Aerobic Exercise on Functional Capacity and Quality of Life in COPD Patients: A systematic review and meta-analysis with trial sequential analysis

Objective Research has indicated that pulmonary rehabilitation (PR) is effective in reducing symptoms in people with COPD. Exercise is part of overall PR, while the isolated effect of aerobic exercise in COPD patients remains unclear. Methods English and Chinese RCTs published from inception to the May 2025 were searched in online nine databases. The Cochrane Risk of Bias tool was used to assess the risk of bias in the included studies. Stata17.0 and RevMan5.3 were used to do the meta-analysis. We conducted a trial sequential analysis (TSA) that included all of the results in order to assess the stability and dependability of the study's findings. This study has been registered with PROSPERO under ID CRD42022377652. Results The meta-analysis comprised 25 trials with 2103 participants in total. According to the findings, aerobic exercise significantly improved the 6MWT, CAT, FEV1%pred, FEV1/FVC%. Subgroup and meta-regression analyses identified sources of heterogeneity. The TSA results show that the study outcomes for the three indicators 6MWT, CAT, and SGRQ are conclusive and reliable. Conclusion Patients with COPD benefit greatly from aerobic exercise in terms of their exercise capacity and quality of life, and to some extent, enhances lung function.