Tai Chi Comparison to Pulmonary Rehabilitation

  

Tai Chi Comparison to Pulmonary Rehabilitation

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By Gerene Bauldoff, PhD, RN, MAACVPR

As pulmonary rehabilitation (PR) continues to grow, investigations into alternative exercise programs are reported. A study by Polkey and colleagues electronically published ahead of print describes a randomized control trial of PR versus tai chi when used for treatment-naïve COPD patients in China. The PR program used in this study followed standard United Kingdom (UK) practice of 3 times per week, 1-hour exercise sessions similar to standard PR in the United States. The tai chi program was a 24-form Yang style where patients participated for one hour per day, five days per week. Both the PR and the tai chi programs were conducted for 12 weeks. A total of 120 patients were enrolled in the study (n=60 in the PR group, n=60 in the tai chi group), with 55 patients completing the study in both groups (total n=110). An intent-to-treat analysis was used to account for all participants who enrolled in the study. The primary end point (outcome of interest) was program benefit as measured using the St. George’s Respiratory Questionnaire (SGRQ). Secondary measures included six-minute walk and other measures of strength and physical activity. No differences were noted for demographic descriptors at baseline between groups. High compliance was noted for both groups in their respective assigned program.

No differences were noted in the SGRQ total score or for six-minute walk when comparison was conducted between the two exercise programs. Both groups had significant improvement in the SGRQ total score and subscores (symptoms, activity, impacts) over time. However, SGRQ improvement was noted to be less than the four-point minimum clinically important difference reported for the instrument total or subscores.

The authors noted in the discussion their rationale for using the SGRQ as their primary outcome and limitations noted within this study design and the sample and setting for this study.

In conclusion, while this study did not reach the clinically meaningful difference in the SGRQ for either the PR or tai chi groups, the improvement in SGRQ scores favored tai chi in this study. Per the authors, this study suggests that tai chi may be an alternative exercise protocol for PR patients with COPD.

What does this mean for the PR professional?

As PR professionals, it is imperative that we are vigilant for innovations arising from published evidence regarding alternatives for PR components. While tai chi may be a reasonable alternative for typical PR exercise, consideration of PR professional expertise and patient preferences must be included in programmatic decisions.

Reference:

Polkey MI, Zhi-Hui Q, Zhou L, Zhu M-D, Wu Y-X, Chen Y-Y, Ye S-P, He Y-S, Jiang M, He B-T, Mehta B, Zhong N-S & Luo Y-M. (2018). Tai chi and pulmonary rehabilitation compared for treatment-naïve patients with COPD: A randomized controlled trial. Electronically published as article in press. Retrieved from: http://journal.chestnet.org/article/S0012-3692(18)30313-1/fulltext
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