Efficacy and safety of Supine Daoyin in the treatment of acute exacerbation of chronic obstructive pulmonary disease: A randomized controlled trial

Jiansheng Li , Hailong Zhang , Jun Wang , Xuechao Lu , Mingyan Zuo , Li Jiao , Xiaofan Lu , Yang Wang

Journal of Evidence-Based Medicine ›› 2024, Vol. 17 ›› Issue (3) : 654 -666.

PDF
Journal of Evidence-Based Medicine ›› 2024, Vol. 17 ›› Issue (3) : 654 -666. DOI: 10.1111/jebm.12650
ARTICLE

Efficacy and safety of Supine Daoyin in the treatment of acute exacerbation of chronic obstructive pulmonary disease: A randomized controlled trial

Author information +
History +
PDF

Abstract

Aim: This study aimed to develop and evaluate the efficacy and safety of Supine Daoyin, a TCM PR technique, in hospitalized patients with AECOPD.

Methods: This is a multicenter, prospective, randomized, controlled trial involving AECOPD inpatients recruited from April 2021 to December 2023 in five tertiary hospitals in China. Participants were randomly assigned to 14 days of Supine Daoyin group or control group and evaluated at days 3, 7, and 14 (posttreatment). The primary outcomes were LOS and CCQ and secondary outcomes were 6MWD, 30-STS, BI, Borg CR10, time on mechanical ventilation, SGRQ, mCOPD-PRO, and mESQ-COPD.

Results: Out of 369 participants screened, 228 were randomly assigned (Supine Daoyin group: n = 114; control group: n = 114). For primary outcomes, there was no significant between-group difference in LOS (p > 0.05), but for CCQ the Supine Daoyin was superior to control at days 7 (p < 0.01) and 14 (p < 0.01). For secondary outcomes, Supine Daoyin groups showed robust and superior improvements in 6MWD, 30-STS, BI, Borg CR10, SGRQ, mCOPD-PRO, and mESQ-COPD (all p < 0.05), but for time on mechanical ventilation there was no significant difference in two groups (p > 0.05).

Conclusion: Supine Daoyin, a novel TCM PR technique, demonstrates safety and efficacy for AECOPD inpatients, yielding clinically meaningful improvements in health status, exercise capacity, and quality of life. This study offers a viable PR option for AECOPD patients with severe symptoms and limited mobility.

Keywords

chronic obstructive pulmonary disease / exacerbation / pulmonary rehabilitation / randomized controlled trial / Supine Daoyin / traditional Chinese exercises

Cite this article

Download citation ▾
Jiansheng Li, Hailong Zhang, Jun Wang, Xuechao Lu, Mingyan Zuo, Li Jiao, Xiaofan Lu, Yang Wang. Efficacy and safety of Supine Daoyin in the treatment of acute exacerbation of chronic obstructive pulmonary disease: A randomized controlled trial. Journal of Evidence-Based Medicine, 2024, 17(3): 654-666 DOI:10.1111/jebm.12650

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

LozanoR,NaghaviM, ForemanK, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859),2095–2128.

[2]

VosT,FlaxmanAD, NaghaviM, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859),2163–2196.

[3]

World Health Organization. Chronic obstructive pulmonary disease (COPD). (accessed 20 July 2024). Available at: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-%28copd%29

[4]

De BackerW,De Backer J,VerlindenI, et al. Functional respiratory imaging assessment of glycopyrrolate and formoterol fumarate metered dose inhalers formulated using co-suspension delivery technology in patients with COPD. Ther Adv Respir Dis. 2020;14:1753466620916990.

[5]

LabakiWW,Rosenberg SR. Chronic obstructive pulmonary disease. Ann Intern Med. 2020;173(3),ITC17–ITC32.

[6]

McCarthyB,CaseyD, DevaneD, et al. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015;2015(2),CD003793.

[7]

SahinH,NazI, VarolY, et al. Is a pulmonary rehabilitation program effective in COPD patients with chronic hypercapnic failure? Expert Rev Respir Med. 2016;10(5),593–598.

[8]

LindenauerPK,StefanMS, PekowPS, et al. Association between initiation of pulmonary rehabilitation after hospitalization for COPD and 1-year survival among Medicare beneficiaries. JAMA. 2020;323(18),1813–1823.

[9]

PuhanMA,Gimeno-Santos E,CatesCJ, et al. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2016;12:CD005305.

[10]

RyrsøCK,Godtfredsen NS,KofodLM, et al. Lower mortality after early supervised pulmonary rehabilitation following COPD-exacerbations: a systematic review and meta-analysis. BMC Pulm Med. 2018;18(1),154.

[11]

RochesterCL,AlisonJA, CarlinB, et al. Pulmonary rehabilitation for adults with chronic respiratory disease: an official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2023;208:e7–e26.

[12]

SpruitMA,SinghSJ, GarveyC, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188(8),e13–64.

[13]

XiF,WangZ, QiY, et al. Long-term effect of respiratory training for chronic obstructive pulmonary disease patients at an outpatient clinic: a randomised controlled trial. Clin Transl Med. 2015;4(1),31.

[14]

van de BoolC,RuttenEPA, van HelvoortA, et al. A randomized clinical trial investigating the efficacy of targeted nutrition as adjunct to exercise training in COPD. J Cachexia Sarcopenia Muscle. 2017;8(5),748–758.

[15]

GarveyC,BaylesMP, HammLF, et al. Pulmonary rehabilitation exercise prescription in chronic obstructive pulmonary disease: review of selected guidelines: an official statement from the american association of cardiovascular and pulmonary rehabilitation. J Cardiopulm Rehabil Prev. 2016;36(2),75–83.

[16]

WageckB,CoxNS, LeeJYT, et al. Characteristics of pulmonary rehabilitation programs following an exacerbation of chronic obstructive pulmonary disease: a systematic review. J Cardiopulm Rehabil Prev. 2021;41(2),78–87.

[17]

MachadoA,Matos Silva P,AfreixoV, et al. Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis. Eur Respir Rev. 2021;30(159),215039.

[18]

RyrsøCK,Godtfredsen NS,KofodLM, et al. Lower mortality after early supervised pulmonary rehabilitation following COPD-exacerbations: a systematic review and meta-analysis. BMC Pulm Med. 2018;18(1),154.

[19]

LiY,JiZ, WangY, et al. Breathing exercises in the treatment of COPD: an overview of systematic reviews. Int J Chron Obstruct Pulmon Dis. 2022;17:3075–3085.

[20]

MeysR,SillenMJ, FranssenFME, et al. Impact of mild-to-moderate exacerbations on outcomes of neuromuscular electrical stimulation (NMES) in patients with COPD. Respir Med. 2020;161:105851.

[21]

BeauchampMK,Nonoyama M,GoldsteinRS, et al. Interval versus continuous training in individuals with chronic obstructive pulmonary disease–a systematic review. Thorax. 2010;65(2),157–164.

[22]

MarksG,ReddelH, Guevara-RattrayE, et al. Monitoring pulmonary rehabilitation and long-term oxygen therapy for people with COPD in Australia: a discussion paper. Canberra: Australian Institute of Health and Welfare (AIHW),2013.

[23]

YohannesAM,Connolly MJ. Pulmonary rehabilitation programmes in the UK: a national representative survey. Clin Rehabil. 2004;18(4),444–449.

[24]

HollandAE,MahalA, HillCJ, et al. Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial. Thorax. 2017;72(1),57–65.

[25]

WangC,SchmidCH, IversenMD, et al. Comparative effectiveness of Tai Chi versus physical therapy for knee osteoarthritis: a randomized trial. Ann Intern Med. 2016;165(2),77–86.

[26]

YaoL,SunG, WangJ, et al. Effects of Baduanjin imagery and exercise on cognitive function in the elderly: a functional near-infrared spectroscopy study. Front Public Health. 2022;10:968642.

[27]

ZhouM,ZhangH, LiF, et al. Pulmonary Daoyin as a traditional Chinese medicine rehabilitation programme for patients with IPF: a randomized controlled trial. Respirology. 2021;26(4),360–369.

[28]

TanX,ZhangY, ShaoH. Healthy China 2030, a breakthrough for improving health. Glob Health Promot. 2019;26(4),96–99.

[29]

LiL,HuangH, SongJ, et al. Network meta-analysis of the effects of different types of traditional chinese exercises on pulmonary function, endurance capacity and quality of life in patients with COPD. Front Med (Lausanne). 2022;9:806025.

[30]

PiaggioG,Elbourne DR,PocockSJ, et al. Reporting of noninferiority and equivalence randomized trials: extension of the CONSORT 2010 statement. JAMA. 2012;308(24),2594–2604.

[31]

Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. (2020 report). (accessed 20 July 2024). Available at: https://goldcopd.org/gold-reports/

[32]

Expert Group Opinion on Management of Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Expert Consensus on Acute Exacerbation of Chronic Obstructive Pulmonary Disease in China (Updated 2017). Int J of Resp. 2017;37(14),1041–1057.

[33]

van der MolenT,Willemse BW,SchokkerS, et al. Development, validity and responsiveness of the Clinical COPD Questionnaire. Health Qual Life Outcomes. 2003;1:13.

[34]

MahoneyFI,BarthelDW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–65.

[35]

BorgG. Borg’s perceived exertion and pain scales. Human Kinetics; 1998.

[36]

HollandAE,SpruitMA, TroostersT, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6),1428–1446.

[37]

JonesCJ,RikliRE, BeamWC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999;70(2),113–119.

[38]

HansenH,BeyerN, FrølichA, et al. Intra-and inter-rater reproducibility of the 6-minute walk test and the 30-second sit-to-stand test in patients with severe and very severe COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:3447–3457.

[39]

JonesPW,QuirkFH, BaveystockCM. The St George’s respiratory questionnaire. Resp Med. 1991;85:25–31.

[40]

LiJ,WangJ, XieY, et al. Development and validation of the modified patient-reported outcome scale for chronic obstructive pulmonary disease (mCOPD-PRO). Int J Chron Obstruct Pulmon Dis. 2020;15:661–669.

[41]

LiJ,XieY, WangJ, et al. Development and verification of the modified effectiveness satisfaction questionnaire for COPD. Chin Gen Pract. 2022(22),2796–2803.

[42]

KimYB,ByunHK, KimDY, et al. Effect of elective internal mammary node irradiation on disease-free survival in women with node-positive breast cancer: a randomized phase 3 clinical trial. JAMA Oncol. 2022;8(1),96–105.

[43]

van de GraafVA,Noorduyn JCA,WilligenburgNW, et al. Effect of early surgery vs physical therapy on knee function among patients with nonobstructive meniscal tears: the ESCAPE randomized clinical trial. JAMA. 2018;320(13),1328–1337.

[44]

BroglioK. Randomization in clinical trials: permuted blocks and stratification. JAMA. 2022;327(9),880.

[45]

KonSS,DilaverD, MittalM, et al. The Clinical COPD Questionnaire: response to pulmonary rehabilitation and minimal clinically important difference. Thorax. 2014;69(9),793–798.

[46]

KesslerR,Ståhl E,VogelmeierC, et al. Patient understanding, detection, and experience of COPD exacerbations: an observational, interview-based study. Chest. 2006;130(1),133–142.

[47]

SullivanSD,RamseySD, LeeTA. The economic burden of COPD. Chest. 2000;117(2),5S–9S.

[48]

QuintanaJM,Unzurrunzaga A,Garcia-GutierrezS, et al. Predictors of hospital length of stay in patients with exacerbations of COPD: a cohort study. J Gen Intern Med. 2015;30(6),824–831.

[49]

CrisafulliE,IelpoA, BarbetaE, et al. Clinical variables predicting the risk of a hospital stay for longer than 7 days in patients with severe acute exacerbations of chronic obstructive pulmonary disease: a prospective study. Respir Res. 2018;19(1),261.

[50]

MoeckeDP,ZhuK, GillJ, et al. Safety and efficacy of inpatient pulmonary rehabilitation for patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease: systematic review and meta-analyses. Ann Am Thorac Soc. 2023;20(2),307–319.

[51]

ZhangD,ZhangH, LiX, et al. Pulmonary rehabilitation programmes within three days of hospitalization for acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2021;16:3525–3538.

[52]

QuintanaJM,Unzurrunzaga A,Garcia-GutierrezS, et al. Predictors of hospital length of stay in patients with exacerbations of COPD: a cohort study. J Gen Intern Med. 2015;30(6),824–831.

[53]

TsiligianniIG,van der Molen T,MoraitakiD, et al. Assessing health status in COPD. A head-to-head comparison between the COPD assessment test (CAT) and the clinical COPD questionnaire (CCQ). BMC Pulm Med. 2012;12:20.

[54]

van Dam van IsseltEF,van Eijk M,van Geloven N, et al. A prospective cohort study on the effects of geriatric rehabilitation following acute exacerbations of COPD. J Am Med Dir Assoc. 2019;20(7),850–856.e2.

[55]

SmidDE,Franssen FM,Houben-WilkeS, et al. Responsiveness and MCID estimates for CAT, CCQ, and HADS in patients with COPD undergoing pulmonary rehabilitation: a prospective analysis. J Am Med Dir Assoc. 2017;18(1),53–58.

[56]

JenkinsS. 6-Minute walk test in patients with COPD: clinical applications in pulmonary rehabilitation. Physiotherapy. 2007;93(3),175–182.

[57]

PuhanMA,ChandraD, MosenifarZ, et al. The minimal important difference of exercise tests in severe COPD. Eur Respir J. 2011;37(4),784–790.

[58]

PuhanMA,MadorMJ, HeldU, et al. Interpretation of treatment changes in 6-minute walk distance in patients with COPD. Eur Respir J. 2008;32(3),637–643.

[59]

RedelmeierDA,BayoumiAM, GoldsteinRS, et al. Interpreting small differences in functional status: the Six Minute Walk test in chronic lung disease patients. Am J Respir Crit Care Med. 1997;155(4),1278–1282.

[60]

PolkeyMI,SpruitMA, EdwardsLD, et al. Six-minute-walk test in chronic obstructive pulmonary disease: minimal clinically important difference for death or hospitalization. Am J Respir Crit Care Med. 2013;187(4),382–386.

[61]

Pinto-PlataVM,CoteC, CabralH, et al. The 6-min walk distance: change over time and value as a predictor of survival in severe COPD. Eur Respir J. 2004;23(1),28–33.

[62]

WangL,HeL, TaoY, et al. Evaluating a web-based coaching program using electronic health records for patients with chronic obstructive pulmonary disease in china: randomized controlled trial. J Med Internet Res. 2017;19(7),e264.

[63]

AlmaHJ,de JongC, JelusicD, et al. Thresholds for clinically important deterioration versus improvement in COPD health status: results from a randomised controlled trial in pulmonary rehabilitation and an observational study during routine clinical practice. BMJ Open. 2019;9(6),e025776.

[64]

PuhanMA,Gimeno-Santos E,CatesCJ, et al. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2016;12(12),CD005305.

[65]

RyrsøCK,Godtfredsen NS,KofodLM, et al. Lower mortality after early supervised pulmonary rehabilitation following COPD-exacerbations: a systematic review and meta-analysis. BMC Pulm Med. 2018;18(1),154.

[66]

ZhangH,LiJ, YuX, et al. An evaluation of activity tolerance, patient-reported outcomes and satisfaction with the effectiveness of pulmonary daoyin on patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2017;12:2333–2342.

RIGHTS & PERMISSIONS

2024 The Author(s). Journal of Evidence-Based Medicine published by Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

AI Summary AI Mindmap
PDF

114

Accesses

0

Citation

Detail

Sections
Recommended

AI思维导图

/