Evidence map›Paper›PMID 41533188›Full record

ArticleApplied psychophysiology and biofeedback2026

Respiratory Biofeedback Training as an Adjunct Intervention in Pulmonary Rehabilitation for Late-Stage COPD: A Pilot Trial.

Gianvito Lagravinese, Giorgio Castellana, Maddalena Genco, Marialuisa Guglielmo, Serena Tagliente, Patrizia Guido, Ioannis Alexandros Charitos, Maria Aliani, Petronilla Battista, Mattia Nese and 1 more

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Article in Applied psychophysiology and biofeedback, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Gianvito LagravineseIstituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Institute of Bari, Bari, Italy. gianvito.lagravinese@icsmaugeri.it.ORCID http://orcid.org/0000-0001-7717-3071
Giorgio CastellanaIstituti Clinici Scientifici Maugeri IRCCS, Division of Respiratory Disease and Respiratory Rehabilitation, Institute of Bari, Bari, Italy.
Maddalena GencoIstituti Clinici Scientifici Maugeri IRCCS, Division of Respiratory Disease and Respiratory Rehabilitation, Institute of Bari, Bari, Italy.ORCID http://orcid.org/0000-0002-2169-8984
Marialuisa GuglielmoIstituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Institute of Bari, Bari, Italy.
Serena TaglienteIstituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Institute of Bari, Bari, Italy.ORCID http://orcid.org/0000-0002-7697-7294
Patrizia GuidoIstituti Clinici Scientifici Maugeri IRCCS, Division of Respiratory Disease and Respiratory Rehabilitation, Institute of Bari, Bari, Italy.ORCID http://orcid.org/0000-0003-4202-8469
Ioannis Alexandros CharitosIstituti Clinici Scientifici Maugeri IRCCS, Division of Respiratory Disease and Respiratory Rehabilitation, Institute of Bari, Bari, Italy.ORCID http://orcid.org/0000-0003-3527-7483
Maria AlianiIstituti Clinici Scientifici Maugeri IRCCS, Division of Respiratory Disease and Respiratory Rehabilitation, Institute of Bari, Bari, Italy.ORCID http://orcid.org/0000-0001-8753-1303
Petronilla BattistaIstituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Institute of Bari, Bari, Italy.ORCID http://orcid.org/0000-0002-3120-1214
Mattia Nese *Sigmund Freud University, Milan, Italy.ORCID http://orcid.org/0000-0003-1422-8199
Mauro Carone *Istituti Clinici Scientifici Maugeri IRCCS, Division of Respiratory Disease and Respiratory Rehabilitation, Institute of Bari, Bari, Italy.ORCID http://orcid.org/0000-0002-5478-8521

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic obstructive pulmonary disease (COPD) is associated with persistent dyspnea, reduced functional capacity, and significant cognitive and affective impairments. Pulmonary rehabilitation improves the physical and psychological condition, however residual symptoms often remain, especially in patients with advanced disease. Respiratory biofeedback training (RBT) may help modulate autonomic and emotional responses to dyspnea, offering a potential adjunctive intervention. This pilot study investigated the effects of RBT integrated into a standard program of pulmonary rehabilitation for hospitalized patients with very severe COPD (GOLD stage 4 and an mMRC dyspnea score of ≥ 3 despite maximal pharmacological therapy). Thirty patients were randomized to receive either standard pulmonary rehabilitation alone (control group) or in combination with daily RBT sessions for three weeks (biofeedback group). Pre- and post-treatment assessments included measures of dyspnea, functional performance, quality of life, cognitive function and mood. Data were analyzed using Bayesian repeated-measures ANOVA, and results were normalized using Minimal Clinically Important Differences (MCIDs). Both groups showed significant improvements in respiratory and functional outcomes (e.g., mMRC, 6MWT), with no group differences. However, the biofeedback group demonstrated greater improvements in cognitive performance (MoCA) and depressive symptoms (HADS-D). While RBT did not enhance dyspnea or physical performance in patients receiving inpatient pulmonary rehabilitation, it was associated with significant gains in cognitive and emotional outcomes. These findings suggest that RBT may serve as a valuable neuropsychological adjunct in the management of late-stage COPD.

Indexed as

BiofeedbackCognitionCOPDDepressionDyspneaPulmonary rehabilitationQuality of life

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.