Evidence for aerobic exercise training on the autonomic function in patients with chronic obstructive pulmonary disease (COPD): a systematic review

Abstract

Objective: To assess evidence for the effectiveness of aerobic exercise training (AET) on the autonomic function (AF) outcomes in patients with chronic obstructive pulmonary disease (COPD).

Data sources: Online databases of PubMed, CINAHL and Web of Science were systematically searched for all years till 26th of January, 2017.

Study selection: Clinical studies assessing any measure of AF following exercise training in patients with COPD were included.

Data extraction and synthesis: Data were extracted from studies with high methodological quality for evidence synthesis. Rating of evidence quality was determined using the GRADE guidelines.

Results: The Majority of the included studies utilized continuous exercise training mode with a vigorous level of intensity. Each exercise training session lasted between 30 to 40minutes, and the frequency of intervention was ≥3 times/week. Evidence synthesis of studies with high methodological quality revealed that a high quality evidence level supported a significant increase for time-domain heart rate variability (HRV) analyses and the heart rate recovery (HRR) following AET. The review also found that frequency domain HRV analyses were not significantly affected by AET. The evidence to support the effect of exercise training on baroreceptor sensitivity (BRS) in patients with COPD is very low.

Conclusion: Aerobic exercise training demonstrated beneficial but limited effects on the AF in COPD. Presently, it is not clear whether these effects are sustained in the long term. Only a limited number of RCTs were available indicating a significant gap in the literature.

Keywords: Autonomic function; Chronic obstructive; Exercise; Pulmonary disease; Systematic review.