Small RCT finds laughter therapy matches pursed-lip breathing for reducing COPD breathlessness

The Ankara Bilkent City Hospital study randomized adults with COPD to 30-minute sessions of guided laughter exercises, pursed-lip breathing, or usual care three times weekly. Both active arms showed statistically significant drops in modified Medical Research Council dyspnea scale scores that persisted one month post-intervention; no between-group difference emerged between laughter and pursed-lip arms, while the control arm remained unchanged. Overall health status improved modestly in both treatment groups without changes in daily care needs. The design was a three-arm, assessor-blinded RCT with remote adherence support via video and text. Laughter therapy exploits forced exhalation and diaphragmatic engagement similar to pursed-lip breathing yet adds positive affect that may improve adherence in a population with high depression rates. Prior observational data from the European Respiratory Journal on laughter yoga in asthma and a 2023 meta-analysis in Respiratory Medicine on mind-body interventions for COPD suggest comparable physiologic mechanisms, though none were powered for hard endpoints such as exacerbations. The present trial adds a direct head-to-head comparison but remains limited by short duration and surrogate outcomes. Conference abstracts carry higher risk of later non-publication or effect attenuation; full peer review and larger multicenter replication measuring exacerbation rates, six-minute-walk distance, and cost-effectiveness are required before guideline consideration. No funding conflicts were declared.