身心运动干预对老年慢性阻塞性肺疾病患者焦虑、抑郁和生活质量的影响：一项系统评价和META分析

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine Pub Date : 2025-08-23 DOI:10.1016/j.ctim.2025.103237

Zhaoying Yan , Tao Zhang , Zifan Ding , Baole Tao , Junwen Shu , Minlei Yu , Qingyu Liang , Jun Yan

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引用次数: 0

摘要

慢性阻塞性肺疾病（COPD）的老年患者通常患有焦虑、抑郁和健康相关生活质量（HRQOL）受损。本综述评估了身心运动对年龄≥ 60岁COPD患者这些结果和运动耐量的影响。方法遵循PRISMA指南，我们系统地检索PubMed， Embase, PsycINFO， Cochrane Library和Web of Science（创刊- 2025年1月），以比较身心锻炼与常规护理的随机对照试验（rct）。结果包括焦虑、抑郁、HRQOL（圣乔治呼吸问卷或慢性呼吸问卷）和运动耐量（6分钟步行测试）。meta分析采用随机效应模型，报告标准化平均差异（SMDs）或平均差异（MDs），置信区间（ci）为95% %。评估证据确定性（GRADE框架）。纳入17项随机对照试验。结果身心运动减少焦虑（SMD = - 0.59, 95 % CI: - 0.84至- 0.34；高确定性）和抑郁（SMD = - 0.34, 95 % CI: - 0.54至- 0.14；高确定性）。HRQOL显著改善（SMD = - 0.79, 95 % CI: - 1.14至- 0.44；低确定性），探索性发现显示东南亚患者的改善更大（SMD = - 3.41）。运动耐量增加（MD = 44.23 m, 95 % CI: 26.12-62.34），超过最小的临床重要差异。抑郁症的干预时间是一个关键的调节因素，干预时间≥ 3080 min的患者获益更大。结论心身运动可减少老年COPD患者的焦虑和抑郁，改善健康相关生活质量，增加运动耐量。对于焦虑和抑郁，干预时间≥ 3080 分钟，获益显著增强。建议将身心锻炼纳入老年人慢性阻塞性肺病的综合管理中。

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Effects of a mind-body exercise intervention on anxiety, depression and quality of life in elderly patients with chronic obstructive pulmonary disease: A systematic evaluation and META analysis

Background

Elderly patients with Chronic Obstructive Pulmonary Disease (COPD) commonly suffer from anxiety, depression, and impaired health-related quality of life (HRQOL). This review evaluated the effects of mind-body exercises on these outcomes and exercise tolerance in COPD patients aged ≥ 60 years.

Methods

Following PRISMA guidelines, we systematically searched PubMed, Embase, PsycINFO, Cochrane Library, and Web of Science (inception-January 2025) for randomized controlled trials (RCTs) comparing mind-body exercise versus usual care. Outcomes were anxiety, depression, HRQOL (St. George's Respiratory Questionnaire or Chronic Respiratory Questionnaire), and exercise tolerance (6-minute walk test). Meta-analyses used random-effects models, reporting Standardized Mean Differences (SMDs) or Mean Differences (MDs) with 95 % confidence intervals (CIs). Evidence certainty was assessed (GRADE framework). Seventeen RCTs were included.

Results

Mind-body exercise reduced anxiety (SMD = −0.59, 95 % CI: −0.84 to −0.34; high certainty) and depression (SMD = −0.34, 95 % CI: −0.54 to −0.14; high certainty). HRQOL improved significantly (SMD = −0.79, 95 % CI: −1.14 to −0.44; low certainty), with exploratory findings showing greater improvement in Southeast Asian patients (SMD = −3.41). Exercise tolerance increased (MD = 44.23 m, 95 % CI: 26.12–62.34), exceeding minimal clinically important differences. Intervention duration for depression was a key moderator, with greater benefits in patients with interventions lasting ≥ 3080 min.

Conclusion

Mind-body exercise reduces anxiety and depression, improves health-related quality of life, and increases exercise tolerance in elderly patients with COPD. For anxiety and depression, benefits are significantly enhanced with intervention durations ≥ 3080 minutes. Incorporating mind-body exercise into comprehensive COPD management for older adults is recommended.

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来源期刊

Complementary therapies in medicine 医学-全科医学与补充医学

CiteScore

8.60

自引率

2.80%

发文量

101

审稿时长

112 days

期刊介绍： Complementary Therapies in Medicine is an international, peer-reviewed journal that has considerable appeal to anyone who seeks objective and critical information on complementary therapies or who wishes to deepen their understanding of these approaches. It will be of particular interest to healthcare practitioners including family practitioners, complementary therapists, nurses, and physiotherapists; to academics including social scientists and CAM researchers; to healthcare managers; and to patients. Complementary Therapies in Medicine aims to publish valid, relevant and rigorous research and serious discussion articles with the main purpose of improving healthcare.