Effects of Tai Chi training on exercise capacity and quality of life in patients with chronic heart failure: A meta-analysis
State Key Laboratory of Respiratory Disease, First Affiliated Hospital, Guangzhou Medical College, 151 Yanjiang Road, Guangzhou 510120, PR China. European Journal of Heart Failure
(Impact Factor: 6.53).
10/2012; 15(3). DOI: 10.1093/eurjhf/hfs170
Whether Tai Chi (TC) is effective in the cardiac rehabilitation of patients with chronic heart failure (CHF) remains controversial. We performed a meta-analysis to examine the effects of TC on exercise capacity and quality of life (QoL) in CHF patients.
Methods and results:
PubMed and EMBASE databases were searched (up to May 2012) for relevant studies. Studies including participants with reduced left ventricular systolic function (ejection fraction ≤ 45%) were selected. Interventions considered were TC with or without comparisons (education or usual care). Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I(2) test. Four randomized controlled trials (RCTs) (n = 242) met the inclusion criteria. TC significantly improved QoL (WMD -14.54 points; 95% CI -23.45 to -5.63). TC was not associated with a significant reduction in N-terminal pro brain natriuretic peptide (WMD -61.16 pg/mL; 95% CI -179.27 to 56.95), systolic blood pressure (WMD -1.06 mmHg; 95% CI -13.76 to 11.63), diastolic blood pressure (WMD -0.08 mmHg; 95% CI -3.88 to 3.73), improved 6 min walking distance (WMD 46.73 m; 95% CI -1.62 to 95.09), or peak oxygen uptake (WMD 0.19 mL/kg/min; 95% CI -0.74 to 1.13).
TC may improve QoL in patients with CHF and could be considered for inclusion in cardiac rehabilitation programmes. However, there is currently a lack of evidence to support TC altering other important clinical outcomes. Further larger RCTs are urgently needed to investigate the effects of TC.
Available from: Ching Lan
- "In a recent meta-analysis study, Pan and colleagues  pooled data from four randomized controlled trials (n = 242). The results found that Tai Chi significantly improved quality of life but is not associated with significant reduction in BNP, systolic/diastolic blood pressure, improved 6-minute walking distance, or peak oxygen uptake. "
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ABSTRACT: Exercise training is the cornerstone of rehabilitation for patients with cardiovascular disease (CVD). Although high-intensity exercise has significant cardiovascular benefits, light-to-moderate intensity aerobic exercise also offers health benefits. With lower-intensity workouts, patients may be able to exercise for longer periods of time and increase the acceptance of exercise, particularly in unfit and elderly patients. Tai Chi Chuan (Tai Chi) is a traditional Chinese mind-body exercise. The exercise intensity of Tai Chi is light to moderate, depending on its training style, posture, and duration. Previous research has shown that Tai Chi enhances aerobic capacity, muscular strength, balance, and psychological well-being. Additionally, Tai Chi training has significant benefits for common cardiovascular risk factors, such as hypertension, diabetes mellitus, dyslipidemia, poor exercise capacity, endothelial dysfunction, and depression. Tai Chi is safe and effective in patients with acute myocardial infarction (AMI), coronary artery bypass grafting (CABG) surgery, congestive heart failure (HF), and stroke. In conclusion, Tai Chi has significant benefits to patients with cardiovascular disease, and it may be prescribed as an alternative exercise program for selected patients with CVD.
Available from: Guoyan Yang
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ABSTRACT: The safety and health benefits of Tai Chi mind-body exercise has been documented in a large number of clinical studies focused on specific diseases and health conditions. The objective of this systematic review is to more comprehensively summarize the evidence base of clinical studies of Tai Chi for healthcare.
We searched for all types of clinical studies on Tai chi in PubMed, the Cochrane Library and four major Chinese electronic databases from their inception to July 2013. Data were analyzed using SPSS17.0 software. A total of 507 studies published between 1958 and 2013 were identified, including 43 (8.3%) systematic reviews of clinical studies, 255 (50.3%) randomized clinical trials, 90 (17.8%) non-randomized controlled clinical studies, 115 (22.7%) case series and 4 (0.8%) case reports. The top 10 diseases/conditions was hypertension, diabetes, osteoarthritis, osteoporosis or osteopenia, breast cancer, heart failure, chronic obstructive pulmonary disease, coronary heart disease, schizophrenia, and depression. Many healthy participants practiced Tai Chi for the purpose of health promotion or preservation. Yang style Tai Chi was the most popular, and Tai Chi was frequently practiced two to three 1-hour sessions per week for 12 weeks. Tai Chi was used alone in more than half of the studies (58.6%), while in other studies Tai Chi was applied in combination with other therapies including medications, health education and other physical therapies. The majority of studies (94.1%) reported positive effects of Tai Chi, 5.1% studies reported uncertain effects and 0.8% studies reported negative effects. No serious adverse events related to Tai Chi were reported.
The quantity and evidence base of clinical studies on Tai Chi is substantial. However, there is a wide variation in Tai Chi intervention studied and the reporting of Tai Chi intervention needs to be improved. Further well-designed and reported studies are recommended to confirm the effects of Tai Chi for the frequently reported diseases/conditions.
Available from: sciencedirect.com
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ABSTRACT: Despite the large number of articles published in the medical literature advocating the use of Tai Ji Quan for a wide variety of health-related outcomes, there has been little systematic broad-scale implementation of these programs. It may be argued that the lack of funding from organizations capable of implementing and overseeing large-scale programs, such as governmental health agencies or national non-governmental organizations concerned with healthcare for older adults, is to blame. However, the evidence these organizations need to justify underwriting such programs is in short supply because of conflicting priorities and standards related to determining the efficacy and effectiveness of Tai Ji Quan. Establishing efficacy through acceptable designs such as randomized controlled trials involves strict protocols to ensure meaningful internal validity but different approaches are needed to demonstrate meaningful effectiveness (external validity) outside the study setting. By examining the quality, quantity, and relative proportions of the randomized controlled trials, systematic reviews, and dissemination studies reported in the medical literature, this paper highlights the disparity in emphasis between efficacy and effectiveness research that has impeded the development of a cohesive literature on Tai Ji Quan and concludes that until more researchers develop a systematic, long-range commitment to investigating its health-related benefits, the research related will remain fractured and sporadic, limiting the incentive of large funding agencies to support its wide-spread use.
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