Comparative Effects of Different Mind-Body Exercises on Lung Function, Exercise Capacity, and Quality of Life in Adults with Stable Chronic Obstructive Pulmonary Disease: A Bayesian Network Meta-Analysis

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. This review evaluated the effects of different mind-body exercises (MBEs) on lung function (LF), exercise capacity (EC), and quality of life (QoL) in adults with stable COPD using Bayesian network meta-analysis (NMA). Eight English and Chinese databases were searched through April 21, 2026. Randomized controlled trials comparing Ba Duan Jin (BDJ), Yi Jin Jing (YJJ), yoga, Liu Zi Jue (LZJ), Tai Chi (TC), and Wu Qin Xi (WQX) with usual care (UC) were included. Outcomes included FEV₁, FEV₁%pred, FEV₁/FVC, FVC, 6-minute walk distance (6MWD), St. George's Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT). Bayesian NMA was conducted using R. A total of 111 RCTs involving 9,240 participants were included. Most trials compared individual MBEs with UC, with limited direct head-to-head comparisons among different MBEs. Different MBE modalities showed potential benefits across LF, EC, and QoL outcomes, although effects varied by outcome. According to the surface under the cumulative ranking curve (SUCRA) ranking, Yoga ranked highest for FEV₁ (mean difference [MD] = 0.48, 95% credible interval [CrI]: 0.11, 0.85) and FVC (MD = 0.46, 95% CrI: 0.09, 0.83), whereas WQX ranked highest for FEV₁/FVC (MD = 8.38, 95% CrI: 4.59, 12.3) and FEV₁%pred (MD = 10.2, 95% CrI: 5.25, 15.35). WQX ranked highest for 6MWD, whereas Yoga, TC, and YJJ showed favorable rankings for some QoL-related outcomes. However, these findings should be interpreted cautiously because some interventions were supported by a relatively small number of trials with varying certainty of evidence and potential risk of bias, and the included trials were predominantly conducted in China. MBEs may improve LF, EC, and QoL in adults with stable COPD. Different MBEs showed potential benefits for specific outcomes. However, comparative effects remain uncertain due to limited direct evidence, unequal numbers of available trials, and variability in evidence certainty. Further high-quality head-to-head RCTs are needed to confirm these findings.