COPD: breathing exercises yield multiple benefits in meta-analysis

  • Ubolnuar N & al.
  • Ann Rehabil Med
  • 1 Aug 2019

  • International Clinical Digest
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Takeaway

  • Breathing exercises improve ventilation (including respiratory rate and tidal volume) and QoL, but fail to improve dyspnoea in COPD, according to a small meta-analysis of randomised controlled trials.

Why this matters

  • Clinicians should consider recommending breathing exercises more aggressively to patients with COPD, bearing in mind the low to moderate evidence quality.

Study design

  • Meta-analysis of 19 trials (n=745) identified from a search of MEDLINE, CINAHL, Cochrane, Scopus, and ScienceDirect.
  • Evidence quality and risk for bias were assessed by 2 methods, including Grading of Recommendation Assessment, Development, and Evaluation (GRADE).
  • Funding: Thailand Research Fund; others.

Key results

  • Respiratory rate was improved by:
    • Pursed-lip breathing vs control (P<.00001>
    • Ventilatory feedback plus exercise vs control (P=.0002).
    • Diaphragmatic breathing exercise vs control (P=.05).
    • Combined breathing exercises vs control (P<.00001>
  • Pursed-lip breathing vs control also increased:
    • Tidal volume (P=.0004).
    • Inspiratory time (P=.007).
    • Total respiratory time (P=.0004).
  • Ventilatory feedback plus exercise vs control also increased inspiratory capacity (P=.0007).
  • Singing vs control improved the physical component of QoL (P=.0005).
  • All breathing exercises failed to improve dyspnea.

Limitations

  • Quality of evidence by 2 methods was low to moderate.
  • Small number of studies, participants.

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