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COPD – Increased Confidence and increased self esteem

Evidence Summary (Updated 2022)
A large body of good quality interventional data shows an improvement in quality of life as measured by mental health outcome scores. Mind body exercises(1), Tai Chi(2), and HIIT(3), all conferred benefit .
The use of step count monitors has been shown to improve self-efficacy and overcome barriers to exercise.(4) Further qualitative research has shown that pulmonary rehabilitation can improve confidence and self-efficacy such that they were major themes in a study by Hogg et al.(5)

Quality of Evidence
Grade C – Low quality.

Strength of recommendation
Grade 1 – strong recommendation.

The evidence for the benefit is mostly qualitative. Improved mental health outcomes have higher quality evidence and can also confer improved confidence and self-esteem according to expert opinion. Increased confidence and self-efficacy can help maintain an active lifestyle.


  1. Li Z, Liu S, Wang L, Smith L. Mind–Body Exercise for Anxiety and Depression in COPD Patients: A Systematic Review and Meta-Analysis. Int J Environ Res Public Heal 2020, Vol 17, Page 22 [Internet]. 2019 Dec 18 [cited 2022 Oct 5];17(1):22. Available from:
  2. Guo C, Xiang G, Xie L, Liu Z, Zhang X, Wu Q, et al. Effects of Tai Chi training on the physical and mental health status in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. J Thorac Dis [Internet]. 2020 Mar 1 [cited 2022 Oct 5];12(3):504–21. Available from:
  3. Gao M, Huang Y, Wang Q, Liu K, Sun G. Effects of High-Intensity Interval Training on Pulmonary Function and Exercise Capacity in Individuals with Chronic Obstructive Pulmonary Disease: A Meta-Analysis and Systematic Review. Adv Ther [Internet]. 2022 Jan 1 [cited 2022 Oct 4];39(1):94–116. Available from:
  4. Selzler AM, Rodgers WM, Berry TR, Stickland MK. Coping Versus Mastery Modeling Intervention to Enhance Self-efficacy for Exercise in Patients with COPD. Behav Med [Internet]. 2020 Jan 2 [cited 2022 Oct 6];46(1):63–74. Available from:
  5. Hogg L, Grant A, Garrod R, Fiddler H. People with COPD perceive ongoing, structured and socially supportive exercise opportunities to be important for maintaining an active lifestyle following pulmonary rehabilitation: a qualitative study. J Physiother. 2012 Sep 1;58(3):189–95.