Mind-body Exercise for Anxiety and Depression in COPD Patients: A Systematic Review and Meta-Analysis

Objectives: Mind-body exercise has been generally recognized as beneficial strategy to improve mental health in those with Chronic Obstructive Pulmonary Disease (COPD). However, to date no attempt has been made to collate this literature. The aim of the present study was to systematically analyze the effects of mind-body exercise for COPD patients with anxiety and depression and provide scientific evidence-based exercise prescription. Methods: both Chinese and English databases (PubMed, the Cochrane Library, EMBASE, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Wanfang, Baidu Scholar) were used as sources of data to search randomized controlled trials (RCT) relating to mind-body exercise in COPD patients with anxiety and depression that were published between January 1982 to June 2019. 13 eligible RCT studies were finally used for meta-analysis. Results: mind-body exercise (taichi, health qigong, yoga) had significant benefits on COPD patients with anxiety (SMD=-0.76, 95%CI=-0.91, -0.60, p=0.04, I2=47.4%) and depression (SMD=-0.86, 95%CI=-1.14, -0.58, p=0.000, I2=71.4%). Sub-group analysis indicated that for anxiety, 30-60 minutes exercise session for 24 weeks of health qigong or yoga had a significant effect on patients with COPD who are more than 70 years and have more than10-year disease course. For depression, 2-3 times a week, 30-60 minutes each time of health qigong had a significant effect on patients with COPD patients who are more than 70 years and have less than10-year disease course. Conclusions: Mind-body exercise could reduce levels of anxiety and depression in those with COPD. More robust RCT are required on this topic.