Effects of complementary therapies on physiological and psychological outcomes in chronic obstructive pulmonary disease patients: A systematic review and meta-analysis of randomized controlled trials.

Santiworakul A, Cetthakrikul S, Nemoto S, Nakabo T, Kuroyama Y, Khuna L, Longlalerng K.

ReviewAbstract only — full text under license

AI summary — for doctors, generated from the abstract only

Complementary therapies such as yoga, tai chi and relaxation may improve both physical and psychological outcomes in COPD and can be added to pulmonary rehabilitation, though effects vary by therapy.

What was studied

Systematic review and meta-analysis of 36 randomized trials (3,148 participants with COPD) of complementary therapies including yoga, tai chi/qigong, music therapy, CBT, relaxation and water-based exercise versus usual care or pulmonary rehabilitation.

Key findings

Versus usual care, exercise-based approaches mainly improved 6-minute walk distance (mean difference 58.73 m), with gains in FEV1% predicted (4.65), dyspnea, COPD Assessment Test score (-3.36) and SGRQ total score (-8.40).
Anxiety and depression scores fell (HADS-A -1.70; HADS-D -1.02).
Compared with pulmonary rehabilitation, complementary therapies showed slightly greater gains in 6-minute walk distance (8.17) and HADS-D (-0.74).

Clinical relevance

These options may help patients who cannot access or tolerate standard rehabilitation, or who want adjunctive support for breathlessness, quality of life and mood.

Who should care

Pulmonary Medicine

Limitations

Effects differed across therapies and the abstract gives no heterogeneity or risk-of-bias data. Pooled differences versus rehabilitation are small, and optimal modalities and patient selection remain unknown.

Complementary therapies look like reasonable adjuncts to rehabilitation in COPD, but they should not be assumed interchangeable.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Background

Pulmonary rehabilitation (PR) is the cornerstone intervention for improving respiratory function and symptoms in patients with chronic obstructive pulmonary disease (COPD). However, evidence on the effects of complementary therapies (CTs), such as yoga, tai chi/qigong, music therapy, cognitive behavioral therapy (CBT), relaxation techniques, and water-based exercise, remains limited.

Methods

Randomized controlled trials (RCTs) involving patients with COPD were systematically searched in Embase, Scopus, PubMed, and MEDLINE (Ovid). Study selection followed PRISMA guidelines. Continuous outcomes were pooled as mean differences (MDs) using random-effects models.

Results

Thirty-six RCTs involving 3,148 participants were included. Compared with usual care, effects on exercise capacity varied across different CTs, with improvements observed primarily in exercise-based approaches (6-minute walk distance [6MWD]; MD = 58.73 m), pulmonary function (FEV1% predicted; MD = 4.65), dyspnea (modified Borg scale; MD = -0.79; CRQ dyspnea; MD = 1.03), symptom burden (COPD Assessment Test; MD = -3.36), and health-related quality of life (SGRQ total score; MD = -8.40). Anxiety and depression (HADS-A and HADS-D) were also reduced (MD = -1.70 and -1.02, respectively). Compared with PR, CTs showed greater improvements in 6MWD (MD = 8.17) and HADS-D (MD = -0.74).

Conclusion

Complementary therapies may improve both physiological and psychological outcomes in patients with COPD and may serve as adjunctive strategies to conventional pulmonary rehabilitation. Further research is needed to identify optimal modalities and patient-specific responses.

DOI

10.1016/j.rmed.2026.109204

PMID

42855085

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

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