Cochrane for Clinicians

Putting Evidence into Practice

The Role of Breathing Exercises in the Treatment of COPD

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Am Fam Physician. 2014 Jan 1;89(1):15-16.

This clinical content conforms to AAFP criteria for continuing medical education (CME). See CME Quiz Questions.

Author disclosure: No relevant financial affiliations

Clinical Question

Do breathing exercises lead to improvements in dyspnea, exercise capacity, and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD)?

Evidence-Based Answer

Patients with COPD who are treated with breathing exercises vs. standard care showed an improvement in exercise capacity, with inconsistent changes in dyspnea and health-related quality of life. Adding breathing exercises to a pulmonary rehabilitation program did not show any increased benefit. Breathing exercises may be helpful for those without access to a pulmonary rehabilitation program. (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

Pulmonary rehabilitation is recommended for all patients with COPD to improve physical function and quality of life. This multidisciplinary approach, which includes exercise training, education, nutritional intervention, and psychosocial support, improves dyspnea and functional capacity, and lowers the rates of hospital admission and mortality.1,2 Breathing exercises are commonly used as part of such programs, but data supporting their use alone are limited.

Breathing exercises are intended to reverse the typical COPD pattern of increased accessory muscle and rib cage

The views expressed in this article are those of the authors and do not reflect the official policy of the U.S. government, Department of the Army, Department of the Navy, or Department of Defense.

The practice recommendations in this activity are available at


Holland AE, Hill CJ, Jones AY, McDonald CF. Breathing exercises for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012;(10):CD008250.


1. Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188(8):e13–e64.

2. Puhan MA, Scharplatz M, Troosters T, Steurer J. Respiratory rehabilitation after acute exacerbation of COPD may reduce risk for readmission and mortality: a systematic review. Respir Res. 2005;6:54.

3. Anderson B, Conner K, Dunn C, et al.; Institute for Clinical Systems Improvement. Diagnosis and management of chronic obstructive pulmonary disease (COPD). Updated March 2013. Accessed December 9, 2013.

These are summaries of reviews from the Cochrane Library.

The series coordinator for AFP is Corey D. Fogleman, MD, Lancaster General Hospital Family Medicine Residency, Lancaster, Pa.

A collection of Cochrane for Clinicians published in AFP is available at

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