title: Gender-associated differences in pulmonary rehabilitation outcomes in people with chronic obstructive pulmonary disease: a systematic review.
abstract: OBJECTIVE
  Although there is substantial evidence to support the importance of pulmonary rehabilitation (PR) in the management of chronic obstructive pulmonary disease, there is less evidence for gender-associated differences in the response to PR. The purpose of this review was to systematically identify and synthesize the available literature on whether men and women with chronic obstructive pulmonary disease respond differently to PR.
  
  
  METHODS
  A search of 4 electronic databases was conducted (January 1990 to May 2012) for all English language articles where the goal was to assess gender differences in outcomes after PR.
  
  
  RESULTS
  Of the 116 articles retrieved, 11 were included. Five studies reported differences between men and women after PR, for the outcomes of dyspnea, health-related quality of life, physical capacity, psychological and functional status, and coping strategies. Six studies reported no difference in response to PR for the same outcomes. No differences in study designs, study quality, participant characteristics, and type and duration of PR programs were observed between studies that showed gender differences and those that did not.
  
  
  CONCLUSIONS
  There was insufficient evidence to support or refute gender-associated differences in PR outcomes. The impact of gender on the outcome of PR and how these differences may affect the delivery of PR programs remains to be defined.
authors.affiliation: Respiratory Medicine, West Park Healthcare Centre (Ms Robles and Drs Brooks, Goldstein, and Mathur), Graduate Department of Rehabilitation Science (Ms Robles and Drs Brooks and Mathur), Department of Physical Therapy (Drs Brooks, Goldstein, Salbach, and Mathur), and Department of Medicine, University of Toronto (Dr Goldstein), Toronto, Ontario, Canada.
authors.forename: Priscila Games
authors.initials: PG
authors.lastname: Robles
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
authors.forename: Roger
authors.initials: R
authors.lastname: Goldstein
authors.forename: Nancy
authors.initials: N
authors.lastname: Salbach
authors.forename: Sunita
authors.initials: S
authors.lastname: Mathur
mesh_terms: D000223:Adaptation, Psychological; D004417:Dyspnea / Q000628:therapy; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D012737:Sex Factors