Meta-analysis shows exercise training improves depressive and anxiety symptoms in 1208 COPD patients

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International journal of chronic obstructive pulmonary disease Published May 12, 2026 Medically reviewed May 12, 2026 Study authors: Chen Siyu, Shang Boyi, Bi Yanze, Xu Rong, Li Qingrong, Zhang Wenbo, Yang Yunyi, Hu Shaodan PubMed ↗ DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Consider integrating exercise into COPD management to improve depressive and anxiety symptoms.

This meta-analysis synthesized evidence regarding the effect of exercise training on mental health outcomes in patients with chronic obstructive pulmonary disease. The review included a total of 1208 COPD patients across the included studies. The setting of these studies was not reported in the source document.

Analysis of depressive symptoms revealed a standardized mean difference of -0.35 with a 95% confidence interval of -0.58 to -0.12 and a p-value less than 0.05. Similarly, anxiety symptoms showed a standardized mean difference of -0.27 with a 95% confidence interval of -0.53 to -0.01 and a p-value less than 0.05. Both results indicated a direction of improvement.

The authors acknowledge that more high-quality, long-term follow-up randomized controlled trials are needed to clarify optimal exercise regimens and mechanisms. Safety data, including adverse events and discontinuations, were not reported in the source. Integrating exercise into comprehensive COPD management is recommended based on these findings.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJan 2026

PMID42117057

View Original Abstract ↓

OBJECTIVE: To evaluate the effects of exercise training on depressive and anxiety symptoms in patients with chronic obstructive pulmonary disease (COPD). METHODS: We searched PubMed, Embase, Cochrane Library, and Web of Science from inception to May 7, 2025, for randomized controlled trials (RCTs) investigating exercise training for depression or anxiety in COPD patients. Two researchers independently screened literature, extracted data, and assessed methodological quality. To reduce measurement heterogeneity, only studies reporting the Hospital Anxiety and Depression Scale (HADS-D for depression, HADS-A for anxiety) were included as outcome indicators. Meta-analysis was performed using a random-effects model, and subgroup analysis explored the influence of cumulative intervention duration. RESULTS: Eleven RCTs involving 1208 COPD patients were included. Using HADS-D and HADS-A as outcome measures, exercise training significantly improved depressive symptoms [SMD = -0.35 (95% CI: -0.58, -0.12), < 0.05] and anxiety symptoms [SMD = -0.27 (95% CI: -0.53, -0.01), < 0.05]. Subgroup analysis indicated that improvement in depression was significant when cumulative intervention duration exceeded 1500 minutes ( < 0.05). For anxiety, although subgroup differences were not significant, the overall trend supported a positive effect. CONCLUSION: Exercise training is an effective non-pharmacological intervention for depression and anxiety in COPD patients. Integrating exercise into comprehensive COPD management is recommended, with exploratory evidence suggesting benefit when cumulative durations exceed 1500 minutes. More high-quality, long-term follow-up RCTs are needed to clarify optimal exercise regimens and mechanisms.