Exercise prescription for hospitalized people with chronic obstructive pulmonary disease and comorbidities: a synthesis of systematic reviews

W Darlene Reid,1,2 Cristiane Yamabayashi,1 Donna Goodridge,3 Frank Chung,4 Michael A Hunt,1 Darcy D Marciniuk,5 Dina Brooks,6 Yi-Wen Chen,1 Alison M Hoens,1,7 Pat G Camp1,21Department of Physical Therapy, University of British Columbia, Vancouver, 2Institute of Heart and Lung Health, University of British Columbia, Vancouver, 3College of Nursing, University of Saskatchewan, 4Physiotherapy, Burnaby Hospital, Fraser Health, British Columbia, 5Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, 6Department of Physical Therapy, University of Toronto, Toronto, ON, 7Providence Health Care, Vancouver, BC, CanadaIntroduction: The prescription of physical activity for hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can be complicated by the presence of comorbidities. The current research aimed to synthesize the relevant literature on the benefits of exercise for people with multimorbidities who experience an AECOPD, and ask: What are the parameters and outcomes of exercise in AECOPD and in conditions that are common comorbidities as reported by systematic reviews (SRs)?Methods: An SR was performed using the Cochrane Collaboration protocol. Nine electronic databases were searched up to July 2011. Articles were included if they (1) described participants with AECOPD, chronic obstructive pulmonary disease (COPD), or one of eleven common comorbidities, (2) were an SR, (3) examined aerobic training (AT), resistance training (RT), balance training (BT), or a combination thereof, (4) included at least one outcome of fitness, and (5) compared exercise training versus control/sham.Results: This synthesis examined 58 SRs of exercise training in people with AECOPD, COPD, or eleven chronic conditions commonly associated with COPD. Meta-analyses of endurance (aerobic or exercise capacity, 6-minute walk distance – 6MWD) were shown to significantly improve in most