Table 3 Outcome measures and main effects in the included SR’s
Authors (year) | BCE or RMT | I and C group (design of comparison) | Intervention descriptor and duration | Outcome variable (measure) | No. of trials (No. of subjects) | Pooled statistics on main effect variables MD/WMD/NU and/or SES (95%CI), p-value, (Effect in favor of intervention or control) | Authors’ comments on quality measure | Authors’ conclusion |
|---|---|---|---|---|---|---|---|---|
Holland et al. (2012) [14] | DB, PLB, YB | PLB compared with no BE (RCT) | 8 -12 weeks training | Dyspnea (BS) | 2 (19) | NQPD (NS) | Low QOE* | The effects of breathing exercises on breathlessness and well-being were variable. |
Dyspnea (UCSD Shortness of Breath Questionnaire) | 2 (19) | NQPD (NS) | Low QOE* | |||||
Dyspnea (MRCS) | 1 (30) | NQPD (I) | NR | |||||
Dyspnea (Hiratsuka Scale) | 2 (60) | MD -12.94 (-22.29, -3.60), p = 0.0066, (I) | Low QOE* | |||||
Health condition (Hiratsuka Scale) | 2 (60) | MD 6.19 (-5.24,17.61), p = 0.29 (NS) | NR | |||||
Mood (Hiratsuka Scale) | 2 (60) | MD 1.08 (-9.60,11.75), p = 0.84 (NS) | NR | |||||
Social function (Hiratsuka Scale) | 2 (60) | MD 11.69 (-0.91,24.28), p = 0.069 (NS) | NR | |||||
House work (Hiratsuka Scale) | 2 (60) | MD 15.58 (0.5,30.66), p = 0.043 (C) | NR | |||||
Headache (Hiratsuka Scale) | 2 (60) | MD -3.30 (-12.37,5.77), p = 0.48 (NS) | NR | |||||
Appetite (Hiratsuka Scale) | 2 (60) | MD 8.42 (-5.3,22.15), p = 0.23 (NS) | NR | |||||
Well being (Hiratsuka Scale) | 2 (60) | MD 0.09 (-9.80,9.98), p = 0.99 (NS) | NR | |||||
QOL (Cai scale) | 1 (89) | NQPD (I) | NR | |||||
DB compared with no BE (RCT) | 4-12 weeks training | Dyspnea (MRCS) | 1(30) | NQPD (NS) | Moderate QOE* | |||
QOL (St. George RQ) | 1(30) | NQPD (I) | Moderate QOE* | |||||
Yoga compared with no BE (RCT) | 12 weeks training | Dyspnea intensity (BS) | 1 (29) | NQPD (NS) | Low QOE* | |||
Dyspnea distress (BS) | 1 (29) | NQPD (NS) | Low QOE* | |||||
Dyspnoea-related QOL | 1 (29) | NQPD (NS) | NR | |||||
Health QOL (St. George RQ) | 1 (45) | NQPD (I) | Moderate QOE* | |||||
PLB compared with EMT (RCT) | 4-12 weeks training | Dyspnea (BS, SOBQ) | 2 (17) | NQPD (I (PLB) on 12 weeks, NS on 4 weeks) | Low QOE* | |||
Low QOE* | ||||||||
Dypsnea (UCSD Shortness of Breath Questionnaire) | 2 (17) | NQPD (NS) | ||||||
DB, PLB and nutritional (RCT) | NR | QOL (Cai scale) | 1 (71) | NQPD (NS) | NR | |||
Roberts. et al. (2009) [30] | PLB | PLB during everyday activities or during exercise (PP) | NR in table # | Dyspnea (BS) | 5 (110) | 40% relief (range 0%–to 63%) # (NR) | Low and moderate QOE # ** | PLB has a role in the symptomatic management of stable COPD. |
Geddes et al. (2008) [13] | IMT | Inspiratory muscle training versus intervention sham (RCT) | Intensity ≥30%–60% or max load, Pimax (threshold) 15–30 minutes 1–2 pr. day, 3–7 days pr. week for 5–24 weeks. | Dyspnea (BS) | 4 (99) | WMD -1.76, (-2.35, -1.16), | No score given. Descriptive summary of the MQ is provided. | IMT improves measure of quality of life and decreases dyspnea for adults with stable COPD. |
p <0.00001, (I) | ||||||||
Dyspnea (TDI focal score) | 5 (96) | WMD 2.55, (0.92, 4.19), p = 0.002, (I) | ||||||
60% MVV (normocapnic hyperpnea tube breathing) 15 minutes × 2 pr. day, 7 days a week for 5 weeks. | Dyspnea (TDI functional impairment) | 3 (56) | WMD 0.72, (0.14, 1.31), p = 0.02, (I) | |||||
Dyspnea (TDI magnitude of task) | 3 (56) | WMD 0.74, (0.49, 1.0), p <0.00001, (I) | ||||||
Dyspnea (TDI magnitude of effort) | 3 (56) | WMD 0.48, (0.24, 0.72), p <0.0001, (I) | ||||||
Quality of life (CRQ total score) | 2 (69) | WMD 0.33, (0.19, 0.47), p <0.00001, (I) | ||||||
Gosselink et al. (2011) [31] | IMT | IMT versus control (RCT) | Intensity ≥30%, Pimax (threshold load) or endurance training in controlled manner (inclusion criteria), 15–90 minute × 2–3 pr. day, 5–7 days a week, for 4 weeks to 12 months.## | Dyspnea (BS) | 14(NR) | NU -0.9, SES -0.45, (-0.66 to -0.24), | MQ score from 30–83% (median 59%) of the maximum score.** | IMT improves dyspnea and health QOL. |
p <0.001, (I) | ||||||||
Dyspnea (TDI score) | 4 (NR) | NU +2.8, SES 1.58, (0.86–2.3), | ||||||
p <0.001, (I) | ||||||||
Dyspnea (CRQ) | 9 (NR) | NU +1.1, SES 0.34, (-0.03–0.71), | ||||||
p = 0.068, (I) | ||||||||
Quality of life (CRQ score) | 9 (NR) | NU +3.8, SES 0.34, (0.09–0.6), p = 0.007, (I) | ||||||
Fatigue (CRQ score) | 10 (NR) | NU + 0.9, SES 0.27, (0.03–0.5), | ||||||
p = 0.024, (I) | ||||||||
Emotion (CRQ score) | 10 (NR) | NU + 0.5, SES 0.19, (-0.04–0.42), | ||||||
p = 0.107 | ||||||||
Mastery (CRQ score) | 10 (NR) | NU–0.005, SES 0.09, (-0.14–0.33), p = 0.432 | ||||||
O’Brien et al. (2008) [32] | IMT | Combined IMT and exercise versus exercise alone (RCT) | Intensity 30%, Pimax-60% (threshold), 30 minutes × 1 pr. day 5 days a week for 16 weeks. <72% MVV (Normocapnic hyperventilation) 1–20 minutes × 1 pr. day, 3 days a week for 8 weeks. | Quality of life CRQ dyspnea | 2 (57) | WMD -1.94, (-2.88, -1.01), p <0.0001, (I) | No score given. MQ information given in a table in the SR. | Results of dyspnea and QOL are less clear. Further trials are required. |
Quality of life CRQ fatigue | 2 (57) | WMD -0.23, (-3.85, 3.4), p = 0.9 | ||||||
Shoemaker et. al. (2009) [34] | IMT | IMT versus control | Intensity load 17-100% Pimax, 15–30 minutes daily, 3–7 days a week for 8–24 weeks | Dyspnea (during IMT) | 3 (85) | NQPD ## | Score 40-90% level 1b **** | IMT improve dyspnea and QOL in COPD patients |
QOL | 6 (188) | NQPD ## | ||||||
Thomas et al. (2010) [33] | IMT | IMT at home versus control (RCT) | No information on intensity, 30–60 minutes pr. day × 3–6 pr. week, for 3–12 months. | Dyspnea (TDI score) | 3 (57) | MD 2.36 (0.76, 3.96), p = 0.004, (I) ## | Score of 5 in one study and 7 in two studies.*** | IMT may improve breathlessness during activities of daily living in severe COPD. |