Physical training and noninvasive ventilation in COPD patients: A meta-analysis

Cristian Ricci, Stefano Terzoni, Maddalena Gaeta, Antonio Sorgente, Anne Destrebecq, Francesco Gigliotti

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Exercise training improves both exercise tolerance and quality of life in patients with COPD. The intensity of exercise training is crucial to achieve a true physiologic effect. However, in COPD patients, exertional dyspnea and leg fatigue mean that the patient cannot maintain intensity of training for enough time to yield a physiologic training effect. The use of noninvasive ventilation (NIV) support has been proposed as an alternative strategy to improve exercise tolerance and respiratory and cardiovascular performances. The first aim of our meta-analysis was to evaluate exercise training with NIV in terms of physiologic effects after the completion of a pulmonary rehabilitation program. The second aim was to investigate the dose-response relationship between physical improvement and training intensity. METHODS: Literature research was performed using MEDLINE, Embase, and CINAHL. Meta-analysis and meta-regressions were performed using random effects models. RESULTS: Eight studies provided a proper description of a training schedule in stable COPD patients. A similar effect between NIV and placebo was observed for the outcomes considered despite differences between studies. However, subjects experienced a relevant and statistically significant improvement after rehabilitation for almost all of the outcomes considered. Heart rate (6 beats/min [95% CI 0.94-11.01], P.02), work load (9.73 W [95% CI 3.78-15.67], P

Original languageEnglish
Pages (from-to)709-717
Number of pages9
JournalRespiratory Care
Issue number5
Publication statusPublished - 2014


  • Chronic obstructive pulmonary disease
  • Noninvasive ventilation
  • Physical rehabilitation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Medicine(all)


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