Tai Chi and Pulmonary Rehabilitation Compared for Treatment-Naive Patients With COPD

Polkey, Michael I.; Qiu, Zhihui; Zhou, Lian; Zhu, Meng-Duo; Wu, Yingxin; Chen, Yongyi; Ye, Sheng-Peng; He, Yu-Shan; Jiang, Mei; He, Baiting; Mehta, Bhavin; Zhong, Nanshan; Luo, Yuan

doi:10.1016/j.chest.2018.01.053

Cited by 76 publications

(93 citation statements)

References 29 publications

(36 reference statements)

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“…01) when compared with usual care 119123. There are fewer studies of these modalities as adjuncts or as alternatives to pulmonary rehabilitation 114128. No data are available to support the use of tai chi or yoga as maintenance therapy after pulmonary rehabilitation, although some studies are under way 129.…”

Section: Chronic Obstructive Pulmonary Disease and Pulmonary Rehabilimentioning

confidence: 99%

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

Richardson

Franklin

Moy

et al. 2019

BMJ

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Much of the burden on healthcare systems is related to the management of chronic conditions such as cardiovascular disease and chronic obstructive pulmonary disease. Although conventional outpatient cardiopulmonary rehabilitation programs significantly decrease morbidity and mortality and improve function and health related quality of life for people with chronic diseases, rehabilitation programs are underused. Barriers to enrollment are multifactorial and include failure to recommend and refer patients to these services; poor communication with patients about potential benefits; and patient factors including logistical and financial barriers, comorbidities, and competing demands that make participation in facility based programs difficult. Recent advances in rehabilitation programs that involve remotely delivered technology could help deliver services to more people who might benefit. Problems with intensity, adherence, and safety of home based programs have been investigated in recent clinical trials, and larger dissemination and implementation trials are under way. This review summarizes the evidence for benefit of in-person cardiac and pulmonary rehabilitation programs. It also reviews the literature on newer developments, such as home based remotely mediated exercise programs developed to decrease cost and improve accessibility, high intensity interval training in cardiac rehabilitation, and alternative therapies such as tai chi and yoga for people with chronic obstructive pulmonary disease.

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Section: Chronic Obstructive Pulmonary Disease and Pulmonary Rehabilimentioning

confidence: 99%

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

Richardson

Franklin

Moy

et al. 2019

BMJ

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“…All these interventions, particularly if they show effects, may have a place in the care of patients with chronic respiratory conditions, but it is not helpful to move the field forward if they are branded as ‘rehabilitation’ or proposed as alternatives for pulmonary rehabilitation . In the past few years, internet‐based self‐management programmes, home‐based minimally supervised rehabilitation, tai chi exercises and yoga have all been proposed as alternatives for pulmonary rehabilitation. While these interventions may have a place in the management of some patients with chronic respiratory diseases, or may be the only alternatives in specific regions, it should be clear that these interventions are no substitute for pulmonary rehabilitation.…”

Section: The Future Of Pulmonary Rehabilitationmentioning

confidence: 99%

The past, present and future of pulmonary rehabilitation

et al. 2019

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Abundant evidence supports the use of pulmonary rehabilitation as a treatment for stable and exacerbated chronic obstructive pulmonary disease. Several questions around the science base of rehabilitation in other patient groups as well as the role of rehabilitation as a component in other comprehensive care trajectories remain to be addressed. The impact of a rehabilitation programme could also perhaps be enhanced if clear guidance would be available on how to individualize the components of a rehabilitation programme in individual patients. The rehabilitation community, in an attempt to increase access to programmes, has developed less rigorous interventions. These may serve specific patients (e.g. less severe patients or may be used as a maintenance programme), but in order to have conceptual clarity they should not be called substitutes for rehabilitation if they do not meet the definition of rehabilitation. Reaching clarity on the best format for maintenance programmes in order to achieve long-lasting health benefits for patients is another challenge. Furthermore, as many patients as possible should be referred to adequate rehabilitation programmes within their reach with fair reimbursement. Programmes should take into account the burden of the disease of a patient, the required components to tackle the problems, adequate assessment to document the outcome and the patient's preference. In summary, pulmonary rehabilitation is one of the most potent evidence-based therapies for patients with respiratory diseases. Researchers should continue to fine tune the interventions, get clarity on terminology as well as the ultimate outcomes for rehabilitation to ensure sustainable health effects.

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“…I read with interest the study by Polkey et al 1 in a recent issue of CHEST (May 2018). The suggestion that Tai Chi is an all-in-one substitute for a conventional exercisebased comprehensive pulmonary rehabilitation (PR) program is not supported by the data presented, unless to say that neither worked.…”

Section: Tai Chi Is Not Equivalent To Pulmonary Rehabilitationmentioning

confidence: 99%

“…To be effective in training, the external challenge of exercise must be progressively increased, which occurred in the PR group but not in the Tai Chi group. 1 Indeed, the exercises in the latter group became less demanding as the users became more accomplished. Participants were encouraged to continue Tai Chi, either alone or via a community group, whereas in the PR group, there was no subsequent maintenance exercise prescription or supervision beyond the verbal encouragement to remain as physically active as possible.…”

Section: Tai Chi Is Not Equivalent To Pulmonary Rehabilitationmentioning

confidence: 99%