肺部復健後持續運動對慢性阻塞性肺疾病患之成效

Effect of Maintenance Exercise after Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

本研究目的乃透過系統性文獻回顧，搜尋並評價慢性阻塞性肺疾病患於肺部復健訓練後，持續執行運動方案的成效，提供臨床運用與研發參考。以「肺部復健後（after pulmonary rehabilitation or post pulmonary rehabilitation）」、「持續運動（exercise maintenance）」、「慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD）」等關鍵字，檢索七個資料庫，並經由引用文獻擴大搜尋範圍，查詢2016年9月前之文獻。共獲得153篇，最終篩選出6篇符合標準的RCT進入CONSORT評讀與文獻資料分析。肺部復健後持續運動有助於COPD病患於肺部復健後維持運動耐力及生活品質。接受監督式運動，未必比持續居家自主運動或中斷運動，獲得較佳的效益。肺部復健計畫後每天持續居家自主步行，可提升運動耐力及生活品質，可做為健康照護團隊於肺部復健後推廣持續運動之依據。

In this study, a systematic review was conducted to evaluate the effects of exercise maintenance programs on the exercise capacity, health-related quality of life, and lung function after a pulmonary rehabilitation program in patients with chronic obstructive pulmonary disease (COPD). This study is expected to be used as a reference for clinical application and future research. A comprehensive search was conducted on seven English and Chinese databases to identify randomized control trials (RCTs) published up to September 2016. A total of 153 articles that matched the search criteria were extracted. The key words used included ＂post pulmonary rehabilitation,＂ ＂after pulmonary rehabilitation,＂ ＂exercise maintenance,＂ ＂chronic obstructive pulmonary disease,＂ and ＂COPD.＂ Six articles were included after the screening inclusion and exclusion criteria, and were assessed the reporting quality of trials according to the CONSORT (consolidating standards of reporting trials) guideline and further analyzed. This systematic review shows that the maintenance exercise after pulmonary rehabilitation (MEAPR) improved the exercise tolerance and health-related quality of life of the COPD patients. Compared with self-monitored home-based exercise training or stop exercising after pulmonary rehabilitation, supervised exercise does not achieve more benefits. Home-based exercise maintenance program after pulmonary rehabilitation can improve COPD patients' exercise tolerance and quality of life, and can be extended to nursing practice in accordance with the results of this review.