Effectiveness of rehabilitation interventions in adults with asthma: a systematic review and meta-analysis

Objective: To evaluate the effectiveness of pulmonary rehabilitation (PR) programs and other rehabilitation interventions in adults with asthma. Design: Systematic review and meta-analysis. Results: MEDLINE (PubMed), EMBASE, Cumulative Index to Nursing & Allied Health Literature and CENTRAL were searched from inception to 31 May 2023. PROSPERO registration number: CRD42022331440. Thirty-six randomised controlled trials (RCTs) were analysed, and only 26 were pooled in the meta-analysis due to the heterogeneity of comparisons and outcomes across the studies. Pulmonary rehabilitation, compared with education associated with breathing exercises, may result in little to no difference in the Asthma Quality of Life Questionnaire (AQLQ) (mean difference 0.01 score, 95% confidence interval -0.48 to 0.50, 163 participants, three studies, low certainty). Conclusion: Our findings show that pulmonary rehabilitation, compared with education associated with breathing exercises, may result in little to no difference in the impact of asthma on health-related quality of life. Overall, the certainty of evidence was low or very low preventing any firm conclusion on the effects of single or combined rehabilitation interventions.