Tai chi mind-body exercise in patients with COPD: study protocol for a randomized controlled trial

Yeh, Gloria Y.; Wayne, Peter M.; Litrownik, Daniel; Roberts, David H.; Davis, Roger B.; Moy, Marilyn L.

doi:10.1186/1745-6215-15-337

Cited by 28 publications

(21 citation statements)

References 90 publications

(79 reference statements)

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“…The Tai Chi intervention is designed specifically for an older, physically limited population with COPD [54,79,80]. The structured intervention emphasizes essential Tai Chi movements that are easily comprehensible and can be performed repetitively in a flowing manner.…”

Section: Methodsmentioning

confidence: 99%

“…In addition to the five formal movements, the intervention includes a complementary set of traditional Tai Chi warm-up exercises which focus on loosening the physical body, incorporating mindfulness and imagery into movement, promoting overall relaxation, and coordinating breathing awareness. Four traditional interrelated breathing techniques are integrated into the training regimen and coordinated with physical movements [80]. Chairs will be provided for tai chi exercises that are performed in a seated position and resting, as well as for stability as needed when performing other exercises.…”

Section: Methodsmentioning

confidence: 99%

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Long-term Exercise After Pulmonary Rehabilitation (LEAP): Design and rationale of a randomized controlled trial of Tai Chi

Moy

Wayne

Litrownik

et al. 2015

Contemporary Clinical Trials

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Background Persons with chronic obstructive pulmonary disease (COPD) have reduced exercise capacity and levels of physical activity. Supervised, facility-based pulmonary rehabilitation programs improve exercise capacity and reduce dyspnea, but novel long-term strategies are needed to maintain the benefits gained. Mind-body modalities such as Tai Chi which combine aerobic activity, coordination of breathing, and cognitive techniques that alleviate the physical inactivity, dyspnea, and anxiety and depression that are the hallmarks of COPD are promising strategies. Methods/Design We have designed a randomized controlled study to examine whether Tai Chi will maintain exercise capacity in persons with COPD who have recently completed a supervised pulmonary rehabilitation program, compared to standard care. The primary outcome is 6-minute walk test distance at 6 months. Secondary outcomes include health-related quality of life, dyspnea, mood, occurrence of acute exacerbations, engagement in physical activity, exercise self-efficacy, and exercise adherence. Simultaneously, we are conducting a pilot study of group walking. We will enroll 90 persons who will be randomized to one of 3 arms in a 2:2:1 ratio: Tai Chi, standard care, or group-based walking. Discussion The Long-term Exercise After Pulmonary Rehabilitation (LEAP) study is a novel and clinically relevant trial. We will enroll a well-characterized cohort of persons with COPD and will comprehensively assess physiological and psychosocial outcomes. Results of this study will provide the evidence base for persons with COPD to engage in Tai Chi as a low-cost, long-term modality to sustain physical activity in persons who have completed a standard short-term pulmonary rehabilitation program.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Long-term Exercise After Pulmonary Rehabilitation (LEAP): Design and rationale of a randomized controlled trial of Tai Chi

Moy

Wayne

Litrownik

et al. 2015

Contemporary Clinical Trials

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“…Both the active mind-body intervention and the comparator group (conventional pulmonary rehabilitation) need to be standardized. Most studies have been conducted in Chinese populations, and several studies are under way to test these interventions in Western populations to increase generalizability 113130…”

Section: Chronic Obstructive Pulmonary Disease and Pulmonary Rehabilimentioning

confidence: 99%

Advances in rehabilitation for chronic diseases: improving health outcomes and function

Richardson

Franklin

Moy

et al. 2019

BMJ

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Much of the burden on healthcare systems is related to the management of chronic conditions such as cardiovascular disease and chronic obstructive pulmonary disease. Although conventional outpatient cardiopulmonary rehabilitation programs significantly decrease morbidity and mortality and improve function and health related quality of life for people with chronic diseases, rehabilitation programs are underused. Barriers to enrollment are multifactorial and include failure to recommend and refer patients to these services; poor communication with patients about potential benefits; and patient factors including logistical and financial barriers, comorbidities, and competing demands that make participation in facility based programs difficult. Recent advances in rehabilitation programs that involve remotely delivered technology could help deliver services to more people who might benefit. Problems with intensity, adherence, and safety of home based programs have been investigated in recent clinical trials, and larger dissemination and implementation trials are under way. This review summarizes the evidence for benefit of in-person cardiac and pulmonary rehabilitation programs. It also reviews the literature on newer developments, such as home based remotely mediated exercise programs developed to decrease cost and improve accessibility, high intensity interval training in cardiac rehabilitation, and alternative therapies such as tai chi and yoga for people with chronic obstructive pulmonary disease.

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“…A number of components of TC may be relevant to the treatment of deconditioned, pulmonary patients with COPD (eg, physical exercise, breathing training, mind-body awareness, stress management), 19 20 however, there have been few large-scale studies of TC in COPD. One recent, randomised controlled trial (RCT), conducted in China, reported TC was equivalent to pulmonary rehabilitation for improving health-related quality of life (HRQL) at 12 weeks.…”

Section: Introductionmentioning

confidence: 99%

BEAM study (Breathing, Education, Awareness, Movement): a randomised controlled feasibility trial of tai chi exercise in patients with COPD

et al. 2020

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BackgroundDespite therapeutic advances, the management of chronic obstructive pulmonary disease (COPD) remains complex. There is growing interest in multidimensional, mind-body exercises to improve both physical and psychosocial aspects of COPD burden. Few US data are available in this population on tai chi (TC) a mind-body exercise incorporating physical activity, breathing and mindful awareness. We explored feasibility and preliminary efficacy of TC in COPD in an US academic medical setting.MethodsPatients with COPD Global Obstructive Lung Disease (GOLD) stages 2–4 were randomised to a 12-week TC programme or education control. At 12 weeks, those in TC were randomised again to continue in maintenance classes or not to further explore optimal duration. All groups were followed to 24 weeks. Feasibility/safety parameters were analysed descriptively. Preliminary between-group differences were estimated in symptoms (dyspnoea, fatigue), health-related quality-of-life (Chronic Respiratory Questionnaire CRQ), cognitive-emotional measures (mood, COPD self-efficacy) and functional status (6 min walk test, lower body strength, flexibility, physical activity).ResultsNinety-two subjects were randomised (N=61 TC, N=31 education). Mean age was 68±8 years, 66% male, mean forced expiratory volume in 1 s % predicted 57±13, 28% were GOLD stage 3–4. Overall retention was 85%. Nineteen adverse events occurred, most being study-unrelated COPD exacerbations. From baseline to 12 weeks, there were between-group improvements favouring TC, in CRQ-total (Cohen’s d effect size (ES)=0.46; adj mean diff (AMD)=0.31), CRQ-emotion (ES=0.54; AMD=0.49), Centre for Epidemiologic Studies Depression (ES=−0.37; AMD=2.39) and Patient-Reported Outcome Measurement Information System (PROMIS)-fatigue (ES=−0.34; AMD=−0.17). From baseline to 24 weeks, there was an improvement favouring TC in CRQ-dyspnoea (ES=0.41; AMD=0.46). Among TC participants, there was a positive effect of maintenance classes on self-efficacy (ES=−0.69; AMD=−0.40), 6 min walk (ES=0.56; AMD=49.26 feet), PROMIS-fatigue (ES=−0.41; AMD=−0.28) and chair stand (0.43; AMD=0.56).ConclusionTC in patients with COPD is feasible and safe. Preliminary analyses support a potential modest role in improving quality-of-life, cognitive-emotional health and function that should be further studied.Trial registration numberNCT01551953.IRB referenceBIDMC 2010P-000412; VA 2540.

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Tai chi mind-body exercise in patients with COPD: study protocol for a randomized controlled trial

Cited by 28 publications

References 90 publications

Long-term Exercise After Pulmonary Rehabilitation (LEAP): Design and rationale of a randomized controlled trial of Tai Chi

Long-term Exercise After Pulmonary Rehabilitation (LEAP): Design and rationale of a randomized controlled trial of Tai Chi

Advances in rehabilitation for chronic diseases: improving health outcomes and function

BEAM study (Breathing, Education, Awareness, Movement): a randomised controlled feasibility trial of tai chi exercise in patients with COPD

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