Effects of Information-Motivation-Behavioural Skills Model-Based Exercise and Mindfulness-Based Stress Reduction on Chronic Obstructive Pulmonary Disease with Anxiety and Depression

Abstract

Background: This study aims to evaluate the effects of an information motivation behavioral skills (IMB) model-based exercise combined with mindfulness-based stress reduction (MBSR) on patients with chronic obstructive pulmonary disease (COPD) and comorbid anxiety and depression.

Methods: This retrospective study included 168 patients with COPD and comorbid anxiety and depression who visited the Department of Respiratory Medicine of The Second Affiliated Hospital of Dalian Medical University between January 2023 and December 2024. Patients were divided into a routine care group (n = 84) and a combined treatment group (n = 84, receiving 12-week IMB model-based exercise rehabilitation combined with MBSR) based on the care they received. Changes in the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), modified Medical Research Council (mMRC) dyspnea scale, 6-minute walk distance (6MWD) and pulmonary function indicators were compared between the two groups before and after the treatment. 

Results: After treatment, the combined treatment group showed significantly greater improvements than the routine care group in reducing HAMA, HAMD, increasing 6MWD and improving forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) (all p < 0.001). The distribution of mMRC grades also differed significantly between the two groups post intervention (χ² = 10.630, df = 3, p = 0.013), favoring the combined treatment.

Conclusions: The IMB model-based exercise rehabilitation and MBSR was associated with reduced the anxiety and depressive symptoms, improved dyspnea, enhanced exercise tolerance and better lung function in patients with COPD and comorbid anxiety and depression. These findings suggest that this integrated mind–body rehabilitation may provide a reference for comprehensive COPD management.