Children and Adults Tai Chi Study (CF-CATS2): a randomised controlled feasibility study comparing internet-delivered with face-to-face Tai Chi lessons in cystic fibrosis

Abstract

Virtual healthcare is fast entering medical practice. Research into the feasibility of using it to teach treatment regimens such as exercise has not been explored. Maintaining an exercise regime can be difficult in cystic fibrosis: group classes risk potential infection, yet motivation is hard to maintain when alone. Tai Chi is a low-impact exercise and involves gentle, demanding movements. This study aimed to assess the feasibility, safety and acceptability of learning Tai Chi via an internet-based approach and compared patient-reported outcomes.Children and adults with cystic fibrosis were recruited to a randomised, comparative effectiveness trial. Participants learnt eight Tai Chi movements; teaching was delivered in eight lessons over 3 months: delivered either via the internet or face-to-face. Assessments were at 3-monthly intervals over 9 months. Outcomes included health status, quality of life, sleep, mindfulness and instructor-led questions.40 adults and children completed the eight sets of Tai Chi lessons. The median age was 22.8 years (range 6.1–51.5 years); 27 patients were female. The cohort comprised 26 adults (aged >16 years), six teenagers and eight children (aged <12 years). The groups were well matched. Feasibility and safety were demonstrated. Participants showed significant improvements in self-reported sleep, cough (both daytime and night-time), stomach ache and breathing. No differences in lung function, health status, quality of life, sleep or mindfulness was shown before or after completing the lessons.Tai Chi was safe and well tolerated; it was feasible to deliver individual lessons via the internet, reducing concerns regarding cross-infection, and appeared to improve self-reported symptoms.

Learning to breathe with Tai Chi online - qualitative data from a randomized controlled feasibility study of patients with cystic fibrosis

“…Objective quantitative data on changes in physical health as measured by the CFQ-R, PSQI, FFQM, CAMM and clinical data was comparable for both groups [13] . The focus groups and interviews (qualitative data) suggested that the internet group reported better outcomes for breathing, although the quantitative data (CFQ-R) did not bear this out.…”

“…Although full details on inclusion and exclusion criteria, recruitment and participants included in this study have previously been published [ 13 , 14 ]. The study flow chart is provided in Figure 2 .…”

“…Clinical and quantitative outcome measures included the validated Cystic Fibrosis Questionnaire- Revised (CFQ-R) (measuring health related quality of life) were collected but are reported elsewhere [ 13 , 14 ].…”

“…Of 116 people approached to participate, 65 declined, but only one of these did so because they said that they did not like the idea of online tuition [13] . Most people declined either because they reported that Tai Chi did not appeal to them (43%) or they could not fit the study into their other commitments (36%) or because of their current health problems.…”

“…Quantitative outcomes in terms of physical and mental health have been published previously [13] . Outcomes were comparable between groups and notably qualitative reports from participants suggested that they were better able to expectorate if they practiced Tai Chi before carrying out their physiotherapy exercises.…”