The effect of graded exercise therapy on fatigue in people with serious respiratory illness : a systematic review
Burge, Angela T. ; Gadowski, Adelle M. ; Romero, Lorena ; Vagheggini, Guido ; Spathis, Anna ; Smallwood, Natasha E. ; Ekström, Magnus LU
and Holland, Anne E.
(2024)
In European Respiratory Review
33(174).
- Abstract
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... (More)
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.
(Less)
- author
- Burge, Angela T.
; Gadowski, Adelle M.
; Romero, Lorena
; Vagheggini, Guido
; Spathis, Anna
; Smallwood, Natasha E.
; Ekström, Magnus
LU
and Holland, Anne E.
- organization
- publishing date
- 2024-10
- type
- Contribution to journal
- publication status
- published
- subject
- in
- European Respiratory Review
- volume
- 33
- issue
- 174
- article number
- 240027
- publisher
- European Respiratory Society
- external identifiers
-
- pmid:39384307
- scopus:85205987366
- ISSN
- 0905-9180
- DOI
- 10.1183/16000617.0027-2024
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © The authors 2024.
- id
- 4cac4f8c-00b9-40eb-8bae-f8bec3300ca7
- date added to LUP
- 2024-12-18 11:47:00
- date last changed
- 2025-06-05 01:02:26
@article{4cac4f8c-00b9-40eb-8bae-f8bec3300ca7,
abstract = {{<p>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.</p>}},
author = {{Burge, Angela T. and Gadowski, Adelle M. and Romero, Lorena and Vagheggini, Guido and Spathis, Anna and Smallwood, Natasha E. and Ekström, Magnus and Holland, Anne E.}},
issn = {{0905-9180}},
language = {{eng}},
number = {{174}},
publisher = {{European Respiratory Society}},
series = {{European Respiratory Review}},
title = {{The effect of graded exercise therapy on fatigue in people with serious respiratory illness : a systematic review}},
url = {{http://dx.doi.org/10.1183/16000617.0027-2024}},
doi = {{10.1183/16000617.0027-2024}},
volume = {{33}},
year = {{2024}},
}