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Meta-Analysis
. 2023 Jun 21;32(168):220243.
doi: 10.1183/16000617.0243-2022. Print 2023 Jun 30.

Meditative movement for breathlessness in advanced COPD or cancer: a systematic review and meta-analysis

Claire M Nolan  1   2 , Lisa Jane Brighton  3   4 , Yihan Mo  3 , Joanne Bayly  3   5 , Irene J Higginson  3 , William D-C Man  2   6   7 , Matthew Maddocks  3
Affiliations
Meta-Analysis

Meditative movement for breathlessness in advanced COPD or cancer: a systematic review and meta-analysis

Claire M Nolan et al. Eur Respir Rev. .

Abstract

The effect of meditative movement, which includes yoga, tai chi and qi gong, on breathlessness in advanced disease is unknown. This systematic review aims to comprehensively assess the evidence on the effect of meditative movement on breathlessness (primary outcome), health-related quality of life, exercise capacity, functional performance and psychological symptoms (secondary outcomes) in advanced disease. 11 English and Chinese language databases were searched for relevant trials. Risk of bias was assessed using the Cochrane tool. Standardised mean differences (SMDs) with 95% confidence intervals were computed. 17 trials with 1125 participants (n=815 COPD, n=310 cancer), all with unclear or high risk of bias, were included. Pooled estimates (14 studies, n=671) showed no statistically significant difference in breathlessness between meditative movement and control interventions (SMD (95% CI) 0.10 (-0.15-0.34); Chi2=30.11; I2=57%; p=0.45), irrespective of comparator, intervention or disease category. Similar results were observed for health-related quality of life and exercise capacity. It was not possible to perform a meta-analysis for functional performance and psychological symptoms. In conclusion, in people with advanced COPD or cancer, meditative movement does not improve breathlessness, health-related quality of life or exercise capacity. Methodological limitations lead to low levels of certainty in the results.

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Conflict of interest statement

Conflict of interest: C.M. Nolan reports personal fees from Novartis, consultancy work (not reimbursed) with Vicore Pharma and grants from the National Institute for Health and Care Research outside the submitted work. W.D-C. Man reports grants from the National Institute for Health and Care Research (NIHR), outside the submitted work. M. Maddocks reports grants from NIHR, outside the submitted work. The remaining authors have nothing to disclose.

Figures

FIGURE 1
FIGURE 1
PRISMA diagram showing literature search and selection of articles. CDSR: Cochrane Database of Systematic Reviews; CENTRAL: Cochrane Central Register of Controlled Trials; CINAHL: Cumulative Index to Nursing and Allied Health Literature; CNKI: Chinese National Knowledge Infrastructure; RCT: randomised controlled trial.
FIGURE 2
FIGURE 2
Number of studies according to a) the type of meditative movement (number on top of bar indicates the number of participants), b) supplemental interventions and c) control interventions. LTOT: long-term oxygen therapy.
FIGURE 3
FIGURE 3
Forest plot comparing meditative movement and control intervention for the primary outcome – breathlessness – for all participants, active comparator and passive comparator. Std: standardised; IV: inverse variance; df: degree of freedom.
FIGURE 4
FIGURE 4
Forest plot comparing meditative movement and control intervention for the primary outcome – breathlessness – for all participants, people with COPD and people with cancer. Std: standardised; IV: inverse variance; df: degree of freedom.
FIGURE 5
FIGURE 5
Forest plot comparing meditative movement and control intervention for the primary outcome – breathlessness – for all participants and according to intervention type (tai chi, yoga, qi gong). Std: standardised; IV: inverse variance; df: degree of freedom.
See this image and copyright information in PMC

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