Comparative efficacy of mind-body exercises for treating chronic obstructive pulmonary disease: a systematic review and network meta-analysis

Objective: The comparative effectiveness of various mind-body exercises for chronic obstructive pulmonary disease remains unclear. This study aimed to compare and rank different mind-body interventions for improving objective and subjective outcomes in patients with chronic obstructive pulmonary disease. Data sources: We systematically searched PubMed, Web of Science, EMBASE, Cochrane Library, and Scopus. Methods: Randomised controlled trials assessing mind-body exercises for chronic obstructive pulmonary disease were included. A network meta-analysis was performed using Stata 16.0. The protocol was registered with PROSPERO (CRD42024592835). Results: Thirty-seven studies involving 3179 participants and nine interventions were analysed. Regarding objective outcomes, Pilates plus pulmonary rehabilitation showed the largest improvement in exercise capacity. For pulmonary function, Pilates plus pulmonary rehabilitation significantly improved forced expiratory volume in the first second as a percentage of the predicted value and forced expiratory volume in the first second/forced vital capacity, while Yoga demonstrated superior effects on forced expiratory volume in the first second and forced vital capacity. Regarding subjective outcomes, Tai Chi, alone or combined with pulmonary rehabilitation, was superior in reducing dyspnea, while Tai Chi plus pulmonary rehabilitation and Qigong showed the greatest benefits for health-related quality of life. Conclusions: Mind-body exercises are beneficial for chronic obstructive pulmonary disease management. Pilates plus pulmonary rehabilitation stands out for improving objective outcomes, particularly exercise capacity and pulmonary function, whereas Tai Chi, alone or combined with pulmonary rehabilitation, emerges as the most effective intervention for subjective outcomes, including dyspnea and health-related quality of life. © The Author(s) 2026