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In people with COPD, some types of breathing exercises improve outcomes

Cai Y, Ren X, Wang J, et al. Effects of Breathing Exercises in Patients With Chronic Obstructive Pulmonary Disease: A Network Meta-analysis. Arch Phys Med Rehabil. 2023 May 6:S0003-9993(23)00283-6.

Review question

In people with chronic obstructive pulmonary disease (COPD), how do different types of breathing exercises compare for improving patient outcomes?

Background

COPD is a lung disease that affects your ability to breathe. Breathing exercises can help improve breathing, the ability to exercise, and quality of life. This review looks at how different types of breathing exercises improve outcomes in people who have COPD.

How the review was done

The researchers did a systematic review of studies available up to October 2022. They found 43 randomized controlled trials that included 1977 people.

The key features of the studies were:

• people were 18 years of age or older, with an average age between 43 and 73 years, and most were men;
• people had COPD;
• breathing exercise types were Chinese traditional fitness exercises, diaphragm breathing, pursed-lip breathing, diaphragm breathing combined with pursed-lip breathing, inspiratory muscle training, singing, and yoga;
• breathing exercises were compared with other types of breathing exercises, health education, or usual care; and
• breathing exercise sessions were 5 to 90 minutes long, once per week to twice daily 5 days a week, for 4 to 48 weeks.

What the researchers found

Three types of exercises improved outcomes.

Chinese traditional fitness exercises:

• improved exercise capacity and endurance by a large amount compared with control; and
• improved quality of life by a large amount compared with inspiratory muscle training, singing, and control.

Inspiratory muscle training improved exercise capacity and endurance by a large amount compared with control.

Yoga improved quality of life by a large amount compared with singing or control.

Conclusion

In people with chronic obstructive pulmonary disease, some types of breathing exercises improve exercise capacity and endurance and quality of life compared with control or other types of exercise therapy.

Effects of breathing exercises in people with chronic obstructive pulmonary disease*

*Analyzed in a network meta-analysis. Only comparisons that affected the outcomes of exercise capacity and endurance and quality of life are reported here. Amount of improvement with exercise therapy is based on standardized mean differences (SMDs), where SMD ≥ 0.80 indicates a large improvement.

†Exercise capacity and endurance were measured with the 6-minute walk test.

‡Quality of life measured with the St. George’s Respiratory Questionnaire.