Yoga breathing exercises may be helpful for improving exercise capacity and pulmonary function in patients with chronic obstructive pulmonary disease (COPD), study results published in Clinical Rehabilitation suggest.

Researchers performed a meta-analysis of 11 randomized controlled trials that included a pooled cohort of 586 patients with COPD. The studies in the analysis evaluated the effect of yoga vs either no yoga, sham yoga, or any active control on quality of life (QoL), dyspnea, exercise capacity, and pulmonary function (ie, absolute or predictive forced expiratory volume in 1 second [FEV1]).

Yoga interventions were categorized as either yoga breathing only without physical movements or complex yoga interventions that included both yoga breathing and physical postures, meditation, and/or lifestyle advice. In addition to yoga’s effects on QoL and pulmonary function, the analysis also examined safety, or the number of patients who experienced adverse events.

The researchers found that yoga was more effective than no treatment for improving QoL (COPD Assessment Test: mean difference [MD], 3.81; 95% CI, 0.97-6.65; P =.009; I2=70%). In addition, yoga was helpful in improving exercise capacity as assessed by the 6-minute walk test (MD, 25.53 m; 95% CI, 12.16-38.90 m; P <.001; I2=0%) and pulmonary function as assessed by predicted FEV1 (MD, 3.95%; 95% CI, 2.74%-5.17%; P <.001; I2=0%).

Only breathing-focused yoga interventions, not complex yoga interventions, were found to be effective in this analysis. According to the investigators, the beneficial effects of yoga on exercise capacity and pulmonary function were the most robust against methodological bias. The researchers found that adverse events were infrequently reported.

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Limitations of the meta-analysis were the small number of included studies as well as the small sample and variation in quality sizes. In addition, only 2 of the 11 studies reported safety outcomes.

“[T]he low attrition rates across the included studies in this review suggest yoga as an acceptable form of physical and psychosocial symptom management for individuals with [COPD],” the investigators wrote. However, the safety of yoga as an intervention in COPD needs to be further evaluated.


Cramer H, Haller H, Klose P, Ward L, Chung VCH, Lauche R. The risks and benefits of yoga for patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis [published online July 29, 2019]. Clin Rehabil. doi:10.1177/0269215519860551