PDF(Pubmed)
Abstract：
Background: Poor cardiorespiratory fitness poses the highest risk of mortality. Long-COVID-19 survivors exhibit a reduced cardiorespiratory fitness (CRF). While exercise rehabilitation, such as cardiopulmonary exercise, is used for long-COVID-19 survivors, the effects of exercise on CRF in this population remain inconclusive. In this study, we aim to systematically summarise and synthesise whether exercise rehabilitation improves CRF among long-COVID-19 survivors. Methods: A comprehensive search was performed through PubMed, CINAHL, Embase, Scopus, and the Cochrane Library (since their inception to November 2023) and study reference lists. Studies presenting the effects of exercise rehabilitation on CRF (peak oxygen consumption (VO2peak) and six-minute walk distance (6MWD)) in long-COVID-19 survivors were identified. The standardised mean difference (SMD), mean difference (MD), and 95% confidence interval (CI) were used for analyses. The certainty of evidence was measured using a Grading of Recommendation Assessment, Development and Evaluation approach. Results: Twelve eligible studies (five RCTs and seven non-RCTs) with 682 participants were analysed. The meta-analysis showed significantly improved 6MWDs (MD 76.47, 95% CI 59.19-93.71, low certainty) and significantly greater 6MWDs (SMD 0.85, 95% CI 0.11-1.59, very low certainty) in the exercise rehabilitation group compared to the control group. A significantly improved 6MWD was found in subgroups of young to middle-aged adults and subgroups of patients who undertook aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. Conclusions: Exercise rehabilitation is effective for improving CRF, as measured by the 6MWD in long-COVID-19 survivors. Improvements are likely to be more pronounced in specific subgroups of young to middle-aged adults and patients undertaking aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. However, recommendations for clinical practice are limited due to the very low evidence certainty.
摘要：
背景：不良的心肺健康构成最高的死亡风险。长期COVID-19幸存者表现出降低的心肺健康(CRF)。运动康复的同时,比如心肺运动，用于长期COVID-19幸存者，在该人群中,运动对CRF的影响尚无定论.在这项研究中,我们旨在系统地总结和综合运动康复是否能改善长期COVID-19幸存者的CRF。方法：通过PubMed进行全面搜索，CINAHL,Embase,Scopus,和Cochrane图书馆（自成立以来至2023年11月）和研究参考清单。研究表明，运动康复对长COVID-19幸存者的CRF（峰值耗氧量（VO2peak）和六分钟步行距离（6MWD））的影响。标准化平均差(SMD)，平均差(MD)，和95%置信区间(CI)用于分析。证据的确定性是使用推荐等级评估来衡量的，开发和评估方法。结果：分析了12项符合条件的研究（5项RCT和7项非RCT），共682名参与者。荟萃分析显示，与对照组相比，运动康复组的6MWDs（MD76.47，95％CI59.19-93.71，低确定性）和6MWDs（SMD0.85，95％CI0.11-1.59，非常低的确定性）显着提高。在进行有氧运动结合阻力和呼吸运动以及基于中心的训练计划的中青年成人亚组和患者亚组中，6MWD得到了显着改善。结论:运动康复对提高CRF有较好的疗效,通过长型COVID-19幸存者的6MWD测量。在年轻人到中年人的特定亚组以及进行有氧运动结合阻力和呼吸运动以及基于中心的训练计划的患者中，改善可能更为明显。然而,由于证据确定性很低，临床实践的建议有限。
