Meditative movement for respiratory function: a systematic review

Background Meditative movement (MM; tai chi/yoga/qi gong) may be beneficial for people with cystic fibrosis (CF) as a form of gentle exercise incorporating meditation, breathing and relaxation. Respiratory function is the most common issue in CF. This systematic review synthesised the evidence for MM for respiratory function to provide a clinical summary and inform research into MM for CF.

Methods Chinese and English language databases were searched using keywords for tai chi/yoga/qi gong, and respiratory function/cough/dyspnoea. Articles were screened and selected by two researchers. Controlled studies published in English/Chinese after 1980 were included. Data were extracted using a specially designed spreadsheet. Two researchers independently evaluated study quality and reporting using three standardised checklists. Meta-analysis was not possible due to heterogeneous methodology.

Results 1649 papers were identified, 43 included (30 English language, 13 Chinese), 23 RCTs, 20 nonrandomised trials. None studied CF; 11 studied patients with respiratory disorders, 27 healthy people. Very few were high quality. The main bias with RCTs was randomisation and nonrandom/poorly reported sampling, for non-randomised studies poor reporting of samples and non-equivalent groups. Although no clinically significant changes were shown, MM may improve FEV1 in healthy people compared to no treatment/exercise (intervention groups showed changes from 0.07 to 0.83) but MM did not appear to affect FEV₁/FVC ratio in COPD. Key study limitations were: poor reporting of sampling or methods; small, potentially underpowered samples; non-randomised design; lacking description of randomisation; randomisation by centre; no blinding; lack of reporting of important aspects of MM; short-term follow up.

Conclusion There is no evidence for MM in CF, and very limited evidence for respiratory function in healthy populations. Due to heterogeneity of populations and lack of sampling information, clinicallyrelevant conclusions cannot be drawn and more research is needed in this area, in particular powered, randomised studies.