Spirituality and religiosity are associated with physical and psychological status in patients with chronic obstructive pulmonary disease.

BACKGROUND: Management strategies that incorporate spirituality and religiosity (S/R) have been associated with better health status in clinical populations. However, few data are available for patients with chronic obstructive pulmonary disease (COPD) to improve the traditional disease-model treatment. AIMS: The objectives of this study were to evaluate the association between S/R and physical and psychological status in patients with stable COPD. DESIGN: This is a cross-sectional study. METHODS: Religiosity, spiritual well-being and S/R Coping were measured. Physical status was evaluated with the activity of daily living, dyspnoea and the impact of the disease. Psychological status was assessed with anxiety and depression symptoms and quality of life. Spearman correlation coefficients were calculated, multivariate linear regression was applied in the analyses. This study is reported following the STROBE recommendations. RESULTS: Seventy-two patients with stable COPD (male 58%, aged 68 ± 9 years, forced expiratory volume in 1s (FEV1 ) of 49.2 ± 19.6% predicted) were included. There was no association between S/R and activity of daily living. However, higher spiritual well-being and lower Negative S/R Coping was associated with reduced dyspnoea and burden of the disease. Increased S/R and lower Negative S/R Coping was also associated with less anxiety, depression and better quality of life. Multivariate linear regression showed that S/R variables explained the physical and psychological health status in people with stable COPD. CONCLUSIONS: Higher spirituality and less negative S/R Coping are associated with reduced dyspnoea, the burden of the disease, anxiety and depression symptoms, and better quality of life in patients with stable COPD. RELEVANCE TO CLINICAL PRACTICE: Understanding how religiosity and spirituality are associated with physical and psychological features in patients with COPD may contribute to the long-term management of this patient population.

The Clinical Effects of Manipulative Therapy in People with Chronic Obstructive Pulmonary Disease.

OBJECTIVES: This study aimed to determine the effects of manipulative therapies (MT), including spinal manipulation, and diaphragmatic release techniques on lung function, exercise capacity, symptoms, and health-related quality of life (HRQOL) in people with chronic obstructive pulmonary disease (COPD). DESIGN: Systematic review. PARTICIPANTS: People diagnosed with COPD. INTERVENTION: Randomized controlled trials of MT (either with or without pulmonary rehabilitation [PR]) compared to other treatments (soft tissue [ST] therapy or sham therapy) applied in people with COPD were identified following the search of seven databases. Two reviewers independently assessed study quality and extracted data. OUTCOME MEASURES: Lung function, exercise capacity, symptoms, and HRQOL. RESULTS: Four studies were included, with a total of 68 participants. The heterogeneity between treatments prevented meta-analysis. There was no beneficial effect on spirometry measures of lung function with MT. MT combined with PR improved exercise capacity by 48-49 m more than ST therapy plus PR. Less dyspnea was reported with MT and ST therapy compared to ST therapy alone (p = 0.01), but there was no effect on HRQOL, or symptoms of anxiety or depression. CONCLUSIONS: In people with COPD, MT (either with or without PR) improved functional exercise capacity, but had no effect on lung function, or HRQOL. Further research is required to determine the underlying mechanism of this treatment approach and its relationship to exercise capacity.