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

Author: Claire M Nolan1,2, Lisa Jane Brighton3,4, Yihan Mo3, Joanne Bayly3,5, Irene J Higginson3, William D-C Man2,6,7, Matthew Maddocks3
1 Brunel University London, College of Medicine, Health and Life Sciences, Department of Health Sciences, London, UK
2 Harefield Respiratory Research Group, Royal Brompton and Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
3 Kings College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK.
4 King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
5 St. Barnabas Hospices, Worthing, UK.
6 King's College London, Faculty of Life Sciences and Medicine, London, UK.
7 National Heart and Lung Institute, Imperial College London, London, UK.
Conference/Journal: Eur Respir Rev
Date published: 2023 Jun 21
Other: Volume ID: 32 , Issue ID: 168 , Pages: 220243 , Special Notes: doi: 10.1183/16000617.0243-2022. , Word Count: 193

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.

PMID: 37343961 DOI: 10.1183/16000617.0243-2022