Effects of tai chi in patients with chronic obstructive pulmonary disease: Preliminary evidence

摘要

Background: Currently, several studies assessed the role of T'ai Chi (TC) in management of chronic obstructive pulmonary disease, but these studies have wide variation of sample and convey inconclusive results. We therefore undertook a meta- analysis to assess the effects of TC. Methods: A computerized search through electronic databases was performed to obtain sample studies. The primary outcomes were 6-min walking distance (6MVVD) and dyspnea. Secondary outcomes included health-related quality of life and pre-bronchodilator spirometry. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated and heterogeneity was assessed with the 12 test. A random-effects meta-analysis model was applied. Results: Eight randomized controlled trials involving 544 patients met the inclusion criteria. The pooled WMDs were 34.22 m (95% Cl 21.25-47.20, P < 0.00001) for 6 MWD, -0.86 units (95% Cl -1.44-0.28, P = 0.004) for dyspnea, 70 ml (95% Cl 0.02-0.13, P = 0.01) for FEV1, 120 ml (95% Cl 0.00-0.23, P = 0.04) for FVC.TC significantly improved the Chronic Respiratory Disease Questionnaire total score, and the St George's Respiratory Questionnaire score except impact score. Conclusions: Findings suggest thatTC may provide an effective alternative means to achieve results similar to those reported following participation in pulmonary rehabilitation programs. Further studies are needed to substantiate the preliminary findings and investigate the long-term effects of TC. Editor's Comment: T'ai chi, in its 3 main forms (Yang, Chen, and Sun), provides mild to moderate aerobic exercise through a combination of posture alignment, weight shifting, and circular movements; these include elements of muscle endurance and strengthening, balance, relaxation, and breathing control. It is now extending its presence in Western societies and is increasingly visible even beyond practitioners of Chinese origin or descent. Unlike conventional aerobic exercise-endurance and strengthening-the physiological impact of t'ai chi is largely unstudied from a scientific perspective, including its equivalence to more conventional types of exercise. Its role as a form of rehabilitative intervention in chronic obstructive pulmonary disease is largely unknown.