An evaluation of the effects of Tai Chi Chuan and Chi Kung training in patients with symptomatic heart failure: a randomised controlled pilot study

Abstract

Objective: To study the effect of Tai Chi on exercise tolerance in patients with moderate heart failure. Design: Randomised parallel group study balanced for baseline variables. Setting: Cardiology Department, Royal Hallamshire Hospital. Patients and methods: 52 patients (42 men, mean age (68.9 years), range (46-90 years), and 10 women, mean age (70.0 years), range (58-82)) with chronic heart failure (New York Heart Association symptom class II-III) were studied. Patients were randomised to Tai Chi Chuan twice a week for 16 weeks or to standard medical care without exercise rehabilitation. Main outcome measures: The primary outcome measure was the change in the distance walked in the shuttle walk test. Secondary outcome measures were changes in symptom scores and quality of life indices. Results: Objective measures of exercise tolerance did not improve significantly with Tai Chi, but patients having Tai Chi exercise had an improvement in symptom scores of heart failure measured by the Minnesota Living with Heart Failure Questionnaire (comparison of deltas, 22.4 control vs 214.9; p = 0.01), and depression scores measured by the SCL-90-R questionnaire (22.9 vs 26.8; p = 0.12) compared with those patients in the control group. Conclusion: In patients with chronic heart failure, 16 weeks of Tai Chi training was safe, with no adverse exercise related problems. It was enjoyed by all taking part and led to significant improvements in symptoms and quality of life.

The effect of Tai Chi on four chronic conditions—cancer, osteoarthritis, heart failure and chronic obstructive pulmonary disease: a systematic review and meta-analyses

“…Other studies used symptoms as an indicator of OA severity, such as pain intensity on a visual analogue scale (VAS), and scored 4.4 of the 10 points36 and 48.6 of the 100 points 54. Four of the five HF studies22 43 52 55 used the New York Heart Association (NYHA) classification for HF and stated that the participants were in classes I–III, indicative of mild-to-moderate HF severity. Three of the five COPD studies40 42 56 reported forced expiratory volume in 1 s (FEV 1 ) indicative of participants with moderate-to-severe COPD and two studies reported stages of severity 35 57…”

“…Sun style Tai Chi was used in four OA studies23 33 37 38 and two COPD studies 56 57. Wu style Tai Chi was taught in only two studies (1 OA54 and 1 HF22). The type of Tai Chi was not stated in six studies 24 34 39 40 45 53.…”

“…Third, the sample sizes of included RCTs were quite small, contributing to limited power in most studies and in the aggregated data examined by meta-analyses. For example, the conflicting findings of the effect of Tai Chi on blood pressure in participants with HF are difficult to interpret because both reports had a small sample size 22 58. A fourth limitation is that participants in most studies represented patients who had one primary condition and may have excluded individuals with multimorbidity.…”

“…Authors of 14 studies were approached to obtain data that were not available in the original paper,22 31–47 and six authors34–39 45–47 provided data for the outcomes of interest. When the SDs were not available after contacting the authors, SEs, CIs, t values and p values were used to calculate SDs 48…”

Effects of interventions on depression in heart failure: A systematic review

“…37,43,44,51 Three studies were weak in quality. 37,43,44 Two studies that reported the percentages willing to participate indicated that large numbers of persons refused, although no reasons were given. 43,51 Although the findings are promising (d range, .4 to 1.6), the overall body of evidence is weak.…”