QUESTION: How much do interventions other than prescribed pharmacology or exercise training change dyspnoea and health-related quality of life in adults with stable chronic lung disease? DESIGN: Systematic review with meta-analysis. PARTICIPANTS: Adults with a chronic lung disease. INTERVENTION AND FOLLOW-UP: Any non-pharmacological intervention, other than exercise training, applied to reduce dyspnoea or improve health-related quality of life. OUTCOME MEASURES: Dyspnoea, measured at rest, on exertion or during daily activities, and health-related quality of life measured using a validated questionnaire. DATA SOURCES: CINAHL, PEDro, PubMed and EMBASE were searched. Studies were included if they had at least one group that was prescribed a non-pharmacological intervention other than exercise training, and at least one group that received usual care. RESULTS: Thirteen randomised controlled trials and two randomised cross-over trials met the study criteria. For adults with obstructive lung diseases, low quality evidence suggests that pursed lip breathing may result in a moderate reduction in dyspnoea when measured within 3 months of treatment initiation (SMD -0.45), although the effect may be substantially larger or smaller (95% CI -0.87 to -0.04). Similarly, breathing re-training may result in small to moderate improvements in health-related quality of life when measured >= 3 months following treatment initiation (SMD -0.31, 95% CI -0.48 to -0.14). CONCLUSION: In adults with chronic lung diseases, there is low quality evidence that breathing techniques may reduce dyspnoea and improve health-related quality of life. REGISTRATION: CRD42024491524.

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