Page 39 - JCTR-11-4

Journal of Clinical and
Translational Research Physical exercise on COPD

Figure 1. Flowchart of the search strategy
The studies included in this analysis provide evidence the I index, allowing the identification of consistency in
2
that physical exercise can have a positive impact on the effects across studies.
functional capacity of patients with COPD. However, the The study by Zwerink et al. observed that participation
16
magnitude and consistency of these effects vary depending in a community-based physiotherapy exercise program
on the type of intervention, program duration, and (COPE-active) resulted in significant improvements
assessment methods used. in functional capacity, as evidenced by increases in the
Although five studies were included in the analysis, distances achieved in the ISWT and endurance shuttle
it is important to highlight that not all employed the walk test (ESWT). The correlations between increases in
same exercise testing protocol, which limits the direct daily step count and performance on the ISWT and ESWT
comparability of the results. While one study adopted (r = 0.47 and r = 0.38, respectively) suggested that an
Nordic walking, another used the 6-min walk test, and a increase in daily physical activity may be a useful predictor
third employed the incremental shuttle walk test (ISWT). of improvements in functional capacity. This finding
These tests assess functional capacity through different supports the idea that engaging in regular, low-impact
methodologies and contexts, and their results, especially physical activities, such as walking, can significantly benefit
in terms of distance covered, are not directly comparable. patients with COPD, as these activities increase muscular
To minimize the effect of heterogeneity among the exercise endurance and improve cardiovascular efficiency without
tests used, data analysis was based on MD only for studies overloading the lungs.
that used the same unit of measurement (meters walked). Gea et al., in a study on the “less aerobic phenotype”
19
In addition, statistical heterogeneity was assessed using of patients with COPD, pointed out that the reduction

Volume 11 Issue 4 (2025) 33 doi: 10.36922/jctr.25.00004