Abstract：
OBJECTIVE: In people with chronic obstructive pulmonary disease (COPD) who complete an exercise training program (ETP) offered at a sufficient dose to result in training-related gains, to what extent are these gains maintained 12 months after program completion? Do variables such as the application of behaviour change techniques moderate the maintenance of these training-related gains?
METHODS: Systematic review, meta-analysis and meta-regression of randomised controlled trials.
METHODS: People with stable COPD.
METHODS: Trials were included if they applied ≥ 4 weeks of a whole-body ETP and reported outcome data immediately following program completion and 12 months after initial program completion. The control group received usual care that did not include a formal exercise training component.
METHODS: Exercise tolerance, health-related quality of life and dyspnoea during activities of daily living.
METHODS: EMBASE, PEDro, PubMed and the Cochrane Library.
RESULTS: Nineteen randomised trials with 2,103 participants were found, of which 12 had a sufficiently similar design to be meta-analysed. At 12 months after ETP completion, compared with the control group, the experimental group demonstrated better exercise tolerance (SMD 0.48, 95% CI 0.19 to 0.77) and quality of life (SMD 0.22, 95% CI 0.03 to 0.41) with no clear effect on dyspnoea. Meta-regression using data from all 19 trials demonstrated that the magnitude of between-group differences at the 12-month follow-up was moderated by: behaviour change being a core aim of the strategies implemented following completion of the ETP; the experimental group receiving more behaviour change techniques during the program; and the magnitude of between-group change achieved from the program.
CONCLUSIONS: At 12 months after completion of an ETP of ≥ 4 weeks, small gains were maintained in exercise tolerance and health-related quality of life. Applying behaviour change techniques with a clear focus on participants integrating exercise into daily life beyond initial program completion is important to maintain training-related gains.
BACKGROUND: CRD42020193833.
METHODS: Systematic review, meta-analysis and meta-regression of randomised controlled trials.
METHODS: People with stable COPD.
METHODS: Trials were included if they applied ≥ 4 weeks of a whole-body ETP and reported outcome data immediately following program completion and 12 months after initial program completion. The control group received usual care that did not include a formal exercise training component.
METHODS: Exercise tolerance, health-related quality of life and dyspnoea during activities of daily living.
METHODS: EMBASE, PEDro, PubMed and the Cochrane Library.
RESULTS: Nineteen randomised trials with 2,103 participants were found, of which 12 had a sufficiently similar design to be meta-analysed. At 12 months after ETP completion, compared with the control group, the experimental group demonstrated better exercise tolerance (SMD 0.48, 95% CI 0.19 to 0.77) and quality of life (SMD 0.22, 95% CI 0.03 to 0.41) with no clear effect on dyspnoea. Meta-regression using data from all 19 trials demonstrated that the magnitude of between-group differences at the 12-month follow-up was moderated by: behaviour change being a core aim of the strategies implemented following completion of the ETP; the experimental group receiving more behaviour change techniques during the program; and the magnitude of between-group change achieved from the program.
CONCLUSIONS: At 12 months after completion of an ETP of ≥ 4 weeks, small gains were maintained in exercise tolerance and health-related quality of life. Applying behaviour change techniques with a clear focus on participants integrating exercise into daily life beyond initial program completion is important to maintain training-related gains.
BACKGROUND: CRD42020193833.
摘要：
目的：在慢性阻塞性肺疾病（COPD）患者中，完成了足够剂量的运动训练计划（ETP），以获得与训练相关的收益，这些收益在项目完成后12个月维持到什么程度？诸如行为改变技术的应用等变量是否会缓和这些与训练相关的收益的维持？
方法：系统评价，随机对照试验的荟萃分析和荟萃回归。
方法：COPD稳定期患者。
方法：如果应用≥4周的全身ETP，并在项目完成后和初始项目完成后12个月立即报告结果数据，则纳入试验。对照组接受常规护理，但不包括正式的运动训练。
方法：运动耐量，日常生活活动中与健康相关的生活质量和呼吸困难。
方法：EMBASE，PEDro,PubMed和Cochrane图书馆。
结果：发现了19项随机试验，共有2,103名参与者，其中12个具有足够相似的设计，可以进行荟萃分析。ETP完成后12个月，与对照组相比，实验组表现出更好的运动耐量(SMD0.48,95%CI0.19~0.77)和生活质量(SMD0.22,95%CI0.03~0.41),对呼吸困难无明显影响.使用来自所有19项试验的数据进行的荟萃回归表明，在12个月的随访中，组间差异的幅度受到以下因素的调节：行为改变是ETP完成后实施策略的核心目标；实验组在程序中接受更多的行为改变技术；以及从程序中获得的组间变化的幅度。
结论：在完成≥4周的ETP后12个月，在运动耐量和与健康相关的生活质量方面,我们保持了微小的进步.应用行为改变技术，明确关注参与者将锻炼纳入日常生活，而不是最初的计划完成，这对于保持与培训相关的收益很重要。
背景：CRD42020193833.
方法：系统评价，随机对照试验的荟萃分析和荟萃回归。
方法：COPD稳定期患者。
方法：如果应用≥4周的全身ETP，并在项目完成后和初始项目完成后12个月立即报告结果数据，则纳入试验。对照组接受常规护理，但不包括正式的运动训练。
方法：运动耐量，日常生活活动中与健康相关的生活质量和呼吸困难。
方法：EMBASE，PEDro,PubMed和Cochrane图书馆。
结果：发现了19项随机试验，共有2,103名参与者，其中12个具有足够相似的设计，可以进行荟萃分析。ETP完成后12个月，与对照组相比，实验组表现出更好的运动耐量(SMD0.48,95%CI0.19~0.77)和生活质量(SMD0.22,95%CI0.03~0.41),对呼吸困难无明显影响.使用来自所有19项试验的数据进行的荟萃回归表明，在12个月的随访中，组间差异的幅度受到以下因素的调节：行为改变是ETP完成后实施策略的核心目标；实验组在程序中接受更多的行为改变技术；以及从程序中获得的组间变化的幅度。
结论：在完成≥4周的ETP后12个月，在运动耐量和与健康相关的生活质量方面,我们保持了微小的进步.应用行为改变技术，明确关注参与者将锻炼纳入日常生活，而不是最初的计划完成，这对于保持与培训相关的收益很重要。
背景：CRD42020193833.
