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Pulmonary Rehabilitation for Pneumoconiosis: Protocol for a Systematic Review and Meta-Analysis

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Pulmonary Rehabilitation for Pneumoconiosis: Protocol for a Systematic Review and Meta-Analysis Open access Protocol BMJ Open: first published as 10.1136/bmjopen-2018-025891 on 22 August 2019. Downloaded from Pulmonary rehabilitation for pneumoconiosis: protocol for a systematic review and meta-analysis Hulei Zhao,1,2,3 Yang Xie,2,3 Jiajia Wang,3 Xuanlin Li,3 Jiansheng Li3 To cite: Zhao H, Xie Y, Wang J, ABSTRACT Strengths and limitations of this study et al. Pulmonary rehabilitation Introduction Pneumoconiosis is characterised by for pneumoconiosis: protocol diffuse fibrosis in lung tissue, and its incidence is on the ► This systematic review aims to evaluate the ef- for a systematic review and rise. At present, there are limited therapeutic options for meta-analysis. BMJ Open ficacy and safety of pulmonary rehabilitation for pneumoconiosis. Pulmonary rehabilitation (PR) has been 2019;9:e025891. doi:10.1136/ pneumoconiosis. widely used to treat pneumoconiosis，however, there is bmjopen-2018-025891 ► The review methods were carefully planned to min- limited evidence concerning its efficacy. Therefore, we plan imise risk of selective bias, reporting bias and pub- ► Prepublication history for to conduct a systematic review to investigate the efficacy lication bias in the completed review according to this paper is available online. and safety of PR for pneumoconiosis. current guidelines and prospectively registered with To view these files please visit Methods and analysis The following databases will be the journal online (http:// dx. doi. the International Prospective Register of Systematic searched from their inception to 1 April 2019: PubMed, org/ 10. 1136/ bmjopen- 2018- Reviews. Embase, The Cochrane Library, Web of Science, Chinese 025891). ► The search strategy for this review is broad and Biomedical Literature Database, China National Knowledge comprehensive, including studies from multiple Infrastructure, Chongqing VIP and Wanfang Data. Received 07 August 2018 electronic databases. Revised 04 July 2019 Randomised controlled trials of PR for pneumoconiosis ► Limitations may include issues of poor reporting af- Accepted 30 July 2019 will be included. Primary outcomes will include 6 min walk fecting risk of bias assessment and confidence in distance and St. George’s Respiratory Questionnaire. Study results. selection, extraction of data and assessment of study quality each will be independently undertaken. Statistical analysis will be conducted using Review Manager 17%.9 A systematic analysis of studies from software. Ethics and dissemination This systematic review will 2001 to 2011 showed that the pooled prev- alence of CWP was 6.02% in China, which provide up-to-date information on PR for pneumoconiosis. http://bmjopen.bmj.com/ The review does not require ethical approval and will was higher compared with UK (0.8%, 1998– 10 be disseminated electronically through a peer-reviewed 2000) and the USA (3.2% in 2000s). During © Author(s) (or their publication or conference presentations. 1999–2016, a total of 38 358 years of potential employer(s)) 2019. Re-use PROSPERO registration number CRD42018095266. life lost to life expectancy (mean per dece- permitted under CC BY-NC. No dent=8.8 years) and 2707 years of potential commercial re-use. See rights life lost before age 65 years (mean per dece- and permissions. Published by 11 BMJ. INTRODUCTION dent=7.3 years) were attributed to CWP. 1 Pneumoconiosis is a disease characterised by Long-term silica dust exposure is associated Longhua Hospital Shanghai on October 2, 2021 by guest. Protected copyright. University of Traditional Chinese diffuse fibrosis in lung tissue, and is mainly with substantially increased mortality among 12 Medicine, Shanghai University caused by long-term inhalation of productive Chinese workers. of Traditional Chinese Medicine, mineral dust in occupational activities.1–3 Dust At present, there are limited therapeutic Shanghai, China exposure in coal mining has been one of the options for pneumoconiosis.13 Pulmonary 2Department of Respiratory Diseases, The First Affiliated main occupational hazard factors in China rehabilitation (PR) is a comprehensive inter- Hospital of Henan University of over time, and coal worker pneumoconiosis vention based on a thorough patient assess- Chinese Medicine, Zhengzhou, (CWP) and silicosis are the main types of the ment followed by patient-tailored therapies China 12 kinds of national occupational pneumoco- that include, but are not limited to, exer- 3 Collaborative Innovation niosis.3 4 In 2016, the National Occupational cise training, education, social support and Center for Respiratory Disease Diagnosis and Treatment & Disease Report shows that China has reported behavioural change, which are designed Chinese Medicine Development a total of 31 789 cases of occupational to improve the physical and psychological of Henan Province, Henan diseases, including 27 992 cases of occupa- condition of people with chronic respiratory University of Chinese Medicine, tional pneumoconiosis accounted for 88.06% disease and promote the long-term adherence Zhengzhou, China of the total cases reported.5 The incidence of to health-enhancing behaviours.14 Evidence- 6–8 Correspondence to pneumoconiosis is on the rise. In China, based support for PR in the management of Dr Yang Xie; the cumulative incidence of pneumoconiosis patients with chronic respiratory disease has xieyanghn@ 163. com in state-owned coal mines ranges from 4% to grown tremendously, and this comprehensive Zhao H, et al. BMJ Open 2019;9:e025891. doi:10.1136/bmjopen-2018-025891 1 Open access BMJ Open: first published as 10.1136/bmjopen-2018-025891 on 22 August 2019. Downloaded from intervention has been clearly demonstrated to reduce Table 1 Search strategy for PubMed dyspnoea, increase exercise performance and improve health-related quality of life (HRQL).15 As an effective No No search terms intervention，PR could provide sustained improvement #1 Pneumoconiosis [MeSH Terms] of functional capacity and reduce healthcare utilisation #2 pneumoconiosis [Title/Abstract] 16 for occupational respiratory diseases. Recently, PR has #3 Asbestosis [MeSH Terms] been widely used to treat pneumoconiosis.16–18 However, #4 asbestosis [Title/Abstract] there is limited evidence concerning its efficacy for pneu- moconiosis patients. Therefore, we plan to conduct a #5 Silicosiss [MeSH Terms] systematic review to investigate the efficacy and safety of #6 silicosis [Title/Abstract] PR for pneumoconiosis. #7 Anthracosis [MeSH Terms] #8 Anthracosis [Title/Abstract] METHODS AND ANALYSIS #9 Anthracosilicosis [MeSH Terms] Study type #10 Anthracosilicosis [Title/Abstract] All published randomised controlled trials (RCTs) with a #11 #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR parallel, cluster or cross-over design will be included. #8 OR #9 OR #10 #12 rehabilitation [MeSH Terms] Participants #13 rehabilitation [Title/Abstract] Pneumoconiosis patients diagnosed by relevant standard (such as GBZ 70–2015 National occupational health stan- #14 health education [MeSH Terms] dards)3 will be included. There will be no restrictions on #15 health education [Title/Abstract] age, sex, ethnicity, education or economic status. We will #16 psychological counselingTitle/Abstract] exclude studies including participants with complica- #17 nutritional guidance [Title/Abstract] tions, such as pulmonary heart disease, tuberculosis and #18 Baduanjin [Title/Abstract] chronic respiratory failure. #19 eight-section brocade [Title/Abstract] Interventions #20 respiratory training [Title/Abstract] The intervention we focus on in this review is a compre- #21 sports training [Title/Abstract] hensive PR, which is based on exercise training, including #22 exercise therapy [MeSH Terms] or not including health education, nutritional interven- tion and psychosocial support. #23 exercise therapy [Title/Abstract] Comparisons investigated are: #24 physical fitness [MeSH Terms] ► PR versus no treatments; #25 physical fitness [Title/Abstract] http://bmjopen.bmj.com/ ► PR adjunctive to other treatments versus other treat- #26 physical exertion [MeSH Terms] ments alone. #27 physical exertion [Title/Abstract] Outcome measures #28 kinesiotherapy [Title/Abstract] ► Primary outcomes #29 muscle training [MeSH Terms] The primary outcome measures were functional #30 muscle training [Title/Abstract] capacity and HRQL, as measured by 6 min walk 16 19–21 #31 physical endurance [MeSH Terms] distance, St. George’s Respiratory Question- on October 2, 2021 by guest. Protected copyright. naire.16 21 22 #32 physical endurance [Title/Abstract] ► Secondary outcomes #33 #12 OR #13 OR #14 OR #15 OR #16 OR #17 OR The secondary outcomes measures were pulmonary #18 OR #19 OR #20 OR #21 OR #22 OR #23 OR function, symptoms, acute exacerbations and adverse #24 OR #25 OR #26 OR #27 OR #28 OR #29 OR events, as measured by forced vital capacity, forced #30 OR #31 OR #32 expiratory volume in the 1 s,21 22 the modified Medical #34 #11 AND #33 23 Research Council dyspnoea scale, frequency of acute This search strategy will be modified as required for other 16 24 exacerbations and incidence of adverse events. electronic databases. Search methods We will search PubMed, Embase, The Cochrane Library, the reference lists of included studies or relevant system- Web of Science, Chinese Biomedical Literature Database, atic reviews to identify any potentially eligible studies. China National Knowledge Infrastructure, Chongqing The search strategy for PubMed is shown in table 1. VIP and Wanfang Data from their inception to 1 April 2019. We have developed detailed search strategies
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