| Comparison 2.2. Strength/anaerobic training compared to aerobic training for cystic fibrosis | ||||||
|---|---|---|---|---|---|---|
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Aerobic training | Strength/anaerobic training | |||||
| [Supervised programme] Change in FEV1 % predicted at hospital discharge Scale from: 0 to 100. Follow-up: at hospital discharge, mean 18.7 days | The mean change in FEV1 % predicted in the aerobic training group was 6.54 | The mean change in FEV1 % predicted in the strength/anaerobic training groups was 3.55 higher (0.94 lower to 8.04 higher) | 44 (Selvadurai 2002) | ⊕⊕⊝⊝ low1,2 | ||
| [Unsupervised programme] Change in FEV1% predicted Scale from: 0 to 100. Follow-up: 3 months | The mean change in FEV1 % predicted in the aerobic training group was 4.89 | The mean change in FEV1% predicted in the strength/anaerobic training groups was 1.7 lower (7.67 lower to 4.27 higher) | 25 (Kriemler 2013) | ⊕⊝⊝⊝ very low2,3 | ||
| [Unsupervised exercise] Change in FEV1 % predicted Scale from: 0 to 100. Follow-up: 6 months | The mean change in FEV1 % predicted in the aerobic training group was 6.17 | The mean change in FEV1 % predicted in the strength/anaerobic training groups was 2.34 higher (6.33 lower to 11.01 higher) | 26 (Kriemler 2013) | ⊕⊝⊝⊝ very low3,4 | ||
| [Supervised exercise] Change in FEV1 % predicted Scale from: 0 to 100. Follow-up: 6 months | The mean change in FEV1 % predicted in the aerobic training group was −2.57 | The mean change in FEV1% predicted in the strength/anaerobic training groups was 1.66 lower (11.24 lower to 7.92 higher) | 56 (Orenstein 2004) | ⊕⊝⊝⊝ very low4,5 | ||
| [Pooled results for supervised and unsupervised programmes] Change in FEV1 % predicted Scale from: 0 to 100 Follow-up: 6 months | The mean change in FEV1 % predicted in the aerobic training group was 6.17 in 1 study and 2.57 in the other study | The mean change in FEV1 % predicted in the strength/anaerobic training groups was 0.54 higher (5.89 lower to 6.97 higher) | 82 (Kriemler 2013, Orenstein 2004) | ⊕⊝⊝⊝ very low4,6 | ||
| [Supervised exercise] Change in FEV1 % predicted Scale from: 0 to 100. Follow-up: 12 months | The mean change in FEV1 % predicted in the aerobic training group was −1.19 | The mean change in FEV1 % predicted in the strength/anaerobic training groups was 0.3 higher (9.21 lower to 9.81 higher) | 53 (Orenstein 2004) | ⊕⊝⊝⊝ very low4,5 | ||
| [Supervised programme] Change in FVC % predicted Scale from: 0 to 100. Follow-up: at hospital discharge, mean 18.7 days | The mean change in FVC % predicted in the aerobic training group was 2.34 | The mean change in FVC % predicted in the strength/anaerobic training groups was 0.11 higher (2.49 lower to 2.71 higher) | 44 (Selvadurai 2002) | ⊕⊝⊝⊝ very low1,7 | ||
| [Unsupervised programme] Change in FVC % predicted Scale from: 0 to 100 Follow-up: 3 months. | The mean change in FVC % predicted in the aerobic training group was 3.67 | The mean change in FVC % predicted in the strength/anaerobic training groups was 1.87 lower (7.33 lower to 3.59 higher) | 25 (Kriemler 2013) | ⊕⊝⊝⊝ very low3 | ||
| [Unsupervised programme] Change in FVC % predicted Scale from: 0 to 100. Follow-up: 6 months | The mean change in FVC % predicted in the aerobic training group was 4.66 | The mean change in FVC % predicted in the strength/anaerobic training groups was 1.54 higher (5.12 lower to 8.2 higher) | 26 (Kriemler 2013) | ⊕⊝⊝⊝ very low3,7 | ||
| [Supervised programme] Change in VO2 peak Follow-up: at hospital discharge, mean 18.7 days | The mean change in VO2 peak in the aerobic training group was 7.31 | The mean change in VO2 peak in the strength/anaerobic training groups was 6.58 lower (10.18 to 2.98 lower) | 44 (Selvadurai 2002) | ⊕⊕⊝⊝ low1,8 | ||
| [Unsupervised programme] Change in VO2 peak Follow-up: 3 months | The mean change in VO2 peak in the aerobic training group was 7.26 | The mean change in VO2 peak in the strength/anaerobic training groups was 0.24 higher (6.1 lower to 6.58 higher) | 26 (Kriemler 2013) | ⊕⊝⊝⊝ very low13,7 | ||
| [Unsupervised exercise] Change in VO2 max Follow-up: 6 months | The mean change in VO2 peak in the aerobic training group was 6.85 | The mean change in VO2 max in the strength/anaerobic training groups was 0.63 lower (10.94 lower to 9.68 higher) | 26 (Kriemler 2013) | ⊕⊝⊝⊝ very low3,7 | ||
| [Supervised exercise] Change in VO2 max Follow-up: 6 months | The mean change in VO2 peak in the aerobic training group was −1.91 | The mean change in VO2 max in the strength/anaerobic training groups was 0.25 lower (3.35 lower to 2.85 higher) | 56 (Orenstein 2004) | ⊕⊝⊝⊝ very low5,8 | ||
| [Pooled results for supervised and unsupervised programmes] Change in VO2 max Follow-up: 6 months | The mean change in VO2 max in the aerobic training group was 6.85 in 1 study and 1.91 in the other study | The mean change in VO2 max in the strength/anaerobic training groups was −0.28 lower (3.25 lower to 2.69 higher) | 82 (Kriemler 2013, Orenstein 2004) | ⊕⊕⊝⊝ low6 | ||
| [Supervised exercise] Change in VO2 max Follow-up: 12 months | The mean change in VO2 peak in the aerobic training group was −0.91 | The mean change in VO2 max in the strength/anaerobic training groups was 0.82 lower (4.32 lower to 2.68 higher) | 53 (Orenstein 2004) | ⊕⊝⊝⊝ very low5,8 | ||
| [Unsupervised programme] Change in BMI Follow-up: 3 months | The mean change in BMI in the aerobic training group was 0 | The mean change in BMI in the strength/anaerobic training groups was 0.2 higher (0.23 lower to 0.63 higher) | 30 (Kriemler 2013) | ⊕⊝⊝⊝ very low3,8 | ||
| [Unsupervised programme] Change in BMI Follow-up: 6 months | The mean change in BMI in the aerobic training group was 0 | The mean change in BMI in the strength/anaerobic training groups was 0.3 higher (0.1 lower to 0.7 higher) | 30 (Kriemler 2013) | ⊕⊝⊝⊝ very low3,8 | ||
| [Supervised programme] Change in BMI - | No evidence available | |||||
| Quality of life | No evidence available | |||||
| Preference for training programme | No evidence available | |||||
| Adverse events | No evidence available | |||||
The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
Abbreviations: BMI: body mass index; CI: confidence interval; CF: cystic fibrosis; FEV1: forced expiratory volume in 1 second; FVC: forced vital capacity; kg: kilogrammes MD: mean difference; min: minute; ml: millilitres; VO2 max/peak: maximal oxygen consumption
The quality of the evidence was downgraded by 1 because of unclear risk of bias in relation to random sequence generation, blinding of participants and personnel and blinding of outcome assessment.
The quality of the evidence was downgraded by 1 because the 95% 95% CI crossed 1 clinical MID
The quality of the evidence was downgraded by 2 because of high risk of bias in relation to random sequence generation and allocation concealment, unclear risk of bias in relation to blinding of participants and personnel, and unclear risk of other bias (due to the deterioration of physical health in the control group)
The quality of the evidence was downgraded by 2 because the 95% 95% CI crossed 2 clinical MIDs
The quality of the evidence was downgraded by 2 due to high risk of bias in relation to blinding of participants and personnel and unclear risk of bias in relation to random sequence generation and allocation concealment.
The quality of the evidence was downgraded by 2 because of high risk of bias in relation to random sequence generation and allocation concealment in 1 study, and unclear risk of bias in relation to the same domains in the other study; high risk of bias in relation to blinding of participants and personnel in 1 study and unclear risk of bias in relation to the same domains in the other study; and unclear risk of other bias in 1 study (due to the deterioration of physical health in the control group)
The quality of the evidence was downgraded by 2 because the 95% 95% CI crossed 2 default MIDs
The quality of the evidence was downgraded by 1 because the 95% 95% CI crossed 1 default MID
From: 10, Other monitoring, assessment and management
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