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Tai Chi for Chronic Obstructive Pulmonary Disease (COPD)
June 27, 2016 -
Tai Chi involves a series of slow and rhythmic circular motions. It emphasizes use of "mind" or concentration to control breathing and circular body motions to facilitate flow of internal energy (i.e. 'qi') within the body. Normal flow of 'qi' is believed to be essential to sustain body homeostasis, ultimately leading to longevity.

The effect of Tai Chi on balance and muscle strength in the elderly population has been reported; however, the effect of Tai Chi on dyspnea, exercise capacity, pulmonary function and psychosocial status among people with chronic obstructive pulmonary disease (COPD) remains unclear.

The Hong Kong Polytechnic University performed a study to explore the effectiveness of Tai Chi in reducing dyspnea and improving exercise capacity in people with COPD. It also aimed to determine the influence of Tai Chi on physiological and psychosocial functions among people with COPD.

They included randomized controlled trials (RCTs) comparing Tai Chi (Tai Chi alone or Tai Chi in addition to another intervention) versus control (usual care or another intervention identical to that used in the Tai Chi group) in people with COPD. Two independent review authors screened and selected studies.

Two independent review authors extracted data from included studies and assessed risk of bias on the basis of suggested criteria listed in the Cochrane Handbook for Systematic Reviews of Interventions. We extracted post-program data and used it for analysis.

Main Results: A total of 984 participants from 12 studies (23 references) were included in this analysis. Study sample size ranged from 10 to 206, and mean age ranged from 61 to 74 years. Programs lasted for six weeks to one year. All included studies were random clinical trials; three studies used allocation concealment, six reported blinded outcome assessors and three studies adopted an intention-to-treat approach to statistical analysis. No adverse events were reported.

Quality of evidence of the outcomes ranged from very low to moderate. Analysis was split into three comparisons: (1) Tai Chi versus usual care; (2) Tai Chi and breathing exercise versus breathing exercise alone; and (3) Tai Chi and exercise versus exercise alone.

Comparison of Tai Chi versus usual care revealed that Tai Chi demonstrated a longer six-minute walk distance and better pulmonary function in post-program data. However, the effects of Tai Chi in reducing dyspnea level and improving quality of life remain inconclusive. Data are currently insufficient for evaluating the impact of Tai Chi on maximal exercise capacity, balance and muscle strength in people with COPD.

Comparison of Tai Chi and other interventions (i.e. breathing exercise or exercise) versus other interventions shows no superiority and no additional effects on symptom improvement nor on physical and psychosocial outcomes with Tai Chi.

Conclusions: No adverse events were reported, implying that Tai Chi is safe to practice in people with COPD. Evidence of very low to moderate quality suggests better functional capacity and pulmonary function in post-program data for Tai Chi versus usual care. When Tai Chi in addition to other interventions was compared with other interventions alone, Tai Chi did not show superiority and showed no additional effects on symptoms nor on physical and psychosocial function improvement in people with COPD. With the diverse style and number of forms being adopted in different studies, the most beneficial protocol of Tai Chi style and number of forms could not be commented upon. Hence, future studies are warranted to address these topics.


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