关键词: 肺疾病，慢性阻塞性, 网络技术, 远程运动康复, 循证护理学

Abstract:

Objective To systematically evaluate the effectiveness and safety of internet-based tele-exercise rehabilitation in COPD patients. Methods 12 electronic databases，such as Cochrane Library，PubMed，Web of Science，EBSCO etc，and clinical trials registry platforms were searched from their inception to December 2022，by computer and manual search. Literature search，study selection，data extraction and methodological quality evaluation were conducted by 2 researchers independently. Meta-analysis was performed by RevMan 5.4. Results 25 studies involving 2 359 patients were included. Meta-analysis indicated that compared to traditional exercise rehabilitation，internet-based tele-exercise rehabilitation contributed to an increase in 6MWD[MD=42.80，95%CI（29.53，56.07），P<0.001] and a decrease in COPD assessment test score[MD=-2.22，95%CI（-3.68，-0.76），P=0.003]；compared to remote rehabilitation without internet-based technology，internet-based tele-exercise rehabilitation increased patients 6MWD[MD=21.07，95%CI（13.29，28.84），P<0.001]，but its long-term maintenance effect was uncertain；it improved the level of exercise behavior，including daily walking steps[MD=805.83，95%CI（435.08，1176.58），P<0.001]，daily exercise time[MD=5.61，95%CI（3.11，8.10），P<0.001]，and moderate to high intensity exercise time[MD=2.32，95%CI（0.77，3.87），P=0.003]；internet-based tele-exercise rehabilitation also improved quality of life，by St. George’s Respiratory Questionnaire[MD=-3.12，95%CI（-5.87，-0.36），P=0.030] and Chronic Respiratory Disease Questionnaire[MD=9.18，95%CI（0.97，17.40），P=0.030]. In terms of safety，there was no significant difference in acute exacer-bations of COPD compared to the control group，but there was a higher risk of adverse events. Conclusion The implementation of internet-based tele-exercise rehabilitation can help improve motor function，exercise behavior level and quality of life in COPD patients，but the outcome evaluation indexes need to be standardized，and the long-term effects and safety of rehabilitation still need to be verified by numerous high-quality studies.

Key words: Pulmonary Disease，Chronic Obstructive, Internet-Based Interventions, Tele-Exercise Rehabilita-tion, Evidence-Based Nursing