Design and methods of the Gentle Cardiac Rehabilitation Study — A behavioral study of tai chi exercise for patients not attending cardiac rehabilitation

Lim

Health Soc Care Community

et al. 2018

123

The purpose of this research was to contribute to the development of a resilience‐promoting programme for patients with chronic diseases. A systematic review of literature concerning resilience interventions for patients with chronic diseases was conducted by searching PubMed (including Medline), Science Direct, Web of Science, PsycARTICLES, CINAHL Plus, Embase, and the Cochrane Database for articles featuring the terms “resilience,” “resiliency,” “resilient,” “cancer,” “stroke,” “heart disease,” “diabetes” and “COPD” and published between 8 January 2017 and 15 January 2017. We included all English studies relevant to the topic; however, we excluded: (1) nonrandomised controlled trials and (2) those that mentioned the term “resilience” but did not apply it in their analysis. Seventeen studies—10 on cancer, four on cardiovascular diseases and three on diabetes—were deemed suitable for analysis. We found that, in these studies, (1) diverse definitions of resilience were applied, (2) various intervention durations were used and (3) complex programmes were applied within the resilience‐improving programmes. Our research encourages efforts to operationalise the construct of resilience, so it can be applied in clinical settings, and for the development of more systematic intervention programmes.

Section: Resultsmentioning

confidence: 99%

Resilience of patients with chronic diseases: A systematic review

Lim

Health Soc Care Community

et al. 2018

123

“…On the basis of the panel's recommendations, a tai chi research expert (P.M.W.) worked with the tai chi instructors (3 certified instructors with 10+ years' experience) to modify existing protocols by increasing aerobic intensity over time (ie, by gradually adjusting the pace of practices [slightly faster over time] and depth of stances [slightly lower over time]) …”

Section: Methodsmentioning

confidence: 99%

“…Methods for this study have been described in detail elsewhere. 33 Briefly, participants were recruited via flyers placed in cardiology practices, community centers, and other public venues; on-line resources; and advertisements on local radio programs and community newspapers. Because tai chi was offered in a class format, we recruited 3 consecutive cohorts of participants.…”

Section: Methods Populationmentioning

confidence: 99%

“…worked with the tai chi instructors (3 certified instructors with 10+ years' experience) to modify existing protocols by increasing aerobic intensity over time (ie, by gradually adjusting the pace of practices [slightly faster over time] and depth of stances [slightly lower over time]). 33 Intervention fidelity was assessed according to the Treatment Fidelity Workgroup guidelines. 40 Tai chi sessions were video recorded, and the study auditor (P.M.W.)…”

Section: Tai Chi Interventionsmentioning

confidence: 99%

See 1 more Smart Citation

Tai Chi Is a Promising Exercise Option for Patients With Coronary Heart Disease Declining Cardiac Rehabilitation

Salmoirago‐Blotcher

Wayne

Dunsiger

et al. 2017

JAHA

Self Cite

BackgroundMore than 60% of patients decline participation in cardiac rehabilitation after a myocardial infarction. Options to improve physical activity (PA) and other risk factors in these high‐risk individuals are limited. We conducted a phase 2 randomized controlled trial to determine feasibility, safety, acceptability, and estimates of effect of tai chi on PA, fitness, weight, and quality of life.Methods and ResultsPatients with coronary heart disease declining cardiac rehabilitation enrollment were randomized to a “LITE” (2 sessions/week for 12 weeks) or to a “PLUS” (3 sessions/week for 12 weeks, then maintenance classes for 12 additional weeks) condition. PA (accelerometry), weight, and quality of life (Health Survey Short Form) were measured at baseline and 3, 6, and 9 months after baseline; aerobic fitness (stress test) was measured at 3 months. Twenty‐nine participants (13 PLUS and 16 LITE) were enrolled. Retention at 9 months was 90% (LITE) and 88% (PLUS). No serious tai chi–related adverse events occurred. Significant mean between group differences in favor of the PLUS group were observed at 3 and 6 months for moderate‐to‐vigorous PA (100.33 min/week [95% confidence interval, 15.70–184.95 min/week] and 111.62 min/week; [95% confidence interval, 26.17–197.07 min/week], respectively, with a trend toward significance at 9 months), percentage change in weight, and quality of life. No changes in aerobic fitness were observed within and between groups.ConclusionsIn this community sample of patients with coronary heart disease declining enrollment in cardiac rehabilitation, a 6‐month tai chi program was safe and improved PA, weight, and quality of life compared with a 3‐month intervention. Tai chi could be an effective option to improve PA in this high‐risk population.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02165254.

Contemporary Clinical Trials

“…The Tai Chi intervention is adapted from protocols used in our prior trials [9, 21, 41, 43–45] with modifications to: 1) assure safety and emphasize training components specifically relevant to individuals who are frail or transitioning to frailty and 2) adapt to the longer-term nature of our proposed intervention (52 vs. 12 weeks). The protocol emphasizes traditional Tai Chi movements that are easily comprehensible and can be performed repetitively in a flowing manner.…”

Section: Methodsmentioning

confidence: 99%

The Mind Body-Wellness in Supportive Housing (Mi-WiSH) study: Design and rationale of a cluster randomized controlled trial of Tai Chi in senior housing

Wayne

Gagnon

Macklin

et al. 2017

Supporting the health of growing numbers of frail older adults living in subsidized housing requires interventions that can combat frailty, improve residents’ functional abilities, and reduce their health care costs. Tai Chi is an increasingly popular multimodal mind–body exercise that incorporates physical, cognitive, social, and meditative components in the same activity and offers a promising intervention for ameliorating many of the conditions that lead to poor health and excessive health care utilization. The Mind Body-Wellness in Supportive Housing (Mi-WiSH) study is an ongoing two-arm cluster randomized, attention-controlled trial designed to examine the impact of Tai Chi on functional indicators of health and health care utilization. We are enrolling participants from 16 urban subsidized housing facilities (n=320 participants), conducting the Tai Chi intervention or education classes and social calls (attention control) in consenting subjects within the facilities for one year, and assessing these subjects at baseline, 6 months, and 1 year. Physical function (quantified by the Short Physical Performance Battery), and health care utilization (emergency visits, hospitalizations, skilled nursing and nursing home admissions), assessed at 12 months are co-primary outcomes. Our discussion highlights our strategy to balance pragmatic and explanatory features into the study design, describes efforts to enhance site recruitment and participant adherence, and summarizes our broader goal of post study dissemination if effectiveness and cost-effectiveness are demonstrated, by preparing training and protocol manuals for use in housing facilities across the U.S.