Ann Rehabil Med.
2019 Aug;43(4):509-523. 10.5535/arm.2019.43.4.509.
Effects of Breathing Exercises in Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis
- Affiliations
-
- 1Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand. anong.ta@chula.ac.th
- 2Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- 3Department of Physical Therapy, California State University, Northridge, CA, USA.
- KMID: 2457760
- DOI: http://doi.org/10.5535/arm.2019.43.4.509
Abstract
OBJECTIVE
To update evidence on the effects of breathing exercises (BEs) on ventilation, exercise capacity, dyspnea, and quality of life (QoL) in chronic obstructive pulmonary disease (COPD) patients.
METHODS
Randomized controlled trials investigating the effects of BEs in COPD patients published through May 2018, were retrieved from five electronic databases (MEDLINE, CINAHL, Cochrane, Scopus, and ScienceDirect). Risk of bias and quality of evidence were assessed, using Cochrane Collaboration's tool, and the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) approach, respectively.
RESULTS
Nineteen studies (n=745), were included. Quality of evidence, was low to moderate. When compared to the control groups, respiratory rate significantly (p≤0.001) improved in the pursed-lip breathing (PLB), ventilatory feedback (VF) plus exercise, diaphragmatic breathing exercise (DBE), and combined BEs. Additionally, PLB significantly improved tidal volume (p<0.001), inspiratory time (p=0.007), and total respiratory time (p<0.001). VF plus exercise significantly improved inspiratory capacity (p<0.001), and singing significantly improved the physical component of QoL, than did the control groups (p<0.001). All BEs did not significantly improve dyspnea, compared to the controls (p>0.05).
CONCLUSION
PLB, VF plus exercise, DBE, combined BEs, and singing could be used to improve ventilation and QoL. Based on low to moderate quality of evidence, use of these BEs to improve ventilation and QoL in COPD patients is conditional (Registration No. CRD42018102995).
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