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To determine the theoretical framework that explains the mechanisms of the success of breathing exercise interventions in people with chronic obstructive pulmonary disease. A realist review. Seven bibliographic databases and the grey literature were searched from 2015-January 2020 to identify the studies of breathing exercises. The evaluation criteria of realist review and the mixed method appraisal tool were both used to evaluate the included studies. We extracted and integrated the context-mechanism-outcome strings of each study to f