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. 2013 Apr;5(4):1194-1200.
doi: 10.3892/etm.2013.926. Epub 2013 Jan 25.

Breathing Exercises Improve Post-Operative Pulmonary Function and Quality of Life in Patients With Lung Cancer: A Meta-Analysis

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Free PMC article

Breathing Exercises Improve Post-Operative Pulmonary Function and Quality of Life in Patients With Lung Cancer: A Meta-Analysis

Wei Liu et al. Exp Ther Med. .
Free PMC article

Abstract

Previous research has shown that breathing exercises may improve the prognosis and health status in patients with lung cancer by enhancing pulmonary function and quality of life (QOL). However, individually published results are inconclusive. The aim of the present meta-analysis was to evaluate the clinical value of breathing exercises on post-operative pulmonary function and QOL in patients with lung cancer. A literature search of Pubmed, Embase, the Web of Science and CBM databases was conducted from their inception through to October 2012. Crude standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to assess the effect of breathing exercises. A total of eight clinical studies were ultimately included with 398 lung cancer patients. When all the eligible studies were pooled into the meta-analysis, there was a significant difference between the pre-intervention and post-intervention results of breathing exercises on post-operative pulmonary function; forced expiratory volume in 1 sec (FEV1): SMD, 3.37; 95% CI, 1.97-4.77; P<0.001; FEV1/FVC: SMD, 1.77; 95% CI, 0.15-3.39; P=0.032). Furthermore, the QOL in patients with lung cancer was significantly improved following the intervention with breathing exercises; there were significant differences between the pre-intervention and post-intervention results on the ability of self-care in daily life (SMD, -1.00; 95% CI, -1.467 to -0.52; P<0.001), social activities (SMD, -0.94; 95% CI, -1.73 to -0.15; P=0.02), symptoms of depression (SMD, -0.91; 95% CI, -1.25 to -0.57; P<0.001) and symptoms of anxiety (SMD, -0.91; 95% CI, -1.20 to -0.63; P<0.001). Results from the present meta-analysis suggest that breathing exercises may significantly improve post-operative pulmonary function and QOL in patients with lung cancer.

Keywords: breathing exercises; lung cancer; meta-analysis; pulmonary function; quality of life.

Figures

Figure 1
Figure 1
Flow chart of the literature search and study selection process.
Figure 2
Figure 2
Forest plot of ORs with a random-effects model for the difference between pre-intervention and post-intervention results of breathing exercises for pulmonary function. OR, odds ratio; SMD, standardized mean difference; CI, confidence interval; FEV1, forced expiratory volume in 1 sec; FVC, forced vital capacity.
Figure 3
Figure 3
Forest plot of ORs with a random-effects model for the differences between the pre-intervention and post-intervention results of breathing exercises on quality of life. OR, odds ratio; SMD, standardized mean difference; CI, confidence interval.
Figure 4
Figure 4
Broken-line graphs for the difference between the pre-intervention and post-intervention results of breathing exercises on visual analog scales: (A) Breathlessness at worst; (B) breathlessness at best; and (C) distress caused by breathlessness. UCL, upper control limit; LCL, lower control limit; CL, control limit.
Figure 5
Figure 5
Broken-line graphs for the differences between the pre-intervention and post-intervention results of breathing exercises on (A) hospital anxiety; and (B) hospital depression. UCL, upper control limit; LCL, lower control limit; CL, control limit.
Figure 6
Figure 6
Sensitivity analysis of pulmonary function and QOL analysis. Results were computed by omitting each study in turn. Meta-analysis random-effects estimates were used. The two ends of the dotted lines represent the 95% CI. QOL, quality of life; CI, confidence interval.
Figure 7
Figure 7
Begg’s funnel plot of publication bias in pulmonary function and quality of life analysis. SMD, standardized mean difference; seSMD, standard error of standardized mean difference.

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