Effects of High-Intensity Interval Training on Pulmonary Function and Exercise Capacity in Individuals with Chronic Obstructive Pulmonary Disease: A Meta-Analysis and Systematic Review

Min Gao; Yangxi Huang; Qianyi Wang; Kouying Liu; Guozhen Sun

doi:10.1007/s12325-021-01920-6

Effects of High-Intensity Interval Training on Pulmonary Function and Exercise Capacity in Individuals with Chronic Obstructive Pulmonary Disease: A Meta-Analysis and Systematic Review

Adv Ther. 2022 Jan;39(1):94-116. doi: 10.1007/s12325-021-01920-6. Epub 2021 Nov 18.

Authors

Min Gao^#¹, Yangxi Huang^#¹, Qianyi Wang², Kouying Liu^{1

3}, Guozhen Sun^{4

5}

Affiliations

¹ The Nursing School, Nanjing Medical University, Nanjing, China.
² Jiangyin People's Hospital of Jiangsu Province, Jiangyin, China.
³ Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
⁴ Cardiology Department of the First Affiliated Hospital of Nanjing Medical University, The Nursing School, Nanjing Medical University, Nanjing, China. gzsun100@njmu.edu.cn.
⁵ The Nursing School, Nanjing Medical University, Nanjing, China. gzsun100@njmu.edu.cn.

^# Contributed equally.

PMID: 34792785
DOI: 10.1007/s12325-021-01920-6

Abstract

Introduction: This study aimed to examine the effectiveness of high-intensity interval training (HIIT) on pulmonary function and exercise capacity in individuals with chronic obstructive pulmonary disease (COPD).

Methods: Ten databases (PubMed, the Cochrane Library, Web of Science, EMBASE, MEDLINE, CINAHL, CNKI, Wanfang, Weipu, and CBM) were searched for relevant articles published from inception to 30 June 2020. Studies were included if they were randomized controlled trials (RCTs) comparing a HIIT group with usual care or other training groups. Quality was assessed using the Physiotherapy Evidence Database (PEDro) scale, and the overall quality of evidence was assessed using the GRADE approach. The primary outcomes were peak VO₂ and FEV₁% predicted, and the secondary outcomes were FEV₁/FVC, peak V_E, peak WR, 6MWD, dyspnea, health-related quality of life, and adverse event.

Results: Twelve articles (689 patients) were included. HIIT was shown to have a positive effect on exercise capacity (peak WR, 6MWD), pulmonary function (FEV₁% pred, peak V_E), dyspnea, and quality of life. However, sensitivity analyses for dyspnea were unstable, and the result changed from positive to negative after removing one study (SMD = - 0.13, 95% CI [- 0.44, 0.17], P = 0.40).

Conclusions: HIIT could improve pulmonary function, exercise capacity, and quality of life but may not decrease dyspnea in patients with COPD. It can be recommended as a safe and effective exercise modality in rehabilitation programs. Given that the overall results were based on a limited number of studies with significant heterogeneity and some of the results were based on low GRADE rating evidence, more high-quality, larger sample size, multicenter, and long-term follow-up RCTs are needed to confirm the clinical efficacy of HIIT in patients with COPD.

Prospero registration: CRD42020165897.

Keywords: Chronic obstructive pulmonary disease; Exercise capacity; High-intensity interval exercise; Pulmonary function.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Dyspnea
Exercise Tolerance
High-Intensity Interval Training*
Humans
Multicenter Studies as Topic
Pulmonary Disease, Chronic Obstructive* / therapy
Quality of Life