Mind-body interventions for cancer-related dyspnoea: a systematic review and meta-analysis of randomised controlled trials

Dyspnoea is a common and distressing symptom experienced by people with cancer which can impact physical functioning, mental health and quality of life (QoL). Mind-body interventions (MBIs) involving physical and mental practices are based on the belief that movement, cognition and emotions influence physical and spiritual well-being. This review investigated the effect of MBIs on dyspnoea and associated outcomes in people with cancer. Searches were performed using seven different electronic databases for studies published after January 1, 2013, with the keywords combined for cancer, dyspnoea and MBIs. The Risk of Bias 2 (RoB-2) tool was used to assess risk of bias, and data were analysed using Review Manager 5.4. Six randomised controlled trials met the inclusion criteria: three studies investigated qigong, two investigated yoga and one investigated combined breathing and relaxation techniques. Considerable heterogeneity was observed in the outcomes, and one study was classified as high risk of bias. Overall, the meta-analysis showed that MBIs did not improve dyspnoea (SMD = −0.48, 95% CI −1.36 to 0.39, p = 0.28), quality of life (QoL) (SMD = −1.04, 95% CI −3.26 to 1.19, p = 0.36), exercise capacity (SMD = −0.02, 95% CI −0.24 to 0.20, p = 0.87) and anxiety (SMD = −0.68, 95% CI −1.55 to 0.19, p = 0.12). Whilst MBIs did not significantly reduce dyspnoea and anxiety, methodological issues in the six included RCTs may have impacted the studies, and further rigorous studies are required to assess the efficacy of MBIs in this patient population.