Determination of whether supplemental oxygen therapy is beneficial during exercise training in patients with COPD: A systematic review and meta‑analysis

Liu,Ying; Gong,Fanghua

doi:10.3892/etm.2019.8026

Determination of whether supplemental oxygen therapy is beneficial during exercise training in patients with COPD: A systematic review and meta‑analysis

Authors:
- Ying Liu
- Fanghua Gong
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Affiliations: Fourth Department of Respiratory and Critical Care Medicine, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan 410005, P.R. China, Department of Nursing, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan 410005, P.R. China
Published online on: September 18, 2019 https://doi.org/10.3892/etm.2019.8026
Pages: 4081-4089
Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Exercise training is an integral component of the pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to systematically search the published literature and analyze the evidence on the efficacy of supplemental oxygen in improving outcomes during exercise training in patients with COPD. The PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Google scholar databases were searched electronically for articles in the English language published up to May, 2019. In total, 7 trials were included in this systematic review and meta‑analysis. There was considerable heterogeneity amongst the included studies. Meta‑analysis indicated no significant difference in power (random: MD = ‑2.38; 95% CI, ‑5.79 to 1.03; P=0.86) and maximum energy expenditure (VO2 max) (random: MD = ‑0.01; 95% CI, ‑0.06 to 0.07; P=0.45) between the oxygen and control groups on maximal exercise testing. Qualitative analysis of the included studies revealed no benefits of supplemental oxygen in improving exercise capacity and dyspnea scores. Data on the quality of life assessed by the Chronic Respiratory Disease Questionnaire was pooled for 95 participants in the study group and 91 participants in the control group. The results indicated no beneficial effects of supplemental oxygen in improving quality of life outcomes (random: MD = ‑0.09; 95% CI, ‑0.16 to ‑0.01; P=0.59). On the whole, the findings of this study indicate that supplemental oxygen during the exercise training of patients with COPD does not improve exercise capacity, dyspnea scores and quality of life. However, the quality of the evidence is weak. Multi‑center randomized controlled trials with homogenous methodology and intervention are required to provide stronger evidence on this subject.

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1	Celli BR and MacNee W; ATS/ERS Task Force, : Standards for the diagnosis and treatment of patients with COPD: A summary of the ATS/ERS position paper. Eur Respir J. 23:932–946. 2004. View Article : Google Scholar : PubMed/NCBI
2	Nonoyama ML, Brooks D, Lacasse Y, Guyatt GH and Goldstein RS: Oxygen therapy during exercise training in chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2:CD0053722007.
3	Ejiofor SI, Bayliss S, Gassamma A and Turner AM: Ambulatory oxygen for exercise-induced desaturation and dyspnea in chronic obstructive pulmonary disease (COPD): Systematic review and meta-analysis. Chronic Obstr Pulm Dis. 3:419–434. 2016.PubMed/NCBI
4	Wagner PD: Skeletal muscles in chronic obstructive pulmonary disease: Deconditioning, or myopathy? Respirology. 11:681–686. 2006. View Article : Google Scholar : PubMed/NCBI
5	Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, Hill K, Holland AE, Lareau SC, Man WD, et al: An official American Thoracic Society/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 188:e13–e64. 2013. View Article : Google Scholar : PubMed/NCBI
6	Ries AL, Bauldoff GS, Carlin BW, Casaburi R, Emery CF, Mahler DA, Make B, Rochester CL, Zuwallack R and Herrerias C: Pulmonary rehabilitation: Joint ACCP/AACVPR evidence-based clinical practice guidelines. Chest. 131((5 Suppl)): 4S–42S. 2007. View Article : Google Scholar : PubMed/NCBI
7	McCarthy B, Casey D, Devane D, Murphy K, Murphy E and Lacasse Y: Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2:CD0037932015.
8	Henriksson J and Reitman JS: Quantitative measures of enzyme activities in type I and type II muscle fibres of man after training. Acta Physiol Scand. 97:392–397. 1976. View Article : Google Scholar : PubMed/NCBI
9	Cranston JM, Crockett A, Moss J and Alpers JH: Domiciliary oxygen for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. CD0017442005.PubMed/NCBI
10	Jolly EC, Di Boscio V, Aguirre L, Luna CM, Berensztein S and Gené RJ: Effects of supplemental oxygen during activity in patients with advanced COPD without severe resting hypoxemia. Chest. 120:437–443. 2001. View Article : Google Scholar : PubMed/NCBI
11	Rooyackers JM, Dekhuijzen PN, Van Herwaarden CL and Folgering HT: Training with supplemental oxygen in patients with COPD and hypoxaemia at peak exercise. Eur Respir J. 10:1278–1284. 1997. View Article : Google Scholar : PubMed/NCBI
12	Garrod R, Paul EA and Wedzicha JA: Supplemental oxygen during pulmonary rehabilitation in patients with COPD with exercise hypoxaemia. Thorax. 55:539–543. 2000. View Article : Google Scholar : PubMed/NCBI
13	Wadell K, Henriksson-Larsén K and Lundgren R: Physical training with and without oxygen in patients with chronic obstructive pulmonary disease and exercise-induced hypoxaemia. J Rehabil Med. 33:200–205. 2001. View Article : Google Scholar : PubMed/NCBI
14	Pépin JL and Lévy P: Principles of oxygen therapyRespiratory Medicine. Gibson G, Geddes D, Costabel U, Sterk P and Corrin B: 3rd. Saunders; Edinburgh: pp. 502–521. 2003
15	Emtner M, Porszasz J, Burns M, Somfay A and Casaburi R: Benefits of supplemental oxygen in exercise training in nonhypoxemic chronic obstructive pulmonary disease patients. Am J Respir Crit Care Med. 168:1034–1042. 2003. View Article : Google Scholar : PubMed/NCBI
16	Moher D, Liberati A, Tetzlaff J and Altman DG; PRISMA Group, : Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 6:e10000972009. View Article : Google Scholar : PubMed/NCBI
17	Higgins J and Green S: Cochrane Handbook for Systemic Reviews of Interventions. Version 5.1.0. The Cochrane Collaboration2011, http://handbook.cochrane.orgUpdated March 2011.
18	Higgins J, Altman D and Sterne J: Chapter 8: Assessing risk of bias in included studiesCochrane Handbook for Systemic Reviews of Interventions. Version 5.1.0. The Cochrane Collaboration. 2011, http://handbook.cochrane.orgUpdated March 2011.
19	Borghi-Silva A, Mendes RG, Toledo AC, Malosá Sampaio LM, da Silva TP, Kunikushita LN, Dutra de Souza HC, Salvini TF and Costa D: Adjuncts to physical training of patients with severe COPD: Oxygen or noninvasive ventilation? Respir Care. 55:885–894. 2010.PubMed/NCBI
20	Ringbaek T, Martinez G and Lange P: The long-term effect of ambulatory oxygen in normoxaemic COPD patients: A randomised study. Chron Respir Dis. 10:77–84. 2013. View Article : Google Scholar : PubMed/NCBI
21	Neunhäuserer D, Steidle-Kloc E, Weiss G, Kaiser B, Niederseer D, Hartl S, Tschentscher M, Egger A, Schönfelder M, Lamprecht B, et al: Supplemental oxygen during high-intensity exercise training in nonhypoxemic chronic obstructive pulmonary disease. Am J Med. 129:1185–1193. 2016. View Article : Google Scholar : PubMed/NCBI
22	Helgerud J, Bjørgen S, Karlsen T, Husby VS, Steinshamn S, Richardson RS and Hoff J: Hyperoxic interval training in chronic obstructive pulmonary disease patients with oxygen desaturation at peak exercise. Scand J Med Sci Sports. 20:e170–e176. 2010. View Article : Google Scholar : PubMed/NCBI
23	Dyer F, Callaghan J, Cheema K and Bott J: Ambulatory oxygen improves the effectiveness of pulmonary rehabilitation in selected patients with chronic obstructive pulmonary disease. Chron Respir Dis. 9:83–91. 2012. View Article : Google Scholar : PubMed/NCBI
24	Scorsone D, Bartolini S, Saporiti R, Braido F, Baroffio M, Pellegrino R, Brusasco V and Crimi E: Does a low-density gas mixture or oxygen supplementation improve exercise training in COPD? Chest. 138:1133–1139. 2010. View Article : Google Scholar : PubMed/NCBI
25	Alison JA, McKeough ZJ, Leung RWM, Holland AE, Hill K, Morris NR, Jenkins S, Spencer LM, Hill CJ, Lee AL, et al: Oxygen compared to air during exercise training in COPD with exercise-induced desaturation. Eur Respir J. 53:18024292019. View Article : Google Scholar : PubMed/NCBI
26	Spielmanns M, Fuchs-Bergsma C, Winkler A, Fox G, Krüger S and Baum K: Effects of oxygen supply during training on subjects with COPD who are normoxemic at rest and during exercise: A blinded randomized controlled trial. Respir Care. 60:540–548. 2015. View Article : Google Scholar : PubMed/NCBI
27	Oga T, Nishimura K, Tsukino M, Hajiro T, Ikeda A and Izumi T: The effects of oxitropium bromide on exercise performance in patients with stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 161:1897–1901. 2000. View Article : Google Scholar : PubMed/NCBI
28	Singh SJ, Morgan MD, Hardman AE, Rowe C and Bardsley PA: Comparison of oxygen uptake during a conventional treadmill test and the shuttle walking test in chronic airflow limitation. Eur Respir J. 7:2016–2020. 1994.PubMed/NCBI
29	Noonan V and Dean E: Submaximal exercise testing: Clinical application and interpretation. Phys Ther. 80:782–807. 2000.PubMed/NCBI
30	Nicolò A, Bazzucchi I, Haxhi J, Felici F and Sacchetti M: Comparing continuous and intermittent exercise: An ‘isoeffort’ and ‘isotime’ approach. PLoS One. 9:e949902014. View Article : Google Scholar : PubMed/NCBI
31	Lam HS, Lau FW, Chan GK and Sykes K: The validity and reliability of a 6-metre timed walk for the functional assessment of patients with stroke. Physiother Theory Pract. 26:251–255. 2010. View Article : Google Scholar : PubMed/NCBI
32	Sweer L and Zwillich CW: Dyspnea in the patient with chronic obstructive pulmonary disease. Etiology and management. Clin Chest Med. 11:417–445. 1990.PubMed/NCBI
33	Wang T, Tan JY, Xiao LD and Deng R: Effectiveness of disease-specific self-management education on health outcomes in patients with chronic obstructive pulmonary disease: An updated systematic review and meta-analysis. Patient Educ Couns. 100:1432–1446. 2017. View Article : Google Scholar : PubMed/NCBI