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The effectiveness of supplemental oxygen during exercise training in patients with chronic obstructive pulmonary disease who show severe exercise-induced desaturation: a protocol for a meta-regression analysis and systematic review

Authors
  • Kawachi, Shohei1, 1
  • Yamamoto, Shuhei2
  • Nishie, Kenichi3, 4
  • Yamaga, Takayoshi5
  • Shibuya, Manaka6
  • Sakai, Yasunari2
  • Fujimoto, Keisaku7
  • 1 Shinshu University, Matsumoto, Japan , Matsumoto (Japan)
  • 2 Shinshu University Hospital, Matsumoto, Japan , Matsumoto (Japan)
  • 3 Shinshu University School of Medicine, Matsumoto, Japan , Matsumoto (Japan)
  • 4 Iida Municipal Hospital, Iida, Japan , Iida (Japan)
  • 5 Health Science University, Minamitsuru-gun, Japan , Minamitsuru-gun (Japan)
  • 6 Kitasato University Hospital, Sagamihara, Japan , Sagamihara (Japan)
  • 7 Shinshu University School of Health Sciences, 3-1-1, Asahi, Matsumoto, 390-8621, Japan , Matsumoto (Japan)
Type
Published Article
Journal
Systematic Reviews
Publisher
BioMed Central
Publication Date
Apr 14, 2021
Volume
10
Issue
1
Identifiers
DOI: 10.1186/s13643-021-01667-9
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundSupplemental oxygen during exercise training is used to increase the training effect of an exercise program in patients with chronic obstructive pulmonary disease (COPD) who show exercise-induced desaturation. Exercise-induced desaturation is not clearly defined in the guidelines; however, it is generally defined in clinical studies as a decrease in SpO2 of more than 4% from rest or a decrease to less than 88% during exercise. Although some meta-analyses examined the effectiveness of supplemental oxygen during exercise training, these studies concluded that it does not further improve exercise tolerance compared to exercise training alone. However, supplemental oxygen during exercise training may be effective in improving exercise tolerance in COPD patients with severe exercise-induced desaturation. Therefore, this study will be performed to elucidate the effectiveness of supplemental oxygen during exercise training and the relationship between its effectiveness and severity of exercise-induced desaturation at baseline.MethodsWe will first assess the effectiveness of supplemental oxygen during exercise training in COPD. The main outcome is the change in exercise tolerance before and after the intervention, indicated by the 6-min walking distance, the walking distance, or the walking time in incremental shuttle walking test, and analyzed as the standardized mean difference (SMD). The quality and risk of bias in individual studies will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and risk-of-bias tool (RoB ver.2). If statistical heterogeneity in terms of the effectiveness of exercise tolerance is shown, we will conduct meta-regression analyses to examine the association between the effectiveness of exercise training with supplemental oxygen and severity of exercise-induced desaturation at baseline.DiscussionOne strength of this study is that it is a systematic review with meta-regression analysis to elucidate the effectiveness of supplemental oxygen during exercise training in patients with COPD who show severe exercise-induced desaturation. Furthermore, we will assess the severity of exercise-induced desaturation for which exercise training with supplemental oxygen is effective, the influence of acute effects at baseline, and the effect of supplemental oxygen on adverse events.Systematic review registrationRegistration number, UMIN000039960.

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