and Evidence Prime, 2022. Accessed August 30th, 2021 at: https://gdt.gradepro.org/app/ GRADEpro GDT: GRADEpro guideline development tool McMaster University and Evidence Prime 2022 Accessed August 30th, 2021 at https://gdt.gradepro.org/app/Search in Google Scholar

35Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–60. doi: 10.1136/bmj.327.7414.557. Higgins JPT Thompson SG Deeks JJ Altman DG Measuring inconsistency in meta-analyses BMJ 20033277414557 60 10.1136/bmj.327.7414.55719285912958120Open DOISearch in Google Scholar

36Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Statist Med. 2002;21(11):1539–58. doi: 10.1002/sim.1186. Higgins JPT Thompson SG Quantifying heterogeneity in a meta-analysis Statist Med 200221111539 58 10.1002/sim.118612111919Open DOISearch in Google Scholar

37Farias CC, Resqueti V, Dias FAL, Borghi-Silva A, Arena R, Fregonezi GAF. Costs and benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease: a randomized controlled trial. Braz J Phys Ther. 2014;18(2):165–73. doi: 10.1590/s1413-35552012005000151. Farias CC Resqueti V Dias FAL Borghi-Silva A Arena R Fregonezi GAF Costs and benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease: a randomized controlled trial Braz J Phys Ther 2014182165 73 10.1590/s1413-35552012005000151418325324838809Open DOISearch in Google Scholar

38Hospes G, Bossenbroek L, Ten Hacken NHT, van Hengel P, de Greef MHG. Enhancement of daily physical activity increases physical fitness of outclinic COPD patients: results of an exercise counseling program. Patient Educ Couns. 2009;75(2):274–8. 10.1016/j.pec.2008.10.005 Hospes G Bossenbroek L Ten Hacken NHT van Hengel P de Greef MHG Enhancement of daily physical activity increases physical fitness of outclinic COPD patients: results of an exercise counseling program Patient Educ Couns 2009752274 8 10.1016/j.pec.2008.10.00510.1016/j.pec.2008.10.00519036552Search in Google Scholar

39Lahham A, McDonald CF, Moore R, Cox NS, Rawlings S, Nichols A, et al. The impact of home-based pulmonary rehabilitation on people with mild chronic obstructive pulmonary disease: a randomised controlled trial. Clin Respir J. 2020;14(4):335–44. doi: 10.1111/crj.13138. Lahham A McDonald CF Moore R Cox NS Rawlings S Nichols A et al The impact of home-based pulmonary rehabilitation on people with mild chronic obstructive pulmonary disease: a randomised controlled trial Clin Respir J 2020144335 44 10.1111/crj.1313831880078Open DOISearch in Google Scholar

40Li Y, Feng J, Li Y, Jia W, Qian H. A new pulmonary rehabilitation maintenance strategy through home-visiting and phone contact in COPD. Patient Prefer Adherence. 2018;12:97–104. doi: 10.2147/PPA. S150679. Li Y Feng J Li Y Jia W Qian H A new pulmonary rehabilitation maintenance strategy through home-visiting and phone contact in COPD Patient Prefer Adherence 20181297 104 10.2147/PPA.S150679576818529391781Open DOISearch in Google Scholar

41Pradella CO, Belmonte GM, Maia MN, Delgado CS, Luise APT, Nascimento OA, et al. Home-based pulmonary rehabilitation for subjects with COPD: a randomized study. Respir Care. 2015;60(4):526–32. doi: 10.4187/respcare.02994. Pradella CO Belmonte GM Maia MN Delgado CS Luise APT Nascimento OA et al Home-based pulmonary rehabilitation for subjects with COPD: a randomized study Respir Care 2015604526–32 10.4187/respcare.0299425269680Open DOISearch in Google Scholar

42Tsai LLY, McNamara RJ, Moddel C, Alison JA, McKenzie DK, McKeough ZJ. Home-based telerehabilitation via real-time videoconferencing improves endurance exercise capacity in patients with COPD: the randomized controlled TeleR study. Respirology. 2017;22(4):699–707. doi: 10.1111/resp.12966. Tsai LLY McNamara RJ Moddel C Alison JA McKenzie DK McKeough ZJ Home-based telerehabilitation via real-time videoconferencing improves endurance exercise capacity in patients with COPD: the randomized controlled TeleR study Respirology 2017224699 707 10.1111/resp.1296627992099Open DOISearch in Google Scholar

43Wijkstra PJ, van der Mark TW, Kraan J, van Altena R, Koeter GH, Postma DS. Effects of home rehabilitation on physical performance in patients with chronic obstructive pulmonary disease (COPD). Eur Respir J. 1996;9(1):104–10. doi: 10.1183/09031936.96.09010104. Wijkstra PJ van der Mark TW Kraan J van Altena R Koeter GH Postma DS Effects of home rehabilitation on physical performance in patients with chronic obstructive pulmonary disease (COPD) Eur Respir J 199691104 10 10.1183/09031936.96.090101048834342Open DOISearch in Google Scholar

44Xi F, Wang Z, Qi Y, Brightwell R, Roberts P, Stewart A, et al. Longterm effect of respiratory training for chronic obstructive pulmonary disease patients at an outpatient clinic: a randomised controlled trial. Clin Transl Med. 2015;4(1):31. doi: 10.1186/s40169-015-0073-2. Xi F Wang Z Qi Y Brightwell R Roberts P Stewart A et al Longterm effect of respiratory training for chronic obstructive pulmonary disease patients at an outpatient clinic: a randomised controlled trial Clin Transl Med 20154131 10.1186/s40169-015-0073-2460202026458936Open DOISearch in Google Scholar

45Yekefallah L, Zohal MA, Keshavarzsarkar O, Barikani A, Gheraati M. Comparing the effects of upper limb and breathing exercises on six-minute walking distance among patients with chronic obstructive pulmonary disease: a three-group randomized controlled clinical trial. Adv Respir Med. 2019;87(2):77–82. doi: 10.5603/ARM.2019.0013. Yekefallah L Zohal MA Keshavarzsarkar O Barikani A Gheraati M Comparing the effects of upper limb and breathing exercises on six-minute walking distance among patients with chronic obstructive pulmonary disease: a three-group randomized controlled clinical trial Adv Respir Med 201987277 82 10.5603/ARM.2019.001331038717Open DOISearch in Google Scholar

46Breyer M-K, Breyer-Kohansal R, Funk G-C, Dornhofer N, Spruit MA, Wouters EFM, et al. Nordic walking improves daily physical activities in COPD: a randomised controlled trial. Respir Res. 2010;11:112. doi: 10.1186/1465-9921-11-112. Breyer M-K Breyer-Kohansal R Funk G-C Dornhofer N Spruit MA Wouters EFM et al Nordic walking improves daily physical activities in COPD: a randomised controlled trial Respir Res 201011112 10.1186/1465-9921-11-112293368320727209Open DOISearch in Google Scholar

47Finnerty JP, Keeping I, Bullough I, Jones J. The effectiveness of outpatient pulmonary rehabilitation in chronic lung disease: a randomized controlled trial. Chest. 2001;119(6):1705–10. doi: 10.1378/ chest.119.6.1705. Finnerty JP Keeping I Bullough I Jones J The effectiveness of outpatient pulmonary rehabilitation in chronic lung disease: a randomized controlled trial Chest 200111961705 10 10.1378/chest.119.6.170511399694Open DOISearch in Google Scholar

48Gallo-Silva B, Cerezer-Silva V, Ferreira DG, Sakabe DI, Kel-Souza LD, Bertholo VC, et al. Effects of water-based aerobic interval training in patients with COPD: a randomized controlled trial. J Cardiopulm Rehabil Prev. 2019;39(2):105–11. doi: 10.1097/HCR.0000000000000352. Gallo-Silva B Cerezer-Silva V Ferreira DG Sakabe DI Kel-Souza LD Bertholo VC et al Effects of water-based aerobic interval training in patients with COPD: a randomized controlled trial J Cardiopulm Rehabil Prev 2019392105 11 10.1097/HCR.000000000000035230720640Open DOISearch in Google Scholar

49Gottlieb V, Lyngsø AM, Nybo B, Frølich A, Backer V. Pulmonary rehabilitation for moderate COPD (GOLD 2) - does it have an effect? COPD. 2011;8(5):380–6. doi: 10.3109/15412555.2011.610393. Gottlieb V Lyngsø AM Nybo B Frølich A Backer V Pulmonary rehabilitation for moderate COPD (GOLD 2) - does it have an effect? COPD 201185380 6 10.3109/15412555.2011.61039321936683Open DOISearch in Google Scholar

50McNamara RJ, McKeough ZJ, McKenzie DK, Alison JA. Water-based exercise in COPD with physical comorbidities: a randomised controlled trial. Eur Respir J. 2013;41(6):1284–91. doi: 10.1183/09031936.00034312. McNamara RJ McKeough ZJ McKenzie DK Alison JA Water-based exercise in COPD with physical comorbidities: a randomised controlled trial Eur Respir J 20134161284 91 10.1183/09031936.0003431222997217Open DOISearch in Google Scholar

51Ringbaek TJ, Broendum E, Hemmingsen L, Lybeck K, Nielsen D, Andersen C, et al. Rehabilitation of patients with chronic obstructive pulmonary disease: exercise twice a week is not sufficient! Respir Med. 2000;94(2):150–4. doi: 10.1053/rmed.1999.0704. Ringbaek TJ Broendum E Hemmingsen L Lybeck K Nielsen D Andersen C et al Rehabilitation of patients with chronic obstructive pulmonary disease: exercise twice a week is not sufficient! Respir Med 2000942150 4 10.1053/rmed.1999.070410714421Open DOISearch in Google Scholar

52Román M, Larraz C, Gómez A, Ripoll J, Mir I, Miranda EZ, et al. Efficacy of pulmonary rehabilitation in patients with moderate chronic obstructive pulmonary disease: a randomized controlled trial. BMC Fam Pract. 2013;14:21. doi: 10.1186/1471-2296-14-21. Román M Larraz C Gómez A Ripoll J Mir I Miranda EZ et al Efficacy of pulmonary rehabilitation in patients with moderate chronic obstructive pulmonary disease: a randomized controlled trial BMC Fam Pract 20131421 10.1186/1471-2296-14-21357746823399113Open DOISearch in Google Scholar

53Wadell K, Webb KA, Preston ME, Amornputtisathaporn N, Samis L, Patelli J, et al. Impact of pulmonary rehabilitation on the major dimensions of dyspnea in COPD. COPD. 2013;10(4):425–35. doi: 10.3109/15412555.2012.758696. Wadell K Webb KA Preston ME Amornputtisathaporn N Samis L Patelli J et al Impact of pulmonary rehabilitation on the major dimensions of dyspnea in COPD COPD 2013104425 35 10.3109/15412555.2012.75869623537344Open DOISearch in Google Scholar

54Yudhawati R, Rasjid Hs M. Effect of yoga on FEV1, 6-minute walk distance (6-MWD) and quality of life in patients with COPD group B. Adv Respir Med. 2019;87(5):261–8. doi: 10.5603/ARM.2019.0047. Yudhawati R Rasjid Hs M Effect of yoga on FEV1, 6-minute walk distance (6-MWD) and quality of life in patients with COPD group B Adv Respir Med 2019875261 8 10.5603/ARM.2019.004731680225Open DOISearch in Google Scholar

55Zhu S, Shi K, Yan J, He Z, Wang Y, Yi Q, et al. A modified 6-form Tai Chi for patients with COPD. Complement Ther Med. 2018;39:36–42. doi: 10.1016/j.ctim.2018.05.007. Zhu S Shi K Yan J He Z Wang Y Yi Q et al A modified 6-form Tai Chi for patients with COPD Complement Ther Med 20183936 42 10.1016/j.ctim.2018.05.00730012390Open DOISearch in Google Scholar

56Kessler R, Faller M, Fourgaut G, Mennecier B, Weitzenblum E. Predictive factors of hospitalization for acute exacerbation in a series of 64 patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999;159(1):158–64. doi: 10.1164/ajrccm.159.1.9803117. Kessler R Faller M Fourgaut G Mennecier B Weitzenblum E Predictive factors of hospitalization for acute exacerbation in a series of 64 patients with chronic obstructive pulmonary disease Am J Respir Crit Care Med 19991591158 64 10.1164/ajrccm.159.1.98031179872834Open DOISearch in Google Scholar

57Holland AE, Nici L. The return of the minimum clinically important difference for 6-minute-walk distance in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2013;187(4):335–6. doi: 10.1164/rccm.201212-2191ED. Holland AE Nici L The return of the minimum clinically important difference for 6-minute-walk distance in chronic obstructive pulmonary disease Am J Respir Crit Care Med 20131874335 6 10.1164/rccm.201212-2191ED23418323Open DOISearch in Google Scholar

58Santiworakul A, Piya-amornphan N, Jianramas N. A home-based multimedia pulmonary rehabilitation program improves clinical symptoms and physical performance of patients with chronic obstructive pulmonary disease. Int J Environ Res Public Health. 2021;18(21):11479. doi: 10.3390/ijerph182111479. Santiworakul A Piya-amornphan N Jianramas N A home-based multimedia pulmonary rehabilitation program improves clinical symptoms and physical performance of patients with chronic obstructive pulmonary disease Int J Environ Res Public Health 2021182111479 10.3390/ijerph182111479858279034769994Open DOISearch in Google Scholar

59de Souza Y, da Silva KM, Condesso D, Figueira B, Noronha Filho AJ, Rufino R, et al. Use of a home-based manual as part of a pulmonary rehabilitation program. Respir Care. 2018;63(12):1485–91. doi: 10.4187/ respcare.05656. de Souza Y da Silva KM Condesso D Figueira B Noronha Filho AJ Rufino R et al Use of a home-based manual as part of a pulmonary rehabilitation program Respir Care 201863121485 91 10.4187/respcare.0565630087196Open DOISearch in Google Scholar

60Imamura S, Inagaki T, Terada J, Nagashima K, Katsura H, Tatsumi K. Long-term efficacy of pulmonary rehabilitation with home-based or low frequent maintenance programs in patients with chronic obstructive pulmonary disease: a meta-analysis. 2020;9(5):2606–15. doi: doi: 10.21037/apm-19-581. Imamura S Inagaki T Terada J Nagashima K Katsura H Tatsumi K Long-term efficacy of pulmonary rehabilitation with home-based or low frequent maintenance programs in patients with chronic obstructive pulmonary disease a meta-analysis 2020952606 15 10.21037/apm-19-58132819118Open DOISearch in Google Scholar

61Gallefoss F, Bakke PS, Rsgaard PK. Quality of life assessment after patient education in a randomized controlled study on asthma and chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999;159(3):812–7. doi: 10.1164/ajrccm.159.3.9804047. Gallefoss F Bakke PS Rsgaard PK Quality of life assessment after patient education in a randomized controlled study on asthma and chronic obstructive pulmonary disease Am J Respir Crit Care Med 19991593812 7 10.1164/ajrccm.159.3.980404710051255Open DOISearch in Google Scholar

62Dong J, Li Z, Luo L, Xie H. Efficacy of pulmonary rehabilitation in improving the quality of life for patients with chronic obstructive pulmonary disease: evidence based on nineteen randomized controlled trials. Int J Surg. 2020;73:78–86. doi: 10.1016/j.ijsu.2019.11.033. Dong J Li Z Luo L Xie H Efficacy of pulmonary rehabilitation in improving the quality of life for patients with chronic obstructive pulmonary disease: evidence based on nineteen randomized controlled trials Int J Surg 20207378 86 10.1016/j.ijsu.2019.11.03331843677Open DOISearch in Google Scholar

63Rugbjerg M, Iepsen UW, Jørgensen KJ, Lange P. Effectiveness of pulmonary rehabilitation in COPD with mild symptoms: a systematic review with meta-analyses. Int J Chron Obstruct Pulmon Dis. 2015;10:791–801. doi: 10.2147/COPD.S78607. Rugbjerg M Iepsen UW Jørgensen KJ Lange P Effectiveness of pulmonary rehabilitation in COPD with mild symptoms: a systematic review with meta-analyses Int J Chron Obstruct Pulmon Dis 201510791 801 10.2147/COPD.S78607440774025945044Open DOISearch in Google Scholar

64Wu W, Liu X, Wang L, Wang Z, hu jun, Yan J. Effects of Tai Chi on exercise capacity and health-related quality of life in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. COPD. 2014;1253. doi: 10.2147/COPD.S70862. Wu W Liu X Wang L Wang Z hu jun Yan J Effects of Tai Chi on exercise capacity and health-related quality of life in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis COPD 20141253 10.2147/COPD.S70862423017125404855Open DOISearch in Google Scholar

65Jackson D, Turner R. Power analysis for random-effects meta-analysis: power analysis for meta-analysis. Res Syn Meth. 2017;8(3):290–302. doi: 10.1002/jrsm.1240. Jackson D Turner R Power analysis for random-effects meta-analysis: power analysis for meta-analysis Res Syn Meth 201783290 302 10.1002/jrsm.1240559073028378395Open DOISearch in Google Scholar