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      Mind-Body Exercise (Wuqinxi) for Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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          Abstract

          Objective: This study is the first meta-analysis investigating the rehabilitative effects of Wuqinxi for patients with chronic obstructive pulmonary disease (COPD). Methods: Five electronic databases (PubMed, Web of Science, Scopus, CNKI, and Wanfang) from inception until early November 2018 were searched. All randomized controlled trials (RCT) using Wuqinxi as the main intervention component were included for meta-analysis. The pooled effect sizes (Standardized mean difference, SMD) were calculated to determine the magnitude of the Wuqinxi intervention effect. Moderator analysis was only conducted for total training time. Results: Overall results of the meta-analysis indicated that Wuqinxi exercise significantly improved exercise capability ( SMD = 1.18, 95% CI 0.53 to 1.84, e < 0.001, I 2 = 84.97%), FEV1 ( SMD = 0.44, 95% CI 0.12 to 0.77, e < 0.001, I 2 = 33.77%), FEV1% ( SMD = 0.59, 95% CI 0.24 to 0.93, e < 0.001, I 2 = 63.79%), FEV1/FVC ( SMD = 0.65, 95% CI 0.37 to 0.93, e = 0.006, I 2 = 44.32%) and CCQ ( SMD = 1.23, 95% CI 0.31 to 2.14, e = 0.01, I 2 = 93.32%). Conclusions: With no occurrence of adverse event, clinicians could try to incorporate Wuqinxi exercise into their first-line rehabilitation regime for COPD patients.

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          Most cited references37

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          Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper

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            Lung function decline in COPD

            The landmark study of Fletcher and Peto on the natural history of tobacco smoke-related chronic airflow obstruction suggested that decline in the forced expiratory volume in the first second (FEV1) in chronic obstructive pulmonary disease (COPD) is slow at the beginning, becoming faster with more advanced disease. The present authors reviewed spirometric data of COPD patients included in the placebo arms of recent clinical trials to assess the lung function decline of each stage, defined according to the severity of airflow obstruction as proposed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. In large COPD populations the mean rate of FEV1 decline in GOLD stages II and III is between 47 and 79 mL/year and 56 and 59 mL/year, respectively, and lower than 35 mL/year in GOLD stage IV. Few data on FEV1 decline are available for GOLD stage I. Hence, the loss of lung function, assessed as expiratory airflow reduction, seems more accelerated and therefore more relevant in the initial phases of COPD. To have an impact on the natural history of COPD, it is logical to look at the effects of treatment in the earlier stages.
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              Pedometers to enhance physical activity in COPD: a randomised controlled trial

              Physical inactivity is a cardinal feature of chronic obstructive pulmonary disease (COPD), and is associated with increased morbidity and mortality. Pedometers, which have been used in healthy populations, might also increase physical activity in patients with COPD. COPD patients taking part in a 3-month individualised programme to promote an increase in their daily physical activity were randomised to either a standard programme of physical activity encouragement alone, or a pedometer-based programme. Assessments were performed by investigators blinded to treatment allocation. Change in average 1-week daily step count, 6-min walking distance (6MWD), modified Medical Research Council scale, St George’s respiratory questionnaire (SGRQ) and COPD assessment test (CAT) were compared between groups. 102 patients were recruited, of whom 97 completed the programme (pedometer group: n=50; control group: n=47); 60.8% were male with a mean±sd age of 68.7±8.5 years, and forced expiratory volume in 1 s (FEV1) 66.1±19.4% and FEV1/forced vital capacity 55.2±9.5%. Both groups had comparable characteristics at baseline. The pedometer group had significantly greater improvements in: physical activity 3080±3254 steps·day−1 versus 138.3±1950 steps·day−1 (p<0.001); SGRQ −8.8±12.2 versus −3.8±10.9 (p=0.01); CAT score −3.5±5.5 versus −0.6±6.6 (p=0.001); and 6MWD 12.4±34.6 versus −0.7±24.4 m (p=0.02) than patients receiving activity encouragement only. A simple physical activity enhancement programme using pedometers can effectively improve physical activity level and quality of life in COPD patients.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                28 December 2018
                January 2019
                : 16
                : 1
                : 72
                Affiliations
                [1 ]Department of Physical Education, Northwestern Polytechnical University, Xi’an 710072, China; wangke123@ 123456nwpu.edu.cn
                [2 ]Department of Physical Education, Wuhan University of Technology, Wuhan 430070, China; liushijie0411@ 123456whut.edu.cn
                [3 ]Faculty of Education, University of Macau, Macau, China; zwkong@ 123456umac.mo
                [4 ]Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul 08826, Korea
                [5 ]Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen 518172, China
                [6 ]Department of Martial Arts, Shanghai University of Sport, Shanghai 200438, China
                Author notes
                Article
                ijerph-16-00072
                10.3390/ijerph16010072
                6338907
                30597878
                da65ced7-c2ee-4b4d-a858-a421c3e48758
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 05 December 2018
                : 24 December 2018
                Categories
                Review

                Public health
                mind-body exercise,mindfulness-based exercise,meditative movement,wuqinxi,copd,randomized controlled trial

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