Effects of Tai Chi on exercise capacity and health-related quality of life in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis

Abstract

BackgroundTai Chi is a traditional Chinese mind-body exercise that has been widely practiced in the People’s Republic of China for many centuries. This exercise has also been applied as a training modality in pulmonary rehabilitation programs for stable chronic obstructive pulmonary disease (COPD). This systematic review and meta-analysis aimed to assess the effects of Tai Chi on exercise capacity and health-related quality of life (HRQoL) in COPD patients.MethodsElectronic databases (PubMed, Embase, Web of Science, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, ClinicalTrials.gov, China National Knowledge Infrastructure, and China Biology Medicine disc) were searched. Entries published from January 1980 to March 2014 were included in the search. Eligible studies included those that involved randomized controlled trials and those that lasted for at least 12 weeks. The primary outcome measures were six-minute walking distance (6MWD), St George’s Respiratory Questionnaire (SGRQ), and Chronic Respiratory Disease Questionnaire (CRQ). Effect estimates were pooled with random-effects meta-analysis.ResultsEleven articles involving 824 patients met the inclusion criteria. All included articles compared COPD patients in a Tai Chi group versus COPD patients in nonexercise and/or physical exercise groups. The meta-analysis showed that compared with the nonexercise group, the COPD patients practicing Tai Chi demonstrated significantly enhanced 6MWD (mean difference 35.99, 95% confidence interval [CI] 15.63–56.35, P=0.0005), decreased SGRQ total score (mean difference −10.02, 95% CI −17.59, −2.45, P=0.009), and increased CRQ total score (mean difference 0.95, 95% CI 0.22–1.67, P=0.01). Compared with the physical exercise group, the Tai Chi group showed significantly reduced SGRQ total score (mean difference −3.52, 95% CI −6.07, −0.97, P=0.007), but no statistical significance was found for 6MWD between the two groups (mean difference 13.65, 95% CI −1.06, 28.37, P=0.07) in COPD patients.ConclusionPreliminary evidence suggests that Tai Chi has beneficial effects on exercise capacity and HRQoL in COPD patients. This exercise can be recommended as an effective alternative training modality in pulmonary rehabilitation programs. Further studies are required to support the preliminary evidence and to observe the long-term effects of Tai Chi.

Advances in rehabilitation for chronic diseases: improving health outcomes and function

“…Along with technology based interventions to deal with the problems of access and adherence to conventional pulmonary rehabilitation, the use of active mind-body movement therapies such as yoga,114119 tai chi,120121122123124 qi gong, and pilates has increased. Tai chi provides mild to moderate aerobic exercise corresponding to 1.6 to 4.6 metabolic equivalents, core strength training, and lower extremity and unsupported upper extremity training 122125126.…”

“…Meta-analyses of small studies have shown benefits in the 6MWT and HRQL in favor of tai chi (6MWT: meters difference 35.99, 15.63 to 56.35; P<0.01; HRQL: by SGRQ difference −10.02, −17.59 to −2.45; P=0.009 ) and yoga (6MWT: meters difference 22.01, 9.9 to 34.11; P<0.01; HRQL: by SGRQ difference −12.59, −18.49 to −.7; P<0. 01) when compared with usual care 119123. There are fewer studies of these modalities as adjuncts or as alternatives to pulmonary rehabilitation 114128.…”

Heliox-Driven Nebulization Has a Positive Effect on the Lung Function in Lipopolysaccharide-Induced Chronic Obstructive Pulmonary Disease Rat Model

“…Chronic obstructive pulmonary disease (COPD) is a serious lung disease that severely threatens people’s health [1]. COPD has become a global health problem and is expected to be the third leading cause of mortality worldwide by 2020 [2].…”

Revealing the Neural Mechanisms Underlying the Beneficial Effects of Tai Chi: A Neuroimaging Perspective

“…Patients with COPD  6-minute walk test 40 min per section, 3 sections per week, 6 months (Niu, et al, 2014) Patients with COPD  6-minute walk test Meta-analysis summary: A total of 11 studies on 824 subjects Mean difference (95%CI) = 35.99 [15.63-56.35], P < 0.0005 (Wu, et al, 2014) Patients with chronic systolic heart failure  Cardiac Exercise Self-efficacy Instrument 60 min per section, 2 sections per week, 12 weeks (Yeh, et al, 2011) Patients with chronic systolic heart failure  6-minute walk test 50 min per section, 4 sections per week, 12 weeks, 10 forms of Yang style (Caminiti, et al, 2011) Patients with MS  FSMC 90 min per section, 2 sections per week, 6 months (Burschka, et al, 2014) Patients with fibromyalgia  6-minute walk test 60 min per section, 2 sections per week, 12 weeks, 10 forms of Yang style Patients with fibromyalgia  Timed up and go test 90 min per section, 2 sections per week, 12 weeks, 8 forms of Yang style (Jones, et al, 2012) Patients with peripheral neuropathy  Timed up and go test  6-minute walk test 60 min per section, 3 sections per week, 24 weeks, 8 forms of Yang style (Li, et al, 2010) Female postmenopausal breast cancer survivors  Fatigue symptom inventory Two 60 min section and five 30 min sections per week for first 2 weeks, followed by one 60 min section and five 30 min sections per week for 10 weeks (Larkey, et al, 2015) Nasopharyngeal cancer survivors  6-minute walk test 90 min per section, 1 sections per week, 6 months, 18 forms Tai Chi Qigong Female (Li, et al, 2004) Lung Function Patients with COPD  Forced expiratory volume  Twitch oesophageal pressure  Twitch gastric pressure  Twitch transdiaphragmatic pressure 40 min per section, 3 sections per week, 6 months (Niu, et al, 2014) Patients with COPD  Dyspnea  Forced expiratory volume in 1s  Forced vital capacity Meta-analysis summary: A total of 8 studies on 544 subjects Dyspnea Mean difference (95%CI) = -0.86 [-1.44, -0.28], P = 0.004 FEV1 mean difference (95%CI) = 0.07 [0.02,0.13], P=0.01 FVC mean difference (95%CI) = 0.12 [0.00,0.23], P=0.04 (Yan, et al, 2013) Muscle Strength Elderly women  Extension strength of hip and knee 40 min per section, 6 sections per week, 12 months (Song, et al, 2014) Female older adults with knee osteoarthritis  Abdominal strength by number of situps performed in 30s 20 min per section, 3 sections per week, 12 weeks, 12 forms of Sun style (Song, et al, 2003) Patients with chronic systolic heart failure  Peak torque of the quadriceps muscles 50 min per section, 4 sections per week, 12 weeks, 10 forms of Yang style (Caminiti, et al, 2011) Patients with peripheral neuropathy  Knee extensor and flexor peak torque 60 min per section, 3 sections per week, 24 weeks, 8 forms of Yang style (Li, et al, 2010) Central obese adults with depression  Number of stands in 30s 60-90 min per section, 3 sections per week, 12 weeks, Kaimai style…”