ArticleJournal of thoracic disease2026
Home-based pulmonary rehabilitation, hospital-based pulmonary rehabilitation, and standard care in chronic obstructive pulmonary disease patients-a systematic review and network meta-analysis.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
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Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of global morbidity, mortality, and healthcare burden. Although pulmonary rehabilitation is a cornerstone of COPD management, the relative effectiveness of hospital-based, home-based, and telerehabilitation programs, as well as guided versus unguided delivery, remains uncertain in patients with moderate to severe stable COPD. This study aims to investigate the differences in intervention effects among home-based pulmonary rehabilitation (PR), hospital-based PR, and standard care for patients with COPD using a network meta-analysis approach. Methods: A comprehensive search was conducted across databases, including the Cochrane Library, ClinicalTrials.gov, EBSCOhost (Dental and Oral Sciences Sources), PubMed, Scopus, and Web of Science, to identify prospective randomized controlled trials (RCTs) comparing different PR modalities in COPD. The 6-minute walk distance (6MWD) was extracted as the primary outcome for direct meta-analysis and network meta-analysis. Results: A total of 16 studies involving 1,235 participants were included in the analysis. The results of the direct meta-analysis indicated that PR significantly improved 6MWD across all follow-up durations, but statistical significance was achieved only at the 12-month follow-up [mean difference (MD) =-110.24, 95% confidence interval (CI): -180.02, -40.45]. Surface under the cumulative ranking curve (SUCRA) values were calculated for each intervention to assess their relative effectiveness: in the <3-month follow-up, SUCRA values were 78.1% for guided PR, 68.1% for unguided PR, and 3.8% for standard care; in the 6-month follow-up, the SUCRA values were 75.7% for guided PR, 59.6% for unguided PR, and 15.7% for standard care; and in the 12-month follow-up, the SUCRA values were 78.0% for unguided PR, 62.3% for guided PR, and 9.7% for standard care. Conclusions: PR is an essential intervention in the management of COPD, with home-based PR offering a feasible and accessible alternative that achieves benefits comparable to those of professionally guided PR and may have advantages in terms of resource use and implementation.
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