This Cochrane systematic review aimed to estimate the effects of physical activity on exercise capacity, lung function and health-related quality of life in people with cystic fibrosis. This review was an update of a previously published review.
This was a Cochrane systematic review of randomised controlled trials (RCTs) or quasi-randomised controlled trials. Relevant trials were identified from three trial registries. Trials were included if they included people with cystic fibrosis (of any age) who underwent any type of physical activity intervention compared to usual care (no physical activity intervention). Interventions needed to be two weeks or more in duration. The primary outcomes were exercise capacity (VO2 peak), lung function (FEV1), and health-related quality of life (using generic or disease-specific instruments).
Two review authors independently assessed studies for inclusion, extracted data, and undertook the assessment of risk of bias of included studies. Risk of bias was evaluated using the Cochrane risk of bias tool. Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.
There were 24 parallel RCTs included in the review (875 participants). Trial size varied from 9 participants to 117 participants and included a mix of adults, children, and adolescents. 12 studies used a supervised training approach, 11 used a partially supervised approach and one study used an unsupervised approach. Physical intervention durations varied from less than a month to up to 3 years.
Compared to no physical activity intervention (usual care), there was moderate certainty evidence that physical activity interventions of longer than 6 months probably have a small positive effect on aerobic exercise capacity in people with cystic fibrosis (MD 1.60 mL/min per kg bodyweight, 95% CI 0.16 to 3.05; I2=59%; n=348). There was low certainty evidence that physical activity interventions probably have no effect on lung function and health-related quality of life. No difference between groups was found for the number of adverse events over six months (odds ratio 6.22, 95% CI 0.72 to 53.40; 2 RCTs, 156 participants; low-certainty evidence).
Physical activity interventions of 6 months or more probably improves exercise capacity in people with cystic fibrosis. Adverse events are rare and there is no reason to discourage physical activity in people with cystic fibrosis.
Ref: Radtke T, Smith S, Nevitt SJ, Hebestreit H, Kriemler S. Physical activity and exercise training in cystic fibrosis. Cochrane Database of Systematic Reviews 2022, Issue 8. Art. No.: CD002768. DOI: 10.1002/14651858.CD002768.pub5.