平衡训练对慢性阻塞性肺疾病患者影响的荟萃分析

Effect of balance training on patients with chronic obstructive pulmonary disease:a systematic review and Meta-analysis

目的分析评价平衡训练对慢性阻塞性肺疾病(简称慢阻肺)患者的影响。方法检索PubMed、Embase、Web of science、The Cochrane Library、中国知网、万方、维普和中国生物医学文献数据库中关于平衡训练对慢阻肺患者影响的随机对照试验。检索时间为从建库至2022年11月20日。采用RevMan5.3对慢阻肺患者平衡能力、运动能力、生活质量及平衡信心进行荟萃分析。结果共纳入7篇文献,共计432例患者。荟萃分析结果显示,与其他训练相比,平衡训练可以改善患者的平衡能力[起立-行走计时测验:均数差(MD)=-2.19,95%CI:-2.86~-1.52;P<0.001;Berg平衡量表:MD=4.02,95%CI:0.78~7.27;P=0.020;平衡评估系统测试:MD=7.83,95%CI:0.13~15.52;P=0.050]、运动能力[6 min步行测试:标准化均数差(SMD)=0.21,95%CI:0.01~0.40;P=0.040]和生活质量(慢阻肺评估测试及圣乔治呼吸问卷:SMD=-0.54,95%CI:-1.08~-0.01;P=0.050),但未有效增强患者的活动平衡信心(活动平衡信心量表:MD=9.34,95%CI:-0.98~19.66;P=0.080)。结论平衡训练可以改善慢阻肺患者的平衡能力、运动能力及生活质量,但是对患者的活动平衡信心的影响需要进一步的验证。

Objective To analyze and evaluate the impact of balance training on patients with chronic obstructive pulmonary disease(COPD).Methods The randomized controlled trials of balance training in COPD patients in PubMed,Embase,Web of science,the Cochrane Library,CNKI,Wanfang,VIP,and Chinese Biomedical Literature Database were searched.The retrieval time was from the establishment of the database to November 20,2022.A Meta-analysis was conducted using RevMan5.3 on balance ability,exercise ability,quality of life,and balance confidence in patients with COPD.Results A total of 432 patients were included in 7 studies.The results of the Meta-analysis showed that compared with other training,balanced training could improve the balance ability of patients[Timed Up and Go Test:mean difference(MD)=-2.19,95%CI(-2.86,-1.52);P<0.001,Berg Balance Scale:MD=4.02,95%CI(0.78,7.27);P=0.020,the Balance Evaluation Systems Test:MD=7.83,95%CI(0.13,15.52);P=0.050],exercise ability[Six-Minute Walk Test:standard mean difference(SMD)=0.21,95%CI(0.01,0.40);P=0.040]and quality of life[COPD Assessment Test and St.George′s Respiratory Questionnaire:SMD=-0.54,95%CI(-1.08,-0.01);P=0.050],but balance training did not effectively enhance patients′activity balance confidence[Activities-Specific Balance Confidence Scale:MD=9.34,95%CI(-0.98,19.66);P=0.080].Conclusion Balance training can improve the balance ability,exercise ability,and quality of life of patients with COPD,but the impact on patients′activity balance confidence needs to be further verified.