Summary
Background: Chronic Obstructive Pulmonary Disease (COPD) requires continuous patient management caused by frequent exacerbations with consequent hospitalizations and a worsening of the patient’s quality of life. Pulmonary rehabilitation improves exercise tolerance, but many patients do not have access to these programs.
Aim: We assumed that 3 months of controlled respiratory training (CRT), providing benefits on well-being in healthy subjects, can represent a valid strategy to improve health status and better disease management in COPD patients.
Design: Quality improvement in health care
Setting: Outpatients attending the rehabilitation treatment room of a single centre.
Population: 34 patients with COPD (according GOLD 2019 classification) were enrolled.
Methods: Patients were divided into TREAT group (n = 18, 16 males, age 73.83 ± 6.71 years) and control group (CTR: 13 males, age 74.06 ± 6.38 years). Before and after CRT a battery of psychological questionnaires were assessed. T
Results: REAT group in Post-CRT, as compared to CTR, showed a reduction in depressive symptoms (BDI, p<0.05; POMS depression, p<0.05), anger (p<0.01), stress perception (PSS, p<0.05), and anxiety levels (BAI, p=0.05). Also, CRT improved general health (p<0.01) and vitality (p<0.05).
Conclusions: This preliminary study demonstrated that CRT is effective to improve quality of life and well-being perception in patients with COPD. Larger studies will need to confirm the long-term clinical and psychological benefits of this holistic approach, addictive to the traditional clinical practice, not only for symptomatic COPD, but also more generally to all patients with chronic diseases.
Clinical rehabilitation impact: In clinical settings, for COPD patients, who experience the chronic nature of illness, we propose an additive holistic approach to the traditional clinical practice to improve health-related quality of life, and thus, a better disease management.

Relevance
Controlled respiratory training (CRT), a method of respiratory training based on Pranayama Yoga procedure, is characterized by conscious slow and deep acts of breathing, without any device support . This method provides benefits on well-being in healthy subjects and in patients with different diseases. Therefore, we hypothesized that CRT could improve psychosocial dimensions in COPD patients. In line with this hypothesis, the aim of this pilot study was to assess the effects of CRT in COPD patients on quality of life and well-being perception.