肺移植候选人的身体虚弱康复:系统性审查
Laura McGarrigle1, Gill Norman2,3, Helen Hurst4,5
1Department of Cardiothoracic Transplantation, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Cardiopulmonary physical therapy journal
|July 4, 2025
概括
运动可以改善肺移植候选人的身体脆弱性标记. 然而,证据因确定性低而受限,需要高质量的试验才能得出关于预康复有效性的最终结论.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 运动科学 运动科学
背景情况:
- 肺移植 (LTx) 候选人的身体虚弱是常见的,与手术前后不良结果有关.
- 众所周知,运动干预可以改善LTx候选人的运动能力和生活质量.
- 运动对这一群体体体力衰弱的具体影响仍然在很大程度上未被探索.
研究的目的:
- 系统地审查现有的关于成人肺移植候选人身体虚弱的运动干预措施的文献.
- 评估各种运动方式对身体虚弱度的措施和替代标记物的影响.
- 评估证据的质量,并确定未来研究的差距.
主要方法:
- 根据一个注册的协议 (PROSPERO CRD42022363730) 进行了系统审查.
- 从1980年到2024年2月,搜索了四个数据库和试验注册表,寻找在等待LTx.的成年人运动研究的研究.
- 使用NIH工具评估研究质量,使用GRADE评估证据确定性,重点关注身体脆弱性结果.
主要成果:
- 纳入了15项涉及664名患者的研究,这些研究使用了肺部康复,家庭炼和远程康复.
- 干预包括有氧,抵抗,平衡和呼吸练习.
- 虽然一些替代脆弱性标志物 (例如,短物理性能电池,5倍的坐站,力量) 显示出改善,但研究质量相当差,由于偏见和不准确性,证据的确定性低至非常低.
结论:
- 运动训练显示出改变肺移植候选人的身体虚弱的替代标志物的潜力.
- 目前的证据受到低确定性,异质性和不受控制的设计的限制.
- 高质量的随机对照试验对于确认有效性和为LTx.的预康复指南提供信息至关重要.
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