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COPD – Improves Mood

Evidence Summary

There are some good quality interventional study data that shows a reduction in anxiety and depression as measured by outcome scores.

Quality of Evidence

Grade B – moderate quality. Evidence comes from randomised controlled trials

Strength of recommendation

Grade 2 – weak recommendation. On the basis of the existing evidence, some patients will be best served by following this piece of evidence. In the context of values-based decision making, fully informed patients may choose alternative options


Weak recommendation, that is not likely to be appropriate for some patients in some circumstances 1) Arnardottir (Respiratory Medicine, 2007)35

Continuous vs Interval Training (16 weeks, twice weekly) – 60 participants

HADS: anxiety improved 2/2.1, depression 1.5/1.4

2) El-Kader (African Health Sciences, 2016)43

Aerobic exercise (treadmill) vs no exercise RCT. Improvement in Beck Depression Index in exercise group was 3.02 (p<0.05)

3) Zwerink (Respiratory Medicine, 2014)42

Outcomes other than physical activity: Maximal exercise capacity, CRQ (chronic respiratory questionnaire) score has dyspnoea, fatigue, emotional function and mastery domains, CCQ (clinical COPD questionnaire) score, HADS (hospital anxiety and depression score)

11-month community based physiotherapy-led exercise programme + 4 self-management sessions  vs 4 self-management sessions only, 12 and 24 month follow-up. Specific outcomes (i.e. p value and absolute change and size of study). 80 patient intervention group, 79 control group. No significant difference in HADS