呼吸困难:与康复相关的Cochrane证据地图,适用于患有COVID-19后遗症的人们。
Dyspnea: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition.
发表日期:2022 Dec
作者:
Claudio Cordani, Stefano G Lazzarini, Elisabetta Zampogna, Matteo J Del Furia, Chiara Arienti, Stefano Negrini, Carlotte Kiekens
来源:
European Journal of Physical and Rehabilitation Medicine
摘要:
康复关注于健康状况的基础上,针对障碍、活动限制和参与限制进行干预。在当前没有直接的针对新冠病后综合症患者进行康复干预的“证据”情况下,我们可以搜索和综合与其他健康状况相关的症状干预的间接“相关证据”。世界卫生组织(WHO)需要这些信息来告知专家团队,并在他们的指南中提供具体建议。通过这个综述和映射,我们旨在综合Cochrane与PCC呼吸困难相关的康复证据。我们使用Cochrane图书馆中“呼吸困难”及其同义词等术语搜索了过去五年的Cochrane系统综述(CSRs)。我们提取并总结了所有可用证据,并分组列出了涉及健康状况和干预的CSRs,包括证据效果和质量。我们发现了2016年至2021年间发表的371篇CSRs,其中有15篇纳入了本总览。在这些纳入样本中,我们发现了8项针对慢性阻塞性肺疾病的研究,2项针对癌症的研究,以及1项针对支气管扩张、慢性呼吸疾病、囊性纤维化、特发性肺纤维化和间质性肺病的研究。有效的干预方法包括肺康复,还可以联合运动训练、非侵入性通气、上肢训练和多元一体化干预,但证据质量很低至中等。这些结果是产生有帮助的临床实践假设和未来与PCC成年患者的呼吸困难相关的研究的间接证据的第一步。它们已成为世界卫生组织指南中针对PCC症状之一——呼吸困难的治疗建议的基础。
Rehabilitation focuses on impairments, activity limitations and participation restrictions being informed by the underlying health condition. In the current absence of direct "evidence on" rehabilitation interventions for people with post COVID-19 condition (PCC), we can search and synthesize the indirect "evidence relevant to" coming from interventions effective on the symptoms of PCC in other health conditions. The World Health Organization (WHO) required this information to inform expert teams and provide specific recommendations in their Guidelines. With this overview of reviews with mapping we aimed to synthesize in a map the Cochrane evidence relevant to rehabilitation for dyspnea due to PCC.We searched the last five years' Cochrane Systematic Review (CSRs) using the terms "dyspnea" and its synonyms in the Cochrane Library. We extracted and summarized all the available evidence using a map. We grouped the included CSRs for health conditions and interventions, indicating the effect and the quality of evidence.We found 371 CSRs published between 2016 and 2021 and included 15 in this overview. We found eight studies on chronic obstructive pulmonary disease, two on cancer, and one for bronchiectasis, chronic respiratory disease, cystic fibrosis, idiopathic pulmonary fibrosis and interstitial lung disease. Effective interventions included pulmonary rehabilitation, also in combination with exercise training, non-invasive ventilation, upper limb training and multicomponent integrated interventions, with very low- to moderate-quality evidence.These results are the first step of indirect evidence to generate helpful hypotheses for clinical practice and future research on dyspnea in adults with PCC. They served as the basis for one recommendation on treatments for dyspnea as a PCC symptom published in the current WHO Guidelines for clinical practice.