Exercise training significantly improved depressive symptoms (SMD -0.35) and anxiety symptoms (SMD -0.27) compared to control in patients with chronic obstructive pulmonary disease.
Meta-Analysis (n=1,208)
Does exercise training improve depression and anxiety in patients with stable COPD?
Exercise training is an effective non-pharmacological intervention that significantly improves depression and anxiety in patients with COPD, with exploratory evidence suggesting greater depression benefits when cumulative exercise duration exceeds 1500 minutes.
Effect estimate: SMD -0.35 (95% CI -0.58, -0.12)
p-value: p=<0.05
Objective: To evaluate the effects of exercise training on depressive and anxiety symptoms in patients with chronic obstructive pulmonary disease (COPD). Methods: We searched PubMed, Embase, Cochrane Library, and Web of Science from inception to May 7, 2025, for randomized controlled trials (RCTs) investigating exercise training for depression or anxiety in COPD patients. Two researchers independently screened literature, extracted data, and assessed methodological quality. To reduce measurement heterogeneity, only studies reporting the Hospital Anxiety and Depression Scale (HADS-D for depression, HADS-A for anxiety) were included as outcome indicators. Meta-analysis was performed using a random-effects model, and subgroup analysis explored the influence of cumulative intervention duration. Results: Eleven RCTs involving 1208 COPD patients were included. Using HADS-D and HADS-A as outcome measures, exercise training significantly improved depressive symptoms SMD = − 0.35 (95% CI: − 0.58, − 0.12), P < 0.05 and anxiety symptoms SMD = − 0.27 (95% CI: − 0.53, − 0.01), P < 0.05. Subgroup analysis indicated that improvement in depression was significant when cumulative intervention duration exceeded 1500 minutes ( P < 0.05). For anxiety, although subgroup differences were not significant, the overall trend supported a positive effect. Conclusion: Exercise training is an effective non-pharmacological intervention for depression and anxiety in COPD patients. Integrating exercise into comprehensive COPD management is recommended, with exploratory evidence suggesting benefit when cumulative durations exceed 1500 minutes. More high-quality, long-term follow-up RCTs are needed to clarify optimal exercise regimens and mechanisms. Keywords: COPD, exercise, depression, anxiety, meta-analysis, randomized controlled trial
Chen et al. (Fri,) conducted a meta-analysis in Chronic obstructive pulmonary disease (COPD) (n=1,208). Exercise training vs. Conventional treatment or different exercise methods was evaluated on Depressive symptoms (HADS-D) (SMD -0.35, 95% CI -0.58, -0.12, p=<0.05). Exercise training significantly improved depressive symptoms (SMD -0.35) and anxiety symptoms (SMD -0.27) compared to control in patients with chronic obstructive pulmonary disease.