Background and objective: The aim of the Pulmonary Rehabilitation Guidelines (Guidelines) is to provide evidence-based recommendations for the practice of pulmonary rehabilitation (PR) specific to Australian and New Zealand healthcare contexts.

The aims of the study were to determine the effect of short-form Sun-style t'ai chi (SSTC) (part A) and investigate exercise intensity of SSTC (part B) in people with chronic obstructive pulmonary disease (COPD).Part A: after confirmation of eligibility, participants were randomly allocated to either the t'ai chi group or control group (usual medical care). Participants in the t'ai chi group trained twice weekly for 12 weeks. Part B: participants who had completed training in the t'ai chi group performed a peak exercise test (incremental shuttle walk test) and SSTC while oxygen consumption (VO 2 ) was measured. Exercise intensity of SSTC was determined by the per cent of VO 2 reserve.Of 42 participants (mean¡SD forced expiratory volume in 1 s 59¡16% predicted), 38 completed part A and 15 completed part B. Compared to control, SSTC significantly increased endurance shuttle walk time (mean difference 384 s, 95% CI 186-510); reduced medial-lateral body sway in semi-tandem stand (mean difference -12.4 mm, 95% CI -21--3); and increased total score on the chronic respiratory disease questionnaire (mean difference 11 points, 95% CI 4-18). The exercise intensity of SSTC was 53¡18% of VO 2 reserve.SSTC was an effective training modality in people with COPD achieving a moderate exercise intensity which meets the training recommendations.KEYWORDS: Anxiety and depression, chronic obstructive pulmonary disease, exercise capacity, exercise physiology, health-related quality of life, rehabilitation T 'ai chi, an exercise involving both upper and lower extremities, originated from China. T'ai chi is characterised by posture alignment, weight shifting and circular movements that incorporate elements of muscle endurance and strengthening, balance, relaxation and breathing control. The movements of t'ai chi are unique and are often described as slow, smooth flowing and graceful.T'ai chi has become a popular training mode in western countries and requires no exercise equipment or specific training venue and thus is easily implemented in the community. Currently, a number of t'ai chi styles are utilised, including Yang, Chen and Sun styles. Each of these styles is characterised by emphasis on slightly different forms (movements). The benefits of t'ai chi on balance, exercise capacity and muscle strength have been demonstrated in the healthy population [1,2] and people with chronic conditions, such as chronic heart disease [3] and osteoarthritis [4].In comparison with other styles of t'ai chi, shortform Sun-style t'ai chi (SSTC), also known as t'ai chi for arthritis, is a modified t'ai chi programme with 21 forms. This is one of the most common styles of t'ai chi and training courses for instructors are available worldwide. Each form can be broken down into several movements which are easy to teach and learn. Compared to some other styles of t'ai chi, SSTC involves less difficult movements, such as less deep-knee bending and single leg standing, which may make it more suitable for older people.Recent studies examining t'ai ...

Almost half the patients referred to pulmonary rehabilitation with chronic obstructive pulmonary disease (COPD) desaturate during exercise. Although oxygen supplementation may ameliorate oxygen desaturation, the effects on outcomes of exercise training have not been rigorously evaluated. This study aimed to determine whether supplemental oxygen during exercise training was more effective than medical air in improving exercise capacity and health-related quality of life (HRQoL) in people with COPD.People with COPD who demonstrated oxygen desaturation <90% during the 6-min walk test were recruited to this multicentre trial with randomisation (independent, concealed allocation) to either an Oxygen group or Air group, blinding (participants, exercise trainers and European Respiratory Journal assessors) and intention-to-treat analysis. Both groups received the respective gas from concentrators via nasal prongs at 5 L·min−1 during exercise training consisting of treadmill and cycle exercise, three times per week for 8 weeks. Primary outcomes were the endurance shuttle walk test (ESWT) time and Chronic Respiratory Disease Questionnaire (CRQ)-Total score.111 participants (60 males), mean±sd age 69±7 years, with moderate to severe COPD were recruited and 97 completed (Oxygen group n=52; Air group n=45). At the end of the 8-week training programme there were no between-group differences in change in ESWT (mean difference 15 s (95% CI −106–136 s) or change in CRQ-Total (0.0 points (95% CI −0.3–0.3 points)). Within-group changes at end-training were significant for ESWT and CRQ-Total (all p<0.01).Exercise capacity and HRQoL improved in both groups, with no greater benefit from training with supplemental oxygen than medical air.

Ground walk training increased endurance walking capacity more than cycle training and was similar to cycle training in improving peak walking capacity, peak and endurance cycle capacity and quality of life. This study provides evidence for ground walking as a mode of exercise training in pulmonary rehabilitation programs.

People attending metropolitan pulmonary rehabilitation, maintenance exercise classes and support groups had substantial technology engagement, with high device access and use, and good self-rated technology competence. The majority of participants were willing to use telerehabilitation, especially if they were regular users of technology devices. [Seidman Z, McNamara R, Wootton S, Leung R, Spencer L, Dale M, Dennis S, McKeough Z (2017) People attending pulmonary rehabilitation demonstrate a substantial engagement with technology and willingness to use telerehabilitation: a survey. Journal of Physiotherapy 63: 175-181].

The primary purpose of this study was to examine the metabolic and cardiorespiratory responses to the continuous performance of Wing Chun and T'ai Chi Chuan exercise. No significant differences in VO2max or HRmax obtained during treadmill exercise were found between the practitioners of the two styles. Average values for oxygen uptake (VO2) were 23.3 +/- 7.5 ml.kg-1.min-1 (6.6 METS) and 16.0 +/- 3.9 ml.kg-1.min-1 (4.6 METS) for Wing Chun and T'ai Chi Chuan exercise, respectively. Mean heart rates obtained during exercise were 137 +/- 25 beats.min-1 for Wing Chun and 116 +/- 22 beats.min-1 for T'ai Chi Chuan exercise. These exercise values corresponded to 52.4% of VO2max and 70.5% of HRmax for Wing Chun and only 36.4% of VO2max and 59.8% of HRmax for T'ai Chi Chuan exercise. Thus, only the continuous performance of Wing Chun exercise elicited VO2 and HR responses that would be expected to bring about a cardiorespiratory training effect in subjects with a relatively low initial VO2max. The ventilatory equivalent for oxygen (VE/VO2) obtained during T'ai Chi Chuan exercise (21.7) was significantly lower than for Wing Chun exercise (24.2), suggesting that T'ai Chi practitioners utilize efficient breathing patterns during exercise. Both Wing Chun and T'ai Chi Chuan styles may have a small static component that produces a slightly elevated heart rate relative to metabolic load when compared to traditional aerobic activities. However, the effect was not severe and these forms of exercise should not be considered dangerous for individuals at high risk for cardiovascular disease.

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IntroductionSimple and scalable strategies are needed to improve ‘out-of-hospital’ support and management for people living with cardiovascular disease (CVD) and respiratory disease. Text messaging via mobile phones has been shown to be effective in helping promote lifestyle change and is supported by quantitative and qualitative evidence. The aim of this study is to test the effectiveness and implementation of a 6-month text messaging support programme for people with CVD and respiratory disease as an addition to cardiac and pulmonary outpatient rehabilitation.Methods and analysisPragmatic randomised controlled trial (n=310) to test the effectiveness of a 6-month text message support programme on clinical outcomes in people with CVD and chronic respiratory disease who are attending outpatient cardiac and pulmonary rehabilitation. The study includes a nested process evaluation to inform scalability and implementation across settings. The intervention group will receive a text message support programme comprising five messages per week for 26 weeks and the control group will continue with standard care. The primary outcome is exercise capacity (6 min walk distance). Secondary outcomes include clinical measures (proportion of people meeting the Australian guideline-recommended blood pressure and cholesterol targets), lifestyle outcomes (smoking rates, achievement of national guidelines for nutrition and physical activity), quality of life, mood (Hospital Anxiety and Depression Scale), medication adherence and attendance at and completion of rehabilitation.Ethics and disseminationPrimary ethics approval was received from the Sydney Local Health District Hospital Human Research Ethics Committee and associated Governance committees at sites. Results will be disseminated via the usual scientific forums including peer-reviewed publications and presentations at international conferences. At its conclusion, the study will determine the effectiveness and implementation of a simple programme that aims to improve health outcomes and attendance at rehabilitation for people with CVD and chronic respiratory disease.Trial registration numberACTRN12616001167459