Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Veterans Crisis Line Badge
Go to the ORD website
Go to the QUERI website

2007 HSR&D National Meeting Abstract

Printable View

National Meeting 2007

3059 — Randomized Controlled Trial of a Mind-Body Therapy for Dyspnea in Advanced COPD

Munjas BA (Sepulveda COE) , Mularski RM (Kaiser Permanente Northwest, Center for Health Research), Lorenz KA (Sepulveda COE), Sun S (Sepulveda COE), Robertson SJ (Greater Los Angeles Medical Center), Schmelzer W (Greater Los Angeles Medical Center), Kim A (Greater Los Angeles Medical Center), Shekelle PG (Sepulveda COE)

Chronic obstructive lung disease results in significant dyspnea. Dyspnea involves complex mind-body interactions. Mind body therapies have been shown to benefit patients with other symptoms such as pain and anxiety. We therefore tested the efficacy of a mindfulness-based breathing therapy (MBBT) on improvement in symptoms and functional limitations.

Randomized controlled trial of 8 week MBBT in COPD. MBBT was based on the work of Kabat-Zinn and Benson and included weekly meetings where patients practiced variations of mindfulness mediation and the relaxation response. Control patients also met weekly in a support group in order to control for contact time with a provider. The main outcome measure was the post-6 minute walk test Borg dyspnea assessment; other outcome measures included the St. George’s Respiratory Questionnaire, veteran SF-36 physical (PCS) and mental (MCS) summary score, 6 minute walk distance, a measure of mindfulness (FFMS), and a general symptom scale (MSAS). ANCOVA compared differences in outcomes between groups; paired t-test evaluated changes within groups. Analysis was done both on an intention-to-treat basis and for the subset of subjects who completed allocated control or intervention.

86 veterans (average SF-36 physical scale=34) were randomized; 29 control and 21 intervention patients completed the trial. We found no differences (p > 0.10 for all comparisons) between groups in any outcome measure by either intention-to-treat analysis or within the subset that attended at least 6 sessions (n=37). In the MBBT group, the PCS score worsened within individuals by an average 3.5 points (p=0.03). In the control group, symptom scores improved modestly, MSAS decreased by < 1 point (p=0.05) and SGRQ symptom subscale decreased 7.5 points (p=0.04).

This trial found no improvements in symptoms or function in veterans with COPD attending a MBBT group as compared to a support group. Retention of veterans in the trial was much lower than in previous mind-body trials, suggesting that this time-intensive intervention may not be well received among ill, community-based veterans.

Complementary and alternative medicine (CAM) therapies should undergo careful testing for efficacy in veterans. Uncritical acceptance of CAM therapies risks implementation of ineffective treatments.

Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.