护理SCI晨读：游泳对哮喘患儿肺功能和哮喘控制有效性的系统评价和荟萃分析

2021-08-20 11:08

确定游泳对 18 岁以下儿童肺功能和哮喘控制的干预效果。还检查了游泳对哮喘的任何不利影响。

护理SCI晨读：

游泳对哮喘患儿肺功能和哮喘控制有效性的系统评价和荟萃分析

摘要

背景

与陆上活动相比，游泳被认为是哮喘儿童最合适的活动，因为它的致哮喘性较低。然而，游泳的好处受到了因暴露于游泳池中的氯副产品而导致哮喘风险增加、气道炎症和支气管高反应性的报告的阻碍。因此，游泳对哮喘儿童的作用仍不清楚。

目标

确定游泳对 18 岁以下儿童肺功能和哮喘控制的干预效果。还检查了游泳对哮喘的任何不利影响。

方法

在六个数据库（PubMed、CINAHL 、Embase、CENTRAL、 Scopus和 PsycINFO）中系统地进行了检索。检索以英文发表的随机对照试验（RCTs）、准实验研究和至少有一个对照/比较组的干预性研究。所有符合条件的研究都经过了两名独立审查员的偏倚风险筛选。使用 Review Manager 5.4 软件进行荟萃分析，在荟萃分析不合适且存在异质性的情况下进行叙述性综合。

结果

检索到 1710 条记录。筛选后共纳入 9 项研究，共 387 名参与者。发现游泳对一秒用力呼气量(L) 和用力肺活量(%)有有利影响，但对一秒用力呼气量 (%) 和峰值呼气流量(%) 没有影响。关于哮喘控制和不良反应的叙述综合有利于游泳组。

结论

未来的研究需要有足够的效力，包括足够强度、频率和持续时间的游泳干预，检查氯副产品的累积暴露量，并考虑潜在的共同因素。

Abstract

Background

Swimming has been considered the most appropriate activity for children with asthma for its lower asthmogenicity compared to land-based activities. However, the benefits of swimming have been hampered by reports of increased asthma risks, airway inflammation and bronchial hyper-responsiveness from exposure to chlorine by-products in swimming pools. Thus, the role of swimming for children with asthma remains unclear.

Objectives

To determine the effectiveness of swimming as an intervention on lung function and asthma control in children below the age of 18 years. Any adverse effects from swimming on asthma were also examined.

Methods

Searches were performed across six databases systematically (PubMed, CINAHL, Embase, CENTRAL, Scopus, and PsycINFO). Randomized controlled trials (RCTs), quasi-experimental studies and interventional studies with at least one control/comparator group that were published in English were included. All eligible studies were screened with risk of bias examined by two independent reviewers. Meta-analyses were conducted using Review Manager 5.4 software while narrative syntheses were performed where meta-analysis was inappropriate and heterogeneity was present.

Results

1710 records were retrieved from the search. A total of 9 studies with 387 participants were included in this review after screening. Swimming was found to have favourable effects on forced expiratory volume in one second (L) and forced vital capacity (%), but not for forced expiratory volume in one second (%) and peak expiratory flow (%). Narrative synthesis on asthma control and adverse effects were in favour of the swimming group.

Conclusion

Future studies that are adequately powered, involve swimming interventions of sufficient intensity, frequency and duration, examine cumulative exposures to chlorine by-products and take into account potential cofounders are warranted.