Effects of Tai Chi on health status in adults with chronic heart failure: A systematic review and meta-analysis

Abstract

BackgroundChronic heart failure (CHF) is among the top causes of cardiovascular morbidity, and most patients with CHF have poor health status. Tai Chi, a mind-body exercise that originated in China, is beneficial for health status. This study was conducted to evaluate the effects of Tai Chi on health status in adults with CHF.MethodsThe Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Database, and Chinese Scientific Journal Database were searched from the inception to 22 October 2021. This meta-analysis was performed using the fixed- or random-effects model. Continuous outcomes were carried out using mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI). Dichotomous outcomes were determined using risk ratio (RR) with 95%CI. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE)pro Guideline Development Tool (GDT) online software was used to present outcome-specific information regarding overall certainty of evidence from studies.ResultsIn total, 15 studies including 1,236 participants were finally included. Compared with usual care alone, Tai Chi combined with usual care achieved efficacy in improving Minnesota Living with Heart Failure Questionnaire (MD = −8.51; 95% CI: −10.32 to −6.70; p < 0.00001), 6-min walk test (MD = 43.47; 95% CI: 33.38 to 54.10; p < 0.00001), left ventricular ejection fraction (MD = 6.07; 95% CI: 3.44 to 8.70; p < 0.00001), B-type natriuretic peptide/N-terminal fragment of pro-BNP (SMD = −1.12; 95% CI: −1.70 to −0.54; p = 0.0002), Hamilton Depression Rating Scale (MD = −2.89; 95% CI: −4.87 to −0.91; p = 0.004), Pittsburgh Sleep Quality Index (MD = −2.25; 95% CI: −3.88 to −0.61; p = 0.007), timed up and go test (MD = −1.34; 95% CI: −2.50 to −0.19; p = 0.02), and reduced the risk of heart failure hospitalization (RR = 0.47; 95% CI: 0.25 to 0.88; p = 0.02). However, there was no difference in the outcome of peak oxygen uptake (MD = 1.38; 95% CI: −1.51 to 4.28; p = 0.35). All-cause mortality or cardiovascular death could not be evaluated due to insufficient data. The certainty of evidence ranged from very low to moderate due to the risk of bias, inconsistency, imprecision, and publication bias.ConclusionTai Chi might be safe and showed beneficial effects on health status in patients with CHF. However, more high-quality and long-term studies are still needed to further evaluate the effects of Tai Chi.

Clinical evidence and potential mechanisms of traditional Chinese medicine for refractory heart failure: a literature review and perspectives

“…Multiple meta-analyses showed that heart failure patients took Tai Chi rehabilitation exercise on the basis of conventional drug treatment. After 6 months of treatment, quality of life, cardiac function grading, 6MWD, LVEF, and LVEDD in the treatment group was significantly better than that of the control group (72,73). Clinical research (74,75) reported that, compared with taking conventional drugs alone, conventional Western medicine combined with Ba Duan Jin's comprehensive treatment can significantly improve patients' BNP, metabolic equivalents (METs), maximum oxygen consumption (VO 2 Max), 6MWD, New York Heart Association (NYHA) classification, LVEF, TCM symptoms, quality of life, and other indicators, and the degree of improvement is obviously better than that of the control group.…”

New approach to heart failure: Integrated traditional Chinese with Western medicine

“…Practicing tai chi can promote the movement of qi throughout the body using a combination of meditation, slow and gentle movements, as well as breathing and relaxation techniques [90]. A recent systematic review of 15 studies concluded that the addition of tai chi to standard care improved LVEF and NT-proBNP levels and reduced MLHFQ scores and hospitalization risk for HF [91]. Another study found that tai chi can reduce depression scores [92] and significantly improve the quality of life and exercise capacity, as measured by the 6MWT [92].…”

Impact of Different Exercise Modalities on Physical Function and Quality of Life in Patients with Heart Failure

“… 45 Similar conclusions were drawn by Hui et al, who found that Tai Chi Chuan alleviated depressive symptoms and improved sleep quality, with no significant impact on VO 2peak . 46 Redwine et al investigated a 16-week Tai Chi Chuan exercise program, observing noteworthy reductions in depressive symptoms in comparison to conventional treatment. 47 Nevertheless, no noticeable disparities in the 6-minute walk distance (6MWD) were seen, which could be attributed to constraints such as the relatively small number of participants, the elderly age of the individuals involved, and the existence of other medical conditions that would have hindered their ability to walk.…”