The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review
Background In adults with serious respiratory illness, fatigue is prevalent and under-recognised, with few treatment options. The aim of this review was to assess the impact of graded exercise therapy (GET) on fatigue in adults with serious respiratory illness. Methods Electronic databases were sear...
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| Format: | Article |
| Language: | English |
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European Respiratory Society
2024-10-01
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| Series: | European Respiratory Review |
| Online Access: | http://err.ersjournals.com/content/33/174/240027.full |
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| author | Angela T. Burge Adelle M. Gadowski Lorena Romero Guido Vagheggini Anna Spathis Natasha E. Smallwood Magnus Ekström Anne E. Holland |
| author_facet | Angela T. Burge Adelle M. Gadowski Lorena Romero Guido Vagheggini Anna Spathis Natasha E. Smallwood Magnus Ekström Anne E. Holland |
| author_sort | Angela T. Burge |
| collection | DOAJ |
| description | Background
In adults with serious respiratory illness, fatigue is prevalent and under-recognised, with few treatment options. The aim of this review was to assess the impact of graded exercise therapy (GET) on fatigue in adults with serious respiratory illness.
Methods
Electronic databases were searched to identify randomised controlled trials (RCTs) testing GET (involving incremental increases in exercise from an established baseline) in adults with serious respiratory illness. The primary outcome was fatigue and secondary outcomes were health-related quality of life (HRQoL) and adverse events. Two authors independently screened for inclusion, evaluated risk of bias and extracted data.
Results
76 RCTs were included with 3309 participants, most with a diagnosis of COPD or asthma. Reductions in fatigue measured by the Chronic Respiratory Disease Questionnaire fatigue domain score were demonstrated following GET consisting of aerobic with/without resistance training (mean difference (MD) 0.53 points, 95% CI 0.41–0.65, 11 RCTs, 624 participants) and GET using resistance training alone (MD 0.58 points, 95% CI 0.21–0.96, two RCTs, 82 participants) compared with usual care. Although the mean effect exceeded the minimal important difference, the lower end of the confidence intervals did not always exceed this threshold so the clinical significance could not be confirmed. GET consistently improved HRQoL in people with a range of chronic respiratory diseases on multiple HRQoL measures. No serious adverse events related to GET were reported.
Conclusion
GET may improve fatigue alongside consistent improvements in HRQoL in people with serious respiratory illness. These findings support the use of GET in the care of people with serious respiratory illness. |
| format | Article |
| id | doaj-art-e7ec09d249d04fceb633ddea9d181d05 |
| institution | DOAJ |
| issn | 0905-9180 1600-0617 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | European Respiratory Review |
| spelling | doaj-art-e7ec09d249d04fceb633ddea9d181d052025-08-20T02:42:57ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172024-10-013317410.1183/16000617.0027-20240027-2024The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic reviewAngela T. Burge0Adelle M. Gadowski1Lorena Romero2Guido Vagheggini3Anna Spathis4Natasha E. Smallwood5Magnus Ekström6Anne E. Holland7 Department of Physiotherapy, Alfred Health, Melbourne, Australia School of Translational Medicine, Monash University, Melbourne, Australia The Ian Potter Library, Alfred Health, Melbourne, Australia Department of Internal Medicine and Medical Specialties, Respiratory Failure Pathway, Azienda USL Toscana Nordovest, Pisa, Italy Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK School of Translational Medicine, Monash University, Melbourne, Australia Respiratory Medicine, Allergology and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden Department of Physiotherapy, Alfred Health, Melbourne, Australia Background In adults with serious respiratory illness, fatigue is prevalent and under-recognised, with few treatment options. The aim of this review was to assess the impact of graded exercise therapy (GET) on fatigue in adults with serious respiratory illness. Methods Electronic databases were searched to identify randomised controlled trials (RCTs) testing GET (involving incremental increases in exercise from an established baseline) in adults with serious respiratory illness. The primary outcome was fatigue and secondary outcomes were health-related quality of life (HRQoL) and adverse events. Two authors independently screened for inclusion, evaluated risk of bias and extracted data. Results 76 RCTs were included with 3309 participants, most with a diagnosis of COPD or asthma. Reductions in fatigue measured by the Chronic Respiratory Disease Questionnaire fatigue domain score were demonstrated following GET consisting of aerobic with/without resistance training (mean difference (MD) 0.53 points, 95% CI 0.41–0.65, 11 RCTs, 624 participants) and GET using resistance training alone (MD 0.58 points, 95% CI 0.21–0.96, two RCTs, 82 participants) compared with usual care. Although the mean effect exceeded the minimal important difference, the lower end of the confidence intervals did not always exceed this threshold so the clinical significance could not be confirmed. GET consistently improved HRQoL in people with a range of chronic respiratory diseases on multiple HRQoL measures. No serious adverse events related to GET were reported. Conclusion GET may improve fatigue alongside consistent improvements in HRQoL in people with serious respiratory illness. These findings support the use of GET in the care of people with serious respiratory illness.http://err.ersjournals.com/content/33/174/240027.full |
| spellingShingle | Angela T. Burge Adelle M. Gadowski Lorena Romero Guido Vagheggini Anna Spathis Natasha E. Smallwood Magnus Ekström Anne E. Holland The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review European Respiratory Review |
| title | The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review |
| title_full | The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review |
| title_fullStr | The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review |
| title_full_unstemmed | The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review |
| title_short | The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review |
| title_sort | effect of graded exercise therapy on fatigue in people with serious respiratory illness a systematic review |
| url | http://err.ersjournals.com/content/33/174/240027.full |
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