Relaxation Techniques for People with Chronic Obstructive Pulmonary Disease: A Systematic Review and a Meta-Analysis

Eleonora Volpato, Paolo Banfi, Sheena Michelle Rogers, Francesco Pagnini, Eleonora Volpato, Paolo Banfi, Sheena Michelle Rogers, Francesco Pagnini

Abstract

Introduction. Chronic Obstructive Pulmonary Disease (COPD) people suffer from severe physical impairments, which often elicit significant psychological distress and impact their quality of life. This meta-analysis aimed to assess evidence from the scientific literature on the effects of relaxation techniques. Methods. We investigated 9 databases to select 25 RCTs. Studies included both inpatients and outpatients with COPD. Both respiratory and psychological outcomes were considered. Results. Relaxation techniques showed a little positive effect on the value of the percentage of predicted FEV1 (d = 0.20; 95% Cl: 0.40--0.01) as well as a slight effect on levels of both the anxiety (d = 0.26; 95% Cl: 0.42-0.10) and depression (d = 0.33; 95% Cl: 0.53-0.13). The higher effect size was found in the quality of life value (d = 0.38; 95% Cl: 0.51-0.24). The assessed quality of the studies, based on the PEDro Scale, was generally medium/high. Conclusion. Relaxation training can have a moderate impact on both psychological well-being and respiratory function, resulting in noticeable improvements in both. Although higher quality research is required, our results sustain the importance of relaxation techniques as a tool to manage COPD.

Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
Risk of bias graph: judgments about each risk of bias item presented as percentages across all included studies.
Figure 3
Figure 3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figure 4
Figure 4
Effect sizes in relation to the intervention proposed in the studies included. DAS: Distractive Auditory Stimuli; 6;3: relaxation therapies and breathing techniques; mixed: many relaxation techniques combined together in the same session.
Figure 5
Figure 5
Forest plot of comparison, outcome: FEV1.
Figure 6
Figure 6
Funnel plot of comparison, outcome: FEV1.
Figure 7
Figure 7
Forest plot of comparison, outcome: anxiety.
Figure 8
Figure 8
Funnel plots of comparison, outcome: anxiety.
Figure 9
Figure 9
Forest plot of comparison, outcome: depression.
Figure 10
Figure 10
Funnel plot of comparison, outcome: depression.
Figure 11
Figure 11
Forest plot of comparison, outcome: quality of life.
Figure 12
Figure 12
Funnel plot of comparison, outcome: quality of life.

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