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J Altern Complement Med · Oct 2009
Randomized Controlled TrialRandomized controlled trial of mindfulness-based therapy for dyspnea in chronic obstructive lung disease.
- Richard A Mularski, Brett A Munjas, Karl A Lorenz, Su Sun, Sandra J Robertson, Wendy Schmelzer, Adina C Kim, and Paul G Shekelle.
- The Center for Health Research , Kaiser Permanente Northwest, Portland, OR 97227, USA. Richard.A.Mularski@kpchr.org
- J Altern Complement Med. 2009 Oct 1;15(10):1083-90.
ObjectivesPatients with chronic obstructive lung disease (COPD) suffer from significant dyspnea and may benefit from complementary and alternative medicine (CAM) therapies aimed at mitigating symptoms. The objective of this study was to test the efficacy of a mindfulness-based breathing therapy (MBBT) on improving symptoms and health-related quality of life in those with COPD.DesignWe conducted a randomized controlled trial of 8-week mindfulness-based breathing therapy (MBBT) compared to support groups to test efficacy on improving symptoms and health-related quality of life in those with COPD.SettingThe setting for this study was an academic-affiliated veterans healthcare system.SubjectsThe subjects consisted of 86 patients with COPD.InterventionsMBBT included weekly meetings practicing mindfulness mediation and relaxation response.Outcome MeasuresThe main outcome measure was a post 6-minute-walk test (6MWT) Borg dyspnea assessment. Other outcome measures included health-related quality of life measures, 6MWT distance, symptom scores, exacerbation rates, and measures of stress and mindfulness. Analysis of covariance compared differences in outcomes between groups; paired t test evaluated changes within groups.ResultsParticipants were predominantly elderly men with moderate to severe COPD. We found no improvements in dyspnea (post 6MWT Borg difference between the MBBT and support group was 0.3 (95% confidence interval [CI]: -1.1, 1.7). We found no differences between groups in almost all other outcome measures by either intention-to-treat analysis or within the subset that completed assigned group sessions. For the physical summary scale of the generic Short Form-36 for Veterans, the difference between outcomes favored the support group (4.3, 95% CI: 0.4, 8.1). Participant retention was low compared to mind-body trials that randomize from CAM wait lists.ConclusionsThis trial found no measurable improvements in patients with COPD receiving a mindfulness-based breathing CAM therapy compared to a support group, suggesting that this intervention is unlikely to be an important therapeutic option for those with moderate-to-severe COPD.
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