Characteristics of the studies
Title
References
Country
Year
Study design
Statistical analysis
Type of training
Control group activity
Type of subjects
Pulmonary functioning
Instrument
Individual/group
Homework
Duration
Dropout
Mean age
SD age
Quality The Effects of Controlled Breathing during Pulmonary Rehabilitation in Patients with COPD
[32 ] Germany 2011 RCT Within-groups comparisons: paired Student’s RBF (Respiratory Biofeedback Training) and breathing techniques Physical exercise training only COPD patients GOLD 1-2-3-4 CRQ Individual No 3-4 weeks 10 sessions 40 20 20 0 Nd 23 17 66.1 6.4 6 Can Ventilation-Feedback Training Augment Exercise Tolerance in Patients with COPD? [37 ] USA 2007-2008 RCT Analysis of covariance, paired Ventilation Biofeedback Training Exercise alone COPD patients GOLD 3 CRQ Individual No 12 weeks 36 sessions 64 22 20 20 15 Nd Nd 67.3 6 Tai Chi Exercise for Patients with Chronic Obstructive Pulmonary Disease: A Pilot Study [29 ] USA 2010 RCT Tai Chi and breathing exercises Usual care alone COPD patients GOLD 2 CRQ; CES-D Group Yes 12 weeks 24 sessions 10 5 5 0 0 4 6 66 6 7 Exercise Maintenance following Pulmonary Rehabilitation Effect of Distractive Stimuli [34 ] USA 2002 RCT DAS (Distractive Auditory Stimuli) Walk at their own pace from 20 to 45 minutes COPD patients GOLD 2 STAI; CES-D; SGRQ; VAS (global QoL) Group No 4 weeks From 2 to 5 times a week 24 12 12 0 0 20 4 68.1 8 6 Distraction Therapy with Nature Sights and Sounds Reduces Pain during Flexible Bronchoscopy: A Complementary Approach to Routine Analgesia [38 ] USA 2003 RCT Chi-square test and Student’s Distraction therapy Usual care COPD and asthma patients, with FB (Flexible Bronchoscopy) Nd STAI Individual No 4 months Nd 80 41 39 0 0 42 38 53.8 6 Effects of Progressive Muscle Relaxation Training on Anxiety and Depression in Patients Enrolled in an Outpatient Pulmonary Rehabilitation Program [21 ] USA 2008 Prospective RCT Independent Progressive muscle relaxation Standard PR program (exercise training, education, and psychosocial support) without PMR COPD patients GOLD 2 HADS Individual No 8 weeks 8 sessions 103 37 46 0 20 Nd Nd 65.5 6 Treatment of Dyspnea in COPD: A Controlled Clinical Trial of Dyspnea Management Strategies [39 ] USA 1995 RCT Progressive muscle relaxation, breathing retraining, pacing, self-talk and panic control General health education COPD patients GOLD 2-3 STAI; CES-D; QWB Group No 6 weeks 6 sessions 98 46 43 0 9 40 49 67.4 7 Efficacy of Pursed-Lips Breathing: A Breathing Pattern Retraining Strategy for Dyspnea Reduction [40 ] USA 2007 RCT Analysis of variance, multilevel modeling PLB (Pursed-Lips Breathing) Usual care COPD patients GOLD 3 SF-36 Individual No 12 weeks Nd 40 14 13 13 0 2 38 65 9 7 Diaphragmatic Breathing Training Program Improves Abdominal Motion during Natural Breathing in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial [41 ] Brazil 2012 Prospective RCT, single blind Independent Diaphragmatic breathing Usual care COPD patients GOLD 3 SGRQ Individual No 4 weeks 12 sessions 30 15 15 0 0 8 22 66.4 7 Effects of Singing Classes on Pulmonary Function and Quality of Life of COPD Patients [42 ] Brazil 2009 RCT Student’s Breathing techniques and vocalization Handcraft work COPD patients GOLD 2-3 SGRQ Group No 24 weeks 24 sessions 16 15 15 0 13 (disc) 6 24 71.7 6 Singing Teaching as a Therapy for Chronic Respiratory Disease: A RCT and Qualitative Evaluation [43 ] UK 2010 RCT Relaxation, vocalization, posture Usual care COPD patients GOLD 3 HADS; SGRQ; SF-36 Individual Yes 6 weeks 12 sessions
36
15
13 0 8 (follow-up) Nd Nd 67.3 8.1
5 Yoga Therapy Decreases Dyspnea-Related Distress and Improves Functional Performance in People with Chronic Obstructive Pulmonary Disease: A Pilot Study [24 ] USA 2009 RCT Two-way repeated measures analysis of variance Yoga Usual care COPD patients GOLD 2-3 SF-36; SSAI; CES-D; CRQ Group Yes 12 weeks 24 sessions 29 14 15 0 0 21 8 69.9 9.5 6 Effectiveness of a Tai Chi Qigong Program in Promoting Health-Related Quality of Life and Perceived Social Support in Chronic Obstructive Pulmonary Disease Clients [44 ] China 2010 RCT, single blind Repeated measures analysis of variance (RANOVA) Tai Chi Qigong Usual care COPD patients GOLD 1-2-3 SGRQ Group Yes 12 weeks 24 sessions 206 70 67 69 48 18 188 72.9 6 Functional and Psychosocial Effects of Health Qigong in Patients with COPD: A Randomized Controlled Trial [45 ] China 2010-2011 RCT Intention-to-treat (ITT) analysis, Student’s Tai Chi Qigong Training sessions reinforcing the breathing and walking exercise COPD patients GOLD 3 SF-36; Chinese CRQ Individual Yes 6 months from 1 to 4 times a day 80 23 29 0 19 9 71 72.4 8 Singing Classes for Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial [46 ] UK 2012 RCT ANCOVA Breathing techniques, relaxation training, vocalization Film workshops COPD patients GOLD 3 HADS; SF-36 Group Yes 8 weeks 16 sessions 33 13 11 0 8 Nd Nd 68.4 6 Role of Pranayama in Rehabilitation of COPD Patients: A Randomized Controlled Study [25 ] India 2006 Prospective RCT Student Newman-Keuls tests Yoga Usual physical activity COPD patients GOLD 2-3 SGRQ Group No 3 months Half an hour, everyday 48 23 22 0 3 7 38 52.2 5 Adjunct Treatment with Yoga in Chronic Severe Airways Obstruction [47 ] Australia 1978 RCT Student’s Yoga Physiotherapy Patients with severe airways obstruction, with or without emphysema GOLD 3 Only FEV1 Group Nd 9 months 3 times a week for the first four weeks, 2 for the other four, and 1 for the remaining 24 12 12 0 0 Nd Nd 60 4 Pulmonary Rehabilitation Improves Depression, Anxiety, Dyspnea, and Health Status in Patients with COPD [48 ] USA 2007 RCT Relaxation, breathing techniques, conservation of energy Usual care COPD patients GOLD 3 STAI; SGRQ; BDI Group No 8 weeks 24 sessions 24 10 14 0 0 6 18 64.5 5 Effectiveness of Incorporating Tai Chi in Pulmonary Rehabilitation Program for Patients in Primary Health Care (COPD) [49 ] China 2011–2013 Prospective RCT, single blind ANCOVA Tai Chi and relaxation exercises Pulmonary rehabilitation without Tai-Chi COPD patients GOLD 2 SGRQ Group No 6 months Nd 192 94 98 0 28 (follow-up) 26 (disc) 17 175 74 6.624 5 Short-Form Sun-Style Tai Chi as an Exercise Training Modality in People with COPD [50 ] Australia 2010–2012 RCT Paired Sun-Style Tai Chi and breathing exercises Usual medical care COPD patients GOLD 2 CRQ; HADS Group Yes 3 months 12 sessions 42 19 19 0 4 15 27 73 8 6 Relaxation to Reduce Dyspnea and Anxiety in COPD Patients [51 ] USA 1992 RCT ANOVA Progressive muscle relaxation Sit quietly COPD patients GOLD 2 STAI Individual Yes Nd 3-4 times a week 26 13 13 0 8 Nd Nd 67 4 One-Session Cognitive Behavioural Therapy for Elderly Patients with Chronic Obstructive Pulmonary Disease [52 ] USA 2001 RCT, single blind Relaxation training and breathing techniques 2 h of COPD education, followed by weekly calls COPD patients Nd GDS; BAI; SF-36 Group Yes 6 weeks 1 session, followed by daily sessions autonomously 53 21 27 0 5 9 44 71.3 5.9 4 Effects of Psychotherapy in Moderately Severe COPD: A Pilot Study [53 ] UK 1997 RCT Paired Muscle relaxation, breathing technique, distraction therapy They attended the laboratory for seven times, usual visits COPD patients GOLD 2-3-4 HADS; SGRQ Group Yes 6 weeks 6 sessions 18 10 8 0 0 10 8 72.2 3 Comparison of the Effectiveness of Music and Progressive Muscle Relaxation for Anxiety in COPD: A Randomized Controlled Pilot Study [54 ] India 2009 RCT ANOVA Progressive muscle relaxation (PMR) Music COPD patients Nd STAI Individual Nd 1 day 2 sessions 72 32 32 0 8 19 45 63 7.5 6 Relax and Breathe Deeply: A Quick Relaxation Training for People with Chronic Obstructive Pulmonary Disease [55 ], [submitted] Italy 2015 RCT, single blind Between-groups comparisons: Mann-Whitney Relaxation training and breathing techniques They watched a documentary movie COPD patients GOLD 2-3 VAS; STAI; PANAS; Short FSS Individual No 1 day 1 session 38 19 19 0 0 15 23 72.66 8.68 7
