Data are available online at https://err.ersjournals.com/content/32/168/220243.figures-only . Supplementary material is available online at https://err.ersjournals.com/content/errev/32/168/220243/DC1/embed/inline-supplementary-material-1.pdf?download=true . The effect of meditative movement, which includes yoga, tai chi and qi gong, on breathlessness in advanced disease is unknown. This systematic review aims to comprehensively assess the evidence on the effect of meditative movement on breathlessness (primary outcome), health-related quality of life, exercise capacity, functional performance and psychological symptoms (secondary outcomes) in advanced disease. 11 English and Chinese language databases were searched for relevant trials. Risk of bias was assessed using the Cochrane tool. Standardised mean differences (SMDs) with 95% confidence intervals were computed. 17 trials with 1125 participants (n=815 COPD, n=310 cancer), all with unclear or high risk of bias, were included. Pooled estimates (14 studies, n=671) showed no statistically significant difference in breathlessness between meditative movement and control interventions (SMD (95% CI) 0.10 (−0.15–0.34); Chi2=30.11; I2=57%; p=0.45), irrespective of comparator, intervention or disease category. Similar results were observed for health-related quality of life and exercise capacity. It was not possible to perform a meta-analysis for functional performance and psychological symptoms. In conclusion, in people with advanced COPD or cancer, meditative movement does not improve breathlessness, health-related quality of life or exercise capacity. Methodological limitations lead to low levels of certainty in the results. L.J. Brighton is funded by an Economic and Social Research Council Post-Doctoral Fellowship (ES/X005259/1). Y. Mo is funded by King’s-China Scholarship Council (K-CSC 202106370016). I.J. Higginson, M. Maddocks, J. Bayly and L.J. Brighton are supported by the NIHR Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. M. Maddocks is supported by a National Institute for Health and Care Research (NIHR) Career Development Fellowship (CDF-2017–10–009) and the NIHR Applied Research Collaboration South London.
