Walking and mindfulness improve the exercise capacity of patients with chronic obstructive pulmonary disease: A randomised controlled trial

Objective: To evaluate the effects of mindful walking practice on the exercise capacity of patients with chronic obstructive pulmonary disease (COPD). Design: A randomised controlled trial with four repeated measurements. Setting: Outpatient departments of a medical centre in northern Taiwan. Participants: Patients with mild to severe COPD. Intervention: The control group received usual care, whereas the mindful walking group received usual care plus undertook a mindful walking practice. Outcome measures: The main outcome was the six-minute walk distance. And the Global Initiative for Chronic Obstructive Lung Disease classification, dyspnoea, heart rate variability and interoceptive awareness were control factors. Results: Compared with the control group ( n = 40), the mindful walking group ( n = 38) achieved a significantly longer six-minute walk distance (longer by 45.57 m; P = 0.04). The interaction effect of the six-minute walk distance significantly increased on Week 4 ( P = 0.01), Week 8 ( P = 0.002) and Week 12 ( P = 0.02). Participants in Global Initiative for Chronic Obstructive Lung Disease class A exhibited significantly improved six-minute walk distance compared with those in class D ( P = 0.001). Moreover, scores on the emotional awareness scale of interoceptive awareness were significantly associated with the six-minute walk distance ( P = 0.02). Conclusion: The eight-week mindful walking practice improved the exercise capacity of patients with COPD, and its effect was sustained for at least four weeks after the end of the practice. This study suggest that this practice improved COPD symptoms, reduced COPD risk and increased the interoceptive awareness of this population.