Effects of traditional mind–body movement therapy on chronic cardiopulmonary dyspnoea: a systematic review and meta-analysis

Purpose To evaluate whether traditional mind–body movement therapy (TMBM) can be used as a complementary or alternative therapy for exercise-based cardiopulmonary rehabilitation (EBCR) on chronic cardiopulmonary dyspnoea. Methods PubMed, Embase, Scopus, Web of Science and China National Knowledge Infrastructure were searched from their inception to 2 July 2021. Randomised clinical trials evaluating the effectiveness of TMBM versus EBCR, and TMBM +EBCR versus TMBM in the treatment of chronic cardiopulmonary dyspnoea were selected. The outcomes were exercise capacity (6 min walk distance, 6MWD) and quality of life (QoL). Results Thirty-four randomised clinical trials with 2456 patients were included. For TMBM vs EBCR alone, statistically significant improvements in the 6MWD favoured the TMBM for chronic obstructive pulmonary disease (COPD) (mean difference(MD)=12.22 m; 95% CI 5.94 to 18.50; I 2 =56%) and heart failure (HF) patients (MD=43.65 m; 95% CI 7.91 to 79.38; I 2 =0%). Statistically significant improvements in QoL also favoured TMBM over EBCR for patients with HF(MD=−9.19; 95% CI −11.05 to −7.32; I 2 =0%) but non-significant trend for COPD (standardised mean difference (SMD)=−0.31; 95% CI −0.62 to 0.01; I 2 =78%). Comparisons of TMBM +EBCR versus EBCR alone revealed significant improvements in the QoL for COPD (SMD=−0.52; 95% CI −0.94 to −0.10; I 2 =86%) and patients with HF (MD=−2.82; 95% CI −4.99 to −0.64; I 2 =0%). The 6MWD results favoured the TMBM +EBCR for patients with COPD (MD=16.76 m; 95% CI 10.24 to 23.29; I 2 =0%), but only showed a slight trend towards additional benefits of TMBM +EBCR in the HF studies (MD=13.77 m; 95% CI −1.01 to 28.54; I2=65%) . Conclusions TMBM has positive effects on patients’ 6MWD and QoL, with similar or even better effects than EBCR. It may be beneficial to use TMBM as a supplementary or alternative strategy for EBCR in treatment plans. PROSPERO registration number CRD42021241181.