Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 8, 2022
Date Accepted: Nov 27, 2023
Clinical Efficacy of Mobile Application-based Self-directed Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis
ABSTRACT
Background:
Pulmonary rehabilitation (PR) is well known to improve clinical symptoms in patients with chronic obstructive pulmonary disease (COPD). Recently, mobile application-based PR have become available in clinical practice. We investigated the outcomes of mobile application-based PR in patients with COPD.
Objective:
The objective of our study was to evaluate clinical efficacy of mobile application-based PR compared with conventional center-based PR in patients with COPD.
Methods:
A systematic literature search was performed using Pubmed, Embase, Cochrane, and CINAHL to identify relevant randomized controlled trials in patients with COPD. The meta-analysis evaluated mean differences (MD) in the 6-minute walk test distance (6MWD), COPD Assessment Test (CAT) score, modified Medical Research Council (mMRC) dyspnea scale, St. George's Respiratory Questionnaire (SGRQ), and risk ratio (RR) of hospitalization from exacerbation.
Results:
Of the 835 screened studies, eight studies were included in the systematic review and seven in the meta-analysis. Four studies assessed 6MWD with a MD of 6.97 (95% confidence interval [CI] –7.93 to 21.87). Four studies assessed CAT score with a MD of –1.28 (95% CI –3.04 to 0.49). Three studies assessed mMRC dyspnea scale with a MD of –0.08 (95% CI –0.29 to 0.13). Two studies assessed SGRQ with a MD of –3.62 (95% CI –9.62 to 2.38). Three studies assessed hospitalization from exacerbation with a RR of 0.65 (95% CI 0.27 to 1.53). These clinical parameters generally favored mobile application-based PR, although not statistically significantly.
Conclusions:
Mobile application-based PR showed comparable clinical outcomes to conventional PR in patients with COPD. Mobile application-based PR may be a useful treatment option when conventional PR is not feasible.
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