Comparative effects of different exercise training modalities on exercise capacity, pulmonary function, and health-related quality of life in patients with interstitial lung disease: a systematic review and network meta-analysis.
完整摘要 · 中文译文
引言：运动训练是间质性肺疾病（ILD）肺康复的核心，但不同运动方式的比较效应仍不确定。我们比较了它们对运动能力、肺功能和健康相关生活质量的影响。 方法：检索了六个数据库，从建库至2026年6月11日。纳入针对成人ILD患者运动训练的随机对照试验。干预措施分为有氧训练（AER）、有氧加抗阻训练（AER_RES）、以呼吸为重点的训练包括呼吸练习或吸气肌训练（BREATH_IMT）、有氧加抗阻加呼吸训练（AER_RES_BREATH）、身心运动（MIND_BODY）或对照（CON）。采用频率学派随机效应网络荟萃分析评估6分钟步行距离（6MWD）、预测用力肺活量百分比（FVC% predicted）和圣乔治呼吸问卷（SGRQ）总分的变化。估计了均数差（MDs）及其95%置信区间（CIs）。使用RoB 2和CINeMA评估偏倚风险和证据置信度。 结果：共纳入26项试验，涉及1，409名参与者。与CON相比，所有主动干预方式均改善了6MWD，MDs范围从AER的29.46 m（95% CI 11.82-47.10）至AER_RES_BREATH的57.12 m（95% CI 41.76-72.48）。AER_RES_BREATH产生的估计改善大于AER（MD 27.67 m，95% CI 4.25-51.08）和AER_RES（MD 25.18 m，95% CI 6.69-43.68），尽管这些比较主要依赖于间接证据。仅AER_RES_ BREATH 在预测 FVC% 方面较 CON 显示出小幅改善（MD 3.08 个百分点，95% CI 0.05-6.12），稳健性有限且置信度低。AER_RES、AER_RES_BREATH 和 MIND_BODY 改善了 SGRQ 总分（MD 10.08-15.20 分）。6MWD 的结果在各项敏感性分析中最为稳健。 讨论：运动训练可改善功能性运动能力，并可能改善间质性肺病（ILD）成人患者的健康相关生活质量。AER_RES_BREATH 在 6MWD 方面显示出最强的信号，但有限的直接比较使其无法被指定为最佳干预措施。预测 FVC% 的证据稳健性较低，不应被解释为疾病修饰的证据。 系统综述注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD420261399024，标识符 PROSPERO CRD420261399024。
完整摘要 · 英文原文
INTRODUCTION: Exercise training is central to pulmonary rehabilitation for interstitial lung disease (ILD), but the comparative effects of different exercise modalities remain uncertain. We compared their effects on exercise capacity, pulmonary function, and health-related quality of life. METHODS: Six databases were searched from inception to June 11, 2026. Randomized controlled trials of exercise training in adults with ILD were included. Interventions were classified as aerobic training (AER), aerobic plus resistance training (AER_RES), respiratory-focused training comprising breathing exercises or inspiratory muscle training (BREATH_IMT), aerobic plus resistance plus breathing training (AER_RES_BREATH), mind-body exercise (MIND_BODY), or control (CON). Frequentist random-effects network meta-analyses evaluated changes in 6-min walk distance (6MWD), percentage predicted forced vital capacity (FVC% predicted), and St George's Respiratory Questionnaire (SGRQ) total score. Mean differences (MDs) with 95% confidence intervals (CIs) were estimated. RoB 2 and CINeMA were used to assess risk of bias and confidence in the evidence. RESULTS: Twenty-six trials involving 1,409 participants were included. Compared with CON, all active modalities improved 6MWD, with MDs ranging from 29.46 m for AER (95% CI 11.82-47.10) to 57.12 m for AER_RES_BREATH (95% CI 41.76-72.48). AER_RES_BREATH produced greater estimated improvements than AER (MD 27.67 m, 95% CI 4.25-51.08) and AER_RES (MD 25.18 m, 95% CI 6.69-43.68), although these comparisons relied mainly on indirect evidence. Only AER_RES_BREATH showed a small improvement in FVC% predicted versus CON (MD 3.08 percentage points, 95% CI 0.05-6.12), with limited robustness and low confidence. AER_RES, AER_RES_BREATH, and MIND_BODY improved SGRQ total scores (MDs 10.08-15.20 points). Findings for 6MWD were the most robust across sensitivity analyses. DISCUSSION: Exercise training improves functional exercise capacity and may improve health-related quality of life in adults with ILD. AER_RES_BREATH showed the strongest signal for 6MWD, but limited direct comparisons preclude its designation as the optimal intervention. Evidence for FVC% predicted was less robust and should not be interpreted as evidence of disease modification. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261399024, identifier PROSPERO CRD420261399024.
摘要 待译
INTRODUCTION: Exercise training is central to pulmonary rehabilitation for interstitial lung disease (ILD), but the comparative effects of different exercise modalities remain uncertain. We compared their effects on exercise capacity, pulmonary function, and health-related quality of life. METHODS: Six databases were searched from inception to June 11, 2026. Randomized controlled trials of exercise training in adults with ILD were included.…