Effectiveness of a Multi-Modal Approach to Treating Chronic Respiratory Disease CRD: A Randomised Controlled Study

Abstract

Background: Chronic respiratory diseases (CRDs) represent a significant cause of global morbidity and mortality, but the implementation of pulmonary rehabilitation (PR) has been hampered by poor adherence and accessibility. This was a trial comparing PR with an IPR program, combining different styles of yoga, Tai Chi and music therapy.

Methods: In a randomized controlled trial (RCT) using data from 350 patients aged over 50 years with COPD, asthma, interstitial lung disease or bronchiectasis or post-tuberculosis sequelae, outcomes were assessed at baseline and again at week 6 and week 12 for each of the measures; the primary outcome was change in exercise tolerance (change from baseline cores to week two successive scores). Mixed models analyzed repeated measures.

Results: Groups were well balanced at baseline (n=175, mean age 51.6±9.8). There were significantly more favorable improvements in the IPR group at 12 weeks for SpO₂, pulmonary function, 6MWD and HRR and Borg scale score (all p<0.001). Disease severity (mMRC grade) affected the SpO₂ (%), 6MWD (m ) and Borg scores [p<0.05].

Conclusions: Combined rehabilitation with yoga, Tai Chi and music therapy improved the exercise capacity as well as lung function and oxygenation in patients with advanced chronic respiratory diseases compared to standard PR; effects were moderated by disease severity. This multimodal, culturally relevant strategy offers a viable framework for CRD rehabilitation