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Long-term Exercise After Pulmonary Rehabilitation (LEAP): A Pilot Trial of Tai Chi in COPD

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July 28, 2021 - Mind-body modalities are promising strategies to maintain the benefits gained after completion of conventional pulmonary rehabilitation in persons with COPD. In a pilot randomized controlled study jointly performed by VA Boston Healthcare System, Harvard Medical School and Boston University School of Medicine, scientists examined Tai Chi in persons with COPD after completing pulmonary rehabilitation. Participants were randomized 2:2:1 to Tai Chi (TC), usual care (UC) or group walking (GW) for 24 weeks.

The scientists assessed feasibility; primary outcome was exercise capacity measured by 6-min walk test (6MWT) distance at 24 weeks. Secondary outcomes included health-related quality of life measured by Chronic Respiratory Questionnaire (CRQ), dyspnea, mood, stress, social support, self-efficacy, physical activity and exercise engagement.

Effect size estimates and estimates from generalized estimating equations were calculated. Ninety-one persons (36 in the Tai Chi group, 37 in UC and 18 in GW) were enrolled, with mean ages ranging from 63 to 75 and 59% male.

There was no difference in adherence and adverse events between groups. There was a small between-group effect size in change in 6MWT distance favoring Tai Chi compared to UC; 24-week comparison was nonsignificant. There were no differences in secondary outcomes. In exploratory analyses, there was a greater percentage of participants in Tai Chi who improved 6MWT distance at 24 weeks, compared to UC (64% versus 39%). There were higher percentages of participants in Tai Chi who improved CRQ Fatigue (59% versus 31%,) and CRQ Mastery domain scores, compared to UC. For GW, there were no differences compared with Tai Chi.

Tai Chi may be a feasible option to maintain the benefits gained after completing conventional pulmonary rehabilitation.




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