Efeitos do uso de dispositivos vestíveis no monitoramento de atividade física em programas de reabilitação pulmonar para doenças respiratórias crônicas: uma revisão sistemática e metanálise

Abstract

Introduction: Pulmonary rehabilitation (PR) is a comprehensive approach aimed at the care of individuals with chronic respiratory diseases (CRD). Patients with chronic obstructive pulmonary disease (COPD) and asthma exhibit reduced physical fitness levels, as they tend to avoid physical exercise due to fear of triggering frequent symptoms. Wearable devices have been integrated into behavior change interventions for physical activity in PR protocols. Objective: To analyze the literature and identify the effects of wearable devices in monitoring physical activity in pulmonary rehabilitation programs for chronic respiratory diseases. Methods and analyses: This is a systematic review registered on PROSPERO (CRD42024504137). Searches were conducted on March 7, 2024, in electronic databases, including Medline, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, CINAHL, and PEDro, as well as in gray literature. Randomized controlled trials involving individuals of both sexes, aged 18 years or older, diagnosed with COPD or asthma were included. The studies utilized wearable devices for monitoring in PR programs with resistance and/or aerobic physical training. There were no restrictions regarding language or publication year. Conference abstracts and studies focusing solely on the development of algorithms or applications for disease evaluation were excluded. Results: The electronic search yielded 3,940 references, of which 2,038 were duplicates and subsequently excluded, leaving 1,902 articles. After screening titles and abstracts, 23 studies were selected for full-text review. 18 articles were excluded and 5 inclused by eligibility criteria, with an additional three studies identified through manual searches and one via Google Scholar, resulting in nine articles included in the review. These studies involved 743 participants aged between 45 and 75 years. Interventions, lasting 8–52 weeks, included aerobic and resistance exercises combined with educational programs. Improvements in physical activity monitored by wearable devices were reported. Methodological analysis using the PEDro scale indicated quality ranging from moderate to excellent, while the risk of bias was more pronounced in qualitative outcomes. Conclusion: The wearable devices are effective in increasing physical activity in patients with chronic respiratory diseases, but they do not produce a significant impact on other clinical outcomes, such as quality of life. This systematic review and meta-analysis provided a comprehensive assessment of the effectiveness and impact of these devices in the PR context, contributing primarily to the evaluation of clinical efficacy, technological integration, improvement in exercise adherence, evidence synthesis, and the identification of research gaps and future needs.