Effects of complementary therapies on physiological and psychological outcomes in chronic obstructive pulmonary disease patients: A systematic review and meta-analysis of randomized controlled trials.
Anoma Santiworakul, Salila Cetthakrikul, Shinji Nemoto et al.
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In 30 seconds
This systematic review and meta-analysis pooled 36 randomized controlled trials involving 3148 people with COPD to assess complementary therapies, including exercise-based and psychological approaches. Compared with usual care, complementary therapies were associated with improvements across several outcomes; the pooled mean difference in 6-minute walk distance was 58.73 m. Compared with pulmonary rehabilitation, they showed a smaller additional improvement in 6-minute walk distance (MD = 8.17) and reduced depressive symptoms. The authors conclude these therapies may complement conventional rehabilitation, while noting that further research is needed to clarify optimal approaches and patient-specific responses.
Key findings
- Compared with usual care, complementary therapies improved 6-minute walk distance (MD = 58.73 m).
- Compared with usual care, pooled improvements included FEV 1 % predicted (MD = 4.65), dyspnea, symptom burden, and health-related quality of life.
- Anxiety and depression scores were lower with complementary therapies than usual care (HADS-A MD = -1.70; HADS-D MD = -1.02).
- Compared with pulmonary rehabilitation, complementary therapies improved 6-minute walk distance (MD = 8.17) and HADS-D (MD = -0.74).
Why it matters
COPD care commonly includes pulmonary rehabilitation, but this review suggests that complementary approaches may also affect functional capacity, symptoms, quality of life, and psychological outcomes. The findings provide a synthesis of randomized-trial evidence that can inform consideration of these approaches as adjuncts, while the variation across therapies and the authors’ call for further research caution against assuming that all modalities or patients will benefit equally.
What to keep in mind
Effects on exercise capacity varied across complementary therapies, and the authors state that further research is needed to identify optimal modalities and patient-specific responses.