**5. Conclusions**

This systematic review estimated the comparative effectiveness of Western and Eastern manual therapies for patients with COPD using the NMA methodology. The optimal treatment for each outcome according to SUCRA was massage, acupressure, massage, and tuina for FEV1, FVC, FEV1/FVC, and 6MWD, respectively. However, the methodological quality of the included studies was generally poor, and the head-to-head trial comparing different types of manual therapies for COPD patients was inadequate. Given the complementary role and promise of manual therapies in the treatment of patients with COPD, high-quality RCTs in this area should be implemented in the future.

**Supplementary Materials:** The following are available online at https://www.mdpi.com/article/10 .3390/healthcare9091127/s1, Supplement S1. Search strategy used in each database; Supplement S2. List of excluded studies after full-text review; Supplement S3. Results of pair-wise meta-analysis; Supplement S4. PRISMA 2020 Checklist.

**Author Contributions:** Conceptualization, C.-Y.K. and K.-I.K.; Methodology, C.-Y.K. and B.L.; Writing—original draft, C.-Y.K. and B.L.; Writing—review and editing, K.-I.K., B.-J.L., and H.-J.J.; Funding, H.-J.J.; Supervision, K.-I.K. and H.-J.J. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HF20C0030).

**Institutional Review Board Statement:** Ethical review and approval were waived for this study, as this study is a systematic review of previously published studies.

**Informed Consent Statement:** Patient consent was waived, as this study is a systematic review of previously published studies.

**Data Availability Statement:** The data presented in this study are available in the article and supplementary materials.

**Conflicts of Interest:** The authors have no conflict of interest to declare.
