Reduce the Symptoms of Fibromyalgia with Tai Chi

Reduce the Symptoms of Fibromyalgia with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment. This mind-body approach may be considered a therapeutic option in the multi-disciplinary management of fibromyalgia.” – Wang et al.

 

Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers.

 

There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But, these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Mindfulness practices that are also exercises may be particularly effective. Indeed, yoga practice has been shown to improve the symptoms of fibromyalgia. This suggests that Tai Chi, another mindful exercise might be similarly effective.

 

In today’s Research News article “Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861462/ ), Wang and colleagues recruited patients with fibromyalgia and randomly assigned them to one of three groups; 60 minutes of Tai Chi once a week for 24 weeks, 60 minutes of Tai Chi twice a week for 12 weeks, or 60 minutes of light to moderate aerobic exercises twice a week for 24 weeks. Participants were encouraged to practice at home and continue the exercises after the end of formal sessions. Participants were measured before and at 12, 24, and 52 weeks into the intervention for overall severity of fibromyalgia, including intensity of pain, physical function, fatigue, morning tiredness, depression, anxiety, job difficulty, and overall wellbeing, anxiety, depression, self-efficacy, sleep quality, symptom severity, physical and mental health, coping strategies, social support, disability, and physical function, including muscle strength and power.

 

They found that at 24 and again at 52 weeks all groups showed significant improvement but the Tai Chi groups had significantly greater improvement than the aerobic exercise group in overall fibromyalgia severity, self-efficacy, anxiety, and coping strategies. Hence, participation in Tai Chi exercise produce significant improvement in the symptoms of fibromyalgia that were better than those produced by aerobic exercise.

 

These are remarkable findings that Tai Chi practice is better than aerobic exercise in treating the symptoms of fibromyalgia. Both helped, but Tai Chi helped more. Fibromyalgia patients suffer greatly and to bring relief with a simple, gentle, safe exercise is very important. Tai Chi is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Hence, Tai Chi practice would appear to be a wonderful effective treatment for the relief of the suffering of fibromyalgia patients.

 

So, reduce the symptoms of fibromyalgia with Tai Chi.

 

“The authors attributed the success of the program to the postures and low impact movements of Tai Chi, and to the “controlled breathing and movements leading to restful state and mental tranquility.” Pain thresholds were likely raised in the process, which helped break the cycle of movement pain.“ – Joanna Fernandes

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Wang, C., Schmid, C. H., Fielding, R. A., Harvey, W. F., Reid, K. F., Price, L. L., … McAlindon, T. (2018). Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial. The BMJ, 360, k851. http://doi.org/10.1136/bmj.k851

 

Abstract

Objectives

To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration.

Design

Prospective, randomized, 52 week, single blind comparative effectiveness trial.

Setting

Urban tertiary care academic hospital in the United States between March 2012 and September 2016.

Participants

226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group.

Interventions

Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone.

Main outcome measures

The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient’s global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life.

Results

FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient’s global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with the same intensity and duration (24 weeks, twice weekly) had greater benefit (between group difference in FIQR scores=16.2 points, 8.7 to 23.6, P<0.001). The groups who received tai chi for 24 weeks showed greater improvements than those who received it for 12 weeks (difference in FIQR scores=9.6 points, 2.6 to 16.6, P=0.007). There was no significant increase in benefit for groups who received tai chi twice weekly compared with once weekly. Participants attended the tai chi training sessions more often than participants attended aerobic exercise. The effects of tai chi were consistent across all instructors. No serious adverse events related to the interventions were reported.

Conclusion

Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment, for a variety of outcomes for patients with fibromyalgia. Longer duration of tai chi showed greater improvement. This mind-body approach may be considered a therapeutic option in the multidisciplinary management of fibromyalgia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861462/

 

Reduce Anxiety and Depression in Patients with Mental and Physical Illness with Mindfulness

Reduce Anxiety and Depression in Patients with Mental and Physical Illness with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When you become aware of the present moment, you gain access to resources you may not have had before. You may not be able to change a situation, but you can mindfully change your response to it. You can choose a more constructive and productive way of dealing with stress rather than a counterproductive or even destructive way of dealing with it.” – Mindful

 

There are vast numbers of people worldwide who suffer with mental or physical illnesses. These illnesses often include or are accompanied by anxiety and depression which exacerbate the suffering. Mindfulness practices have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. In addition, mindfulness practices have been found to relieve anxiety and depression. The mindfulness practices include mindfulness training, meditation, body scan, yoga, and a variety of mindful movement practices such as Tai Chi, Qigong, and Baduanjin. Baduanjin is a mind-body training that is very similar to Tai Chi and consists of 8 movements for limbs, body-trunk, and eye movements.

 

In today’s Research News article “Mindfulness-Based Baduanjin Exercise for Depression and Anxiety in People with Physical or Mental Illnesses: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858390/ ), Zou and colleagues review, summarize and perform a meta-analysis of the effectiveness of Baduanjin practice for the relief of the anxiety and depression that often accompany mental and physical illnesses. They discovered 26 published randomized controlled studies.

 

They found that the published studies showed large significant improvements in both anxiety and depression produced by Baduanjin practice; the amount of practice appeared to matter. The greater the number of hours of practice the lower the levels of anxiety and the greater the number of Baduanjin practice sessions the lower the levels of depression. Hence Baduanjin practice appears to significantly improve the psychological health of patients with mental and/or physical ailments in a dose response manner.

 

Baduanjin practice, like all mindful movement practices, is gentle and safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Baduanjin practice would appear to be an almost ideal, safe and effective treatment for the anxiety and depression that often accompany other mental and physical illness.

 

So, reduce anxiety and depression in patients with mental and physical illness with mindfulness.

 

“Mindfulness keeps us focused on the present, and helps us meet challenges head on while we appreciate all our senses absorb. On the contrary, focus on the future contributes to anxiety, while perseveration on the past feeds depression. Far too often when we look to the future, we ask ourselves, “What if,” and the answer we give ourselves is often a prediction of a negative result.” – Vincent Fitzgerald

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Zou, L., Yeung, A., Quan, X., Hui, S. S.-C., Hu, X., Chan, J. S. M., … Wang, H. (2018). Mindfulness-Based Baduanjin Exercise for Depression and Anxiety in People with Physical or Mental Illnesses: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 15(2), 321. http://doi.org/10.3390/ijerph15020321

 

Abstract

Objectives: we used a quantitative method to systematically synthesize the emerging literature and critically evaluate the effects of Baduanjin on depression and anxiety in people with physical or mental illnesses. Additionally, we determined if the number of total Baduanjin training sessions is associated with decreased anxiety and depression levels. Methods: both English and Chinese databases were searched for potential studies published between January 1982 and October 2017. The eligible randomized controlled trials were considered for meta-analysis. Effect size (Hedge’s g) was computed for the pooled effects while the random-effect model was set. For moderator analysis; Subgroup meta-analysis for categorical variables and meta-regression for continuous variables were performed. Results: the aggregated result has shown a significant benefit in favour of Baduanjin on anxiety (Hedge’s g = −0.99; CI −1.63 to −0.74) and depression (Hedge’s g = −1.07; CI −1.3 to −0.83). For continuous potential moderators; meta-regression indicated a significant effect for total hours in Baduanjin practice (β = −0.0053; 95% CI −0.009 to −0.0014; p = 0.008). With regard to depression; meta-regression indicated a significant effect for total sessions of Baduanjin practice (β = −0.0023; 95% CI −0.006 to −0.0004; p = 0.028). Conclusions: the encouraging findings indicate the efficacy of Baduanjin exercise in reducing depression and anxiety symptoms in people with physical or mental illnesses. However; the results should be interpreted with caution because of existing methodological limitations (e.g., high risk of bias; Baduanjin combined with other behavioral interventions; and heterogeneity of control groups).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858390/

 

Improve Adult Onset Diabetes with Qigong

Improve Adult Onset Diabetes with Qigong

 

By John M. de Castro, Ph.D.

 

“After 12 weeks, the qigong patients had lowered their fasting blood glucose and their levels of self-reported stress and improved their insulin resistance. The gentle exercise group also brought down blood glucose levels, though somewhat less…and lowered stress.” – BottomLine

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. Qigong and Tai Chi have been practiced for thousands of years with benefits for health and longevityQigong and Tai Chi trainings are designed to enhance function and regulate the activities of the body through controlled breathing, mindful concentration, and gentle movements. Only recently though have the effects of these practices been scrutinized with empirical research. This research has found that they are effective for an array of physical and psychological issues.

 

Diet and exercise are prescribed to treat Type 2 Diabetes. Qigong and Tai Chi are gentle exercises that are potentially useful in treating Type 2 Diabetes. In today’s Research News article “The Effects of Qigong on Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5817377/ ), Meng and colleagues review, summarize, and perform a meta-analysis of the 21 published research studies regarding the effectiveness of Qigong practice in the treatment of Type 2 Diabetes.

 

The summary of the research indicates that Qigong practice improves fasting glucose levels in Type 2 Diabetes patients when compared to a no-exercise condition, but the improvement is not significantly different than that produced by other exercise programs. Importantly, Qigong practice was found to improve Glycosylated Hemoglobin (HbA1c) and two-hour postprandial (after eating) blood glucose levels both in comparison to no-exercise and other exercise groups. Hence, the published research suggests that Qigong practice is superior to other exercises in improving the symptoms of Type 2 Diabetes.

 

These are encouraging findings. Qigong practice appears to be an almost ideal exercise for adult-onset diabetes (Type 2). It not only produces better results than other exercises but it is also not strenuous, involving slow gentle movements, is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice.

 

So, improve adult onset diabetes with Qigong.

 

“Many people, however, are unable to keep up with their regular exercise because they either don’t enjoy it, or have a problem finding time to exercise. Tai chi offers a major advantage: It’s enjoyable, and to many, it’s almost addictive. . . . You can practice Tai Chi almost anywhere. Stress stands in the way of controlling diabetes. Since tai chi encourages mental relaxation and reduces stress, it follows that Tai Chi can improve the control of diabetes.” – Paul Lam

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Meng, D., Chunyan, W., Xiaosheng, D., & Xiangren, Y. (2018). The Effects of Qigong on Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine : eCAM, 2018, 8182938. http://doi.org/10.1155/2018/8182938

 

Abstract

Objective

The purpose of this study was to investigate the effects of Qigong on type 2 diabetes mellitus (DM) using the systematic review and meta-analysis.

Methods

All prospective, randomized, controlled clinical trials published in English or Chinese and involving the use of Qigong by patients with DM were searched in 7 electronic databases from their respective inception to June 2016. The meta-analysis was conducted using the Revman 5.2. The quality of the included trials was assessed using the Jadad rating scale. Two researchers independently completed the inclusion, data extraction, and quality assessment.

Results

Twenty-one trials with 1326 patients met the inclusion criteria and were reviewed. The meta-analysis demonstrated that, compared with no exercise, the Qigong had significant effects on fasting blood glucose (MD = −0.99, 95% CI (−1.23, 0.75), P < 0.0001), HbA1c (MD = −0.84, 95% CI (−1.02, −0.65), P < 0.0001), and postprandial blood glucose (MD = −1.55, 95% CI (−2.19, −0.91), P < 0.00001).

Conclusion

The Qigong training can improve the blood glucose status of the type 2 DM patients and has positive effects on the management of type 2 DM. However, future research with better quality still needs to be conducted to address the effects of Qigong on type 2 DM.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5817377/

 

Increase Brain Matter and Memory in Aging with Tai Chi

 

Increase Brain Matter and Memory in Aging with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi can be used as exercise to improve the body, as well as reversing the natural tendency for the brain to shrink with age.” – Functional Aging Institute

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our mental abilities which decline with age including impairments in memory, attention, and problem solving ability. It is inevitable and cannot be avoided. Using modern neuroimaging techniques, scientists have been able to view the changes that occur in the nervous system with aging. In addition, they have been able to investigate various techniques that might slow the process of neurodegeneration that accompanies normal aging. They’ve found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners.

 

Hence, there is some hope for age related cognitive decline, as there is evidence that it can be slowed. There are some indications that physical and mental exercise can reduce the rate of cognitive decline and lower the chances of dementia. For example, contemplative practices such as meditationyoga, and Tai Chi and Qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging. Mindfulness practices have been shown to improve cognitive processes while gentle mindful exercises such as Tai Chi and Qigong have been shown to slow age related cognitive decline. It would seem reasonable to hypothesize that Tai Chi and Baduanjin practices might decrease age related decreases in cognitive ability and degeneration of the nervous system.

 

In today’s Research News article “Tai Chi Chuan and Baduanjin increase grey matter volume in older adults: a brain imaging study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5659386/ ), Tao and colleagues recruited healthy sedentary older adults (50-70 years of age) and randomly assigned them to receive either Tai Chi practice, Baduanjin practice (a very similar practice to Tai Chi), or no-treatment. Practice occurred for 12 weeks, 5 days per week, for 1 hour. Before and after training the participants underwent Magnetic Resonance Imaging (MRI) scans of their brains. They were also measured for memory ability.

 

They found that in comparison to baseline and control participants, the Tai Chi or Baduanjin practice participants had significant increases in the amount of grey matter in the left insula, left putamen, left parahippocampus/hippocampus, left amygdala, and left inferior temporal lobe. Hence, Tai Chi or Baduanjin practice appeared to produce increases in neural tissue. In addition, the Tai Chi or Baduanjin practice participants had significant increases in overall memory ability and visual reproduction memory. These improvements in memory were related to the increases in grey matter, with large increases in neural tissue associated with large improvements in memory. Hence, Tai Chi or Baduanjin practice not only increased neural tissue and memory, but the increases in both changed together in the same direction.

 

Caution must be taken in interpreting these results as the control condition was inactive. As a result, it cannot be determined if Tai Chi or Baduanjin practice per se or any form of exercise could produce comparable benefits. Further research is needed employing other forms of exercise to compare to the effects of Tai Chi or Baduanjin practice.

 

Nonetheless, these results are interesting and exciting. They suggest that Tai Chi or Baduanjin practice can reduce or possibly reverse brain degeneration and cognitive decline associated with aging. By engaging in these mindful movement practices aging individuals appear to preserve their brains and their mental ability. In addition, the fact that these practices are safe, convenient, low cost, and social suggests that they can be widely applied to the aging population.

 

So, increase brain matter and memory in aging with Tai Chi.

 

“Keep your brain younger longer by adding tai chi to your workout routine.” – Linda Melone

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Tao, J., Liu, J., Liu, W., Huang, J., Xue, X., Chen, X., … Kong, J. (2017). Tai Chi Chuan and Baduanjin increase grey matter volume in older adults: a brain imaging study. Journal of Alzheimer’s Disease : JAD, 60(2), 389–400. http://doi.org/10.3233/JAD-170477

 

Abstract

The aim of this study is to investigate and compare how 12-weeks of Tai Chi Chuan and Baduanjin exercise can modulate brain structure and memory function in older adults. Magnetic Resonance Imaging(MRI) and memory function measurements (Wechsler Memory Scale-Chinese revised, WMS-CR)were applied at both the beginning and end of the study. Results showed that both Tai Chi Chuan and Baduanjin could significantly increase grey matter volume (GMV) in the insula, medial temporal lobe (MTL), and putamen after 12-weeks of exercise. No significant differences were observed in grey matter volume (GMV) between the Tai Chi Chuan and Baduanjin groups. We also found that compared to healthy controls, Tai Chi Chuan and Baduanjin significantly improved visual reproduction subscores on the WMS-CR. Baduanjin also improved mental control, recognition, touch and comprehension memory subscores of the WMS-CR compared to the control group. Memory quotient (MQ)and visual reproduction subscores were both associated with GMV increases in the putamen and hippocampus. Our results demonstrate the potential of Tai Chi Chuan and Baduanjin exercise for the prevention of memory deficits in older adults.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5659386/

Improve Cardiovascular Function in Heart Failure Patients with Tai Chi

Improve Cardiovascular Function in Heart Failure Patients with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai chi has proven especially beneficial for people with heart failure, who tend to be tired and weak as a result of their heart’s diminished pumping ability. The upper- and lower-body movements safely strengthen the heart and major muscle groups.” – Harvard Health Letter

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” (Centers for Disease Control). A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Cardiac rehabilitation programs for patients recovering from a heart failure, emphasize these lifestyle changes. Unfortunately, for a variety of reasons, 60% of heart failure patients decline participation, making these patients at high risk for another attack.

 

Contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. In addition, mindfulness practices have also been shown to be helpful for producing the kinds of other lifestyle changes needed such as smoking cessationweight reduction and stress reduction.  Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice.

 

Since Tai Chi is both a mindfulness practice and an exercise, it may be an acceptable and effective treatment for heart failure patients. In today’s Research News article “The Effects of Tai Chi Training in Patients with Heart Failure: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770613/ ), Ren and colleagues review, summarize, and perform a meta-analysis of the 11 published research studies with a combined 636 patients, on the effectiveness of Tai Chi practice for the treatment of heart failure patients.

 

They report that the research findings support the conclusions that Tai Chi practice significantly increases the distance that the patients can walk in 6 minutes. It also significantly reduces heart rate and the levels of serum B-type natriuretic peptide; a marker of heart failure and significantly increases left ventricular ejection fraction; a marker of heart health. But, they also report that Tai Chi practice did not improve a number of other measures of cardiac function; including systolic and diastolic blood pressure, maximum oxygen uptake, and timed get up and go.

 

These results are encouraging and suggest that Tai Chi practice can improve many aspects of cardiac function in patients with heart failure. But, its’ usefulness must be tempered with the understanding that not all measure of heart health are improved. This suggests that that Tai Chi practice should be used in combination with other therapies to improve the symptoms of heart failure. The fact that it’s gentle and safe, convenient, inexpensive and social make it an ideal exercise to be employed as a step toward more intense exercises for heart health. It should be helpful in helping the 60% of heart failure patients who refuse exercise programs to slowly improve and transition into more intense exercise.

 

So, improve cardiovascular function in heart failure patients with Tai Chi.

 

“for people who don’t do cardiac rehab, tai chi may be a way to entice them to start exercising in a gentle, less intimidating way. It may also act as a gateway to other types of more traditional and intensive exercise that have been shown to improve fitness and potentially lower risk of having further heart attacks.” – Alice Park

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Xiaomeng Ren, Yanda Li, Xinyu Yang, Jie Li, Huilong Li, Zhengzhong Yuan, Yikun Sun, Hongcai Shang, Yanwei Xing, Yonghong Gao. The Effects of Tai Chi Training in Patients with Heart Failure: A Systematic Review and Meta-Analysis. Front Physiol. 2017; 8: 989. Published online 2017 Dec 7. doi: 10.3389/fphys.2017.00989

 

Abstract

Heart Failure (HF) is associated with significantly high morbidity and mortality. We performed a meta-analysis and updated new evidences from randomized controlled trials (RCTs) to determine the effects of Tai Chi (TC) in patients with HF. Electronic literature search of Medline, PubMed, EMBASE, the Cochrane Library, China national knowledge infrastructure (CNKI), and Wan Fang Database was conducted from inception of their establishment until 2017. And we also searched Clinical Trials Registries (https://clinicaltrials.gov/ and www.controlled-trials.com) for on-going studies. A total of 11 trials with 656 patients were available for analysis. The results suggested that TC was associated with an obviously improved 6-min walk distance [6MWD, weighted mean difference (WMD) 65.29 m; 95% CI 32.55–98.04] and quality of life (Qol, WMD −11.52 points; 95% CI −16.5 to −6.98) and left ventricular ejection fraction (LVEF, WMD 9.94%; 95% CI 6.95 to 12.93). TC was shown to reduce serum B-type natriuretic peptide [BNP, standard mean difference (SMD) −1.08 pg/mL; 95% CI −1.91 to −0.26] and heart rate (HR, WMD −2.52 bpm; 95% CI −3.49 to −1.55). In summary, our meta-analysis demonstrated the clinical evidence about TC for HF is inconclusive. TC could improve 6MWD, Qol and LVEF in patients with HF and may reduce BNP and HR. However, there is a lack of evidence to support TC altering other important long-term clinical outcomes so far. Further larger and more sustainable RCTs are urgently needed to investigate the effects of TC.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770613/

Improve Arthritis with Qigong

Improve Arthritis with Qigong

 

By John M. de Castro, Ph.D.

 

“Qigong techniques are simple and do not need to be carried out precisely to bring about its great benefits. Qigong practice is known for preventing disease, strengthening immunity and producing better health and well-being. However it is under-appreciated, even in China, that Qigong therapy can be effective for relieving pain and treating arthritis.” – Kellen Chia

 

Arthritis is a chronic disease that most commonly affects the joints. There are over 100 different types of arthritis. Depending on the type of arthritis symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. It is associated with aging as arthritis occurs in only 7% of adults ages 18–44, while 30% adults ages 45–64 are affected, and 50% of adults ages 65 or older. The pain, stiffness, and lack of mobility associate with arthritis produce fatigue and markedly reduce the quality of life of the sufferers. Arthritis can have very negative psychological effects diminishing the individual’s self-image and may lead to depression, isolation, and withdrawal from friends and social activities Arthritis reduces the individual’s ability to function at work and may require modifications of work activities which can lead to financial difficulties. It even affects the individual’s physical appearance. In addition, due to complications associated with rheumatoid arthritis, particularly cardiovascular disease, the lifespan for people with rheumatoid arthritis may be shortened by 10 years.

 

It is obvious that there is a need for a safe and effective treatment to help rheumatoid arthritis sufferers cope with the disease and its consequences. Increasing exercise has been shown to increase flexibility and mobility but many form of exercise are difficult for the arthritis sufferer to engage in and many drop out. But all that may be needed is gentle movements of the joints. Qigong or Tai Chi training are designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. They have been shown to have many physical and psychological benefits, especially for the elderly. Because They are not strenuous, involving slow gentle movements, and are safe, having no appreciable side effects, they are appropriate for an elderly population. So, it would seem that Qigong or Tai Chi practice would be well suited to treat arthritis in seniors.

 

In today’s Research News article “Qigong Exercise and Arthritis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750595/ ), Marks reviewed and summarized the published research on the effectiveness of Qigong practice for the treatment of arthritis. He found that Qigong practice produced significant improvements in the musculoskeletal system including increased strength, joint flexibility, posture, balance motor function, and motor coordination, and improvements in quality of life and cognitive function. In addition, the research reported decreased pain, fatigue, and blood pressure and improved immune function, metabolic function, circulation, aerobic capacity, and reduced falls, improved psychological health, mood, and sleep.

 

These are impressive results. Scientific research suggests that Qigong practice produces  widespread improvements in mental and physical health in arthritis sufferers. In addition, it is inexpensive, convenient, appropriate for individuals of all ages and health condition and is safe to practice, making it an almost ideal treatment for the symptoms of arthritis.

 

So, improve arthritis with Qigong.

 

“Qigong focuses on relaxing the body, which over time, allows the joints and muscles to loosen up, improving the circulation of fluids and blood. The practice focuses on rebuilding overall health and strengthening the spirit, while encouraging one to change the way one looks at life in general, and at the illness affecting you.” – 1MD

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ray Marks. Qigong Exercise and Arthritis. Medicines (Basel) 2017 Dec; 4(4): 71. Published online 2017 Sep 27. doi: 10.3390/medicines4040071

 

Abstract

Background: Arthritis is a chronic condition resulting in considerable disability, particularly in later life. Aims: The first aim of this review was to summarize and synthesize the research base concerning the use of Qigong exercises as a possible adjunctive strategy for promoting well-being among adults with arthritis. A second was to provide related intervention directives for health professionals working or who are likely to work with this population in the future. Methods: Material specifically focusing on examining the nature of Qigong for minimizing arthritis disability, pain and dependence and for improving life quality was sought. Results: Collectively, despite almost no attention to this topic, available data reveal that while more research is indicated, Qigong exercises—practiced widely in China for many centuries as an exercise form, mind-body and relaxation technique—may be very useful as an intervention strategy for adults with different forms of painful disabling arthritis. Conclusion: Health professionals working with people who have chronic arthritis can safely recommend these exercises to most adults with this condition with the expectation they will heighten the life quality of the individual, while reducing pain and depression in adults with this condition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750595/

Improve Cognition in the Elderly with Tai Chi

Improve Cognition in the Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi has consistent, small effects on improving cognitive performance in both healthy older adults and older adults with some cognitive impairment.” – PM Wayne

 

The aging process involves a systematic progressive decline of the body and the brain. Every system in the body deteriorates including cognitive function (thinking ability) and motor function with a decline in strength, flexibility, and balance. It is inevitable. In addition, many elderly experience withdrawal and isolation from social interactions. There is some hope as there is evidence that these declines can be slowed. For example, a healthy diet and a regular program of exercise can slow the physical and cognitive decline of the body with aging. Also, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline.

 

Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Only recently though have the effects of Tai Chi practice been scrutinized with empirical research. But, it has been found to be effective for an array of physical and psychological issues. Tai Chi has been shown to help the elderly improve attentionbalance, reducing fallsarthritiscognitive functionmemory, and reduce age related deterioration of the brain. Because Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion.

 

In today’s Research News article “Effects of tai chi on cognition and instrumental activities of daily living in community dwelling older people with mild cognitive impairment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797349/ ), Siu and Lee examine the effectiveness of Tai Chi practice for elderly individuals with mild cognitive impairment. They recruited elderly individuals (> 60 years of age) with mild cognitive impairment from 4 community centers for the elderly. Participants from two community centers were randomly assigned to a no-treatment control condition or to receive 16 weeks of Tai Chi training for 1-hour twice a week. They were measured before and after training for cognitive ability and daily living activities; including using telephone, shopping, preparing food, doing house-keeping and laundry, using transportation, managing finances, handling medication, and doing handyman work.

 

They found that the Tai Chi practice group compared to baseline and the control group had significant improvements in cognitive ability and in the performance of daily activities. These are important findings. With an aging population, the maintenance of ability to perform daily activities may reduce the burden and cost of caregivering. In addition, the improvements in cognitive function may reduce the incidence of dementia and allow for better quality of life in the elderly. Importantly, these benefits can be produced with a convenient, inexpensive, safe, and fun social activity.

 

So, improve cognition in the Elderly with Tai Chi.

 

“A comparison of the effects of regular sessions of tai chi, walking, and social discussion, has found tai chi was associated with the biggest gains in brain volume and improved cognition.” – Fiona MsPherson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Mei-yi Siu, Diana T. F. Lee. Effects of tai chi on cognition and instrumental activities of daily living in community dwelling older people with mild cognitive impairment. BMC Geriatr. 2018; 18: 37. Published online 2018 Feb 2. doi: 10.1186/s12877-018-0720-8

 

Abstract

Background

Cognitive impairment places older adults at high risk of functional disability in their daily-life activities, and thus affecting their quality of life. This study aimed to examine the effects of Tai Chi on general cognitive functions and instrumental activities of daily living (IADL) in community-dwelling older people with mild cognitive impairment (MCI) in Hong Kong.

Methods

The study adopted a multi-site nonequivalent control-group pretest-posttest design. 160 community-dwelling older people, aged ≥60, with MCI, from four community elderly centers participated in the study. The intervention group (IG, n = 80) received training in the Yang-style simple form of Tai Chi, at a frequency of two lessons per week for 16 weeks. Each lesson lasted for one hour. The control group (CG, n = 80) had no treatment regime and joined different recreational activity groups in community centers as usual within the study period. Outcome measures included measures of global cognitive status and IADL. The Chinese version of the Mini-Mental State Examination (CMMSE) was used for global cognitive assessment. The Hong Kong Chinese version of Lawton’s Instrumental Activities of Daily Living (IADL-CV) was used to assess the participants’ IADL levels. General Estimating Equations (GEE) was used to examine each of the outcome variables for the two groups at the two study time points (the baseline and at the end of the study). Meanwhile, minimum detectable change (MDC) was calculated to estimate the magnitude of changes required to eradicate the possibility of measurement error of outcome measures.

Results

Seventy four participants in the IG and 71 participants in the CG completed the study. With adjustments for differences in age, education, marital status and living conditions, the findings revealed that the participants in the IG scored significantly better on the CMMSE test (P = 0.001), and the instrumental ADL questionnaire (P = 0.004). However, those scores changes did not exceed the limits of the respective MDCs in the study, the possibility of measurement variation due to error could not be excluded.

Conclusion

Tai Chi may be an effective strategy to enhance cognitive health and maintain functional abilities in instrumental ADL in older people with MCI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797349/

Slow Mental Decline in the Elderly with Tai Chi

Slow Mental Decline in the Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“improvement of heart function combined with increased muscular power meant that the martial art should be considered the preferred technique for elderly people to maintain good health.” – The Telegraph

 

We celebrate the increasing longevity of the population. But, aging is a mixed blessing. The aging process involves a systematic progressive decline of the body and the brain. Every system in the body deteriorates including cognitive function (thinking ability) and motor function with a decline in strength, flexibility, and balance. It is inevitable. In addition, many elderly experience withdrawal and isolation from social interactions. There is some hope as there is evidence that these declines can be slowed. For example, a healthy diet and a regular program of exercise can slow the physical and cognitive decline of the body with aging. Also, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline.

 

Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Only recently though have the effects of Tai Chi practice been scrutinized with empirical research and found to be effective for an array of physical and psychological issues. Tai Chi has been shown to help the elderly improve attentionbalance, reducing fallsarthritiscognitive functionmemory, and reduce age related deterioration of the brain. Because Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion.

 

In today’s Research News article “Tai Chi Improves Cognition and Plasma BDNF in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial.”  Sungkarat and colleagues recruited elderly participants with mild cognitive impairments and randomly assigned them to either receive educational instruction related to cognitive impairment and fall prevention or practice Tai Chi at home guided by a 50-minute video, 3 times per week, for 6 months. They were measured at the beginning and end of training for cognitive performance, including memory, visuospatial ability, and executive function, and plasma markers for inflammation and neuroprotection, including plasma BDNF, TNF-α, and IL-10 levels.

 

They found that compared to baseline and control participants, the elderly who practiced Tai Chi had significantly improved levels of cognitive function, including improvements in memory and thinking ability (executive function). In addition, Tai Chi practice was found to significantly increase the levels of brain-derived neurotrophic factor (BDNF). BDNF is a neurotrophic factor that works to protect the brain from deterioration and promote the growth of brain cells. Hence, they found that Tai Chi practice reduces cognitive decline with aging and increases neuroprotection.

 

The cognitive decline with aging has been associated with degeneration of neural tissues. On the other hand, mindfulness practices have been found to change the brain and protect it against age related decline. The present results add further evidence that mindfulness practices, Tai Chi  in particular, improves memory and cognitive performance and promotes neuroprotection in the elderly. The attractiveness of the low intensity, low cost, convenient, and socially fun nature of Tai Chi practice makes it a great treatment for the prevention of age related decline.

 

So, slow mental decline in the elderly with Tai Chi.

 

“Scientists . . . found increases in brain volume and improvements on tests of memory and thinking in Chinese seniors who practiced Tai Chi three times a week.” – Science Daily

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Somporn Sungkarat, PhD, SirinunBoripuntakul, PhD, Sirinart Kumfu, PhD, Stephen R. Lord, PhD, Nipon Chattipakorn, MD, PhD. Tai Chi Improves Cognition and Plasma BDNF in Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial. Neurorehabilitation and Neural Repair. First Published January 20, 2018, https://doi-org.ezproxy.shsu.edu/10.1177/15459683177536

 

Abstract

Background. Effects of Tai Chi (TC) on specific cognitive function and mechanisms by which TC may improve cognition in older adults with amnestic mild cognitive impairment (a-MCI) remain unknown. Objective. To examine the effects of TC on cognitive functions and plasma biomarkers (brain-derived neurotrophic factor [BDNF], tumor necrosis factor-α [TNF-α], and interleukin-10 [IL-10]) in a-MCI. Methods. A total of 66 older adults with a-MCI (mean age = 67.9 years) were randomized to either a TC (n = 33) or a control group (n = 33). Participants in the TC group learned TC with a certified instructor and then practiced at home for 50 min/session, 3 times/wk for 6 months. The control group received educational material that covered information related to cognition. The primary outcome was cognitive performance, including Logical Memory (LM) delayed recall, Block Design, Digit Span, and Trail Making Test B minus A (TMT B-A). The secondary outcomes were plasma biomarkers, including BDNF, TNF-α, and IL-10. Results. At the end of the trial, performance on the LM and TMT B-A was significantly better in the TC group compared with the control group after adjusting for age, gender, and education (P < .05). Plasma BDNF level was significantly increased for the TC group, whereas the other outcome measures were similar between the 2 groups after adjusting for age and gender (P < .05). Conclusions. TC training significantly improved memory and the mental switching component of executive function in older adults with a-MCI, possibly via an upregulation of BDNF.

http://journals.sagepub.com.ezproxy.shsu.edu/doi/full/10.1177/1545968317753682

Improve Cardiorespiratory Fitness with Tai Chi

Improve Cardiorespiratory Fitness with Tai Chi

By John M. de Castro, Ph.D.

 

“practicing Tai Chi Chuan regularly may delay the decline of cardiorespiratory function in older individuals. In addition, TCC may be prescribed as a suitable aerobic exercise for older adults.” – J.S. Lai

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” (Centers for Disease Control). A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Cardiac rehabilitation programs for patients recovering from a heart attack, emphasize these lifestyle changes. Unfortunately, for a variety of reasons, 60% of cardiac patients decline participation, making these patients at high risk for another attack.

 

Contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. In addition, mindfulness practices have also been shown to be helpful for producing the kinds of other lifestyle changes needed such as smoking cessationweight reduction and stress reduction.  Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Since Tai Chi is both a mindfulness practice and an exercise, it may be an acceptable and effective treatment for cardiac patients.

 

In today’s Research News article “The Effect of Tai Chi on Cardiorespiratory Fitness for Coronary Disease Rehabilitation: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758591/ ), Yang and colleagues review, summarize and perform a meta-analysis of 5 published studies involving the application of Tai Chi practice for cardiac patients. Two studies were randomized controlled trials while 2 did not have a comparison (control) condition.

 

They report that the published studies found that Tai Chi practice produced significant improvement in the oxygen carrying capacity of the blood (VO2max) and was superior to light or moderate exercise but not different from intense exercise. Tai Chi practice also produced a significant improvement in peak heart rate in comparison to baseline and no exercise, but was inferior to intense exercise in this regard. Hence, there is evidence that Tai Chi practice can be of benefit to cardiac patients improving cardiorespiratory function.

 

The studies reviewed tended to have small samples or had week or nonexistent control conditions. So, conclusions must be tempered. The present summary, however, suggest that larger randomized controlled trials are justified. Tai Chi was not found to be as beneficial as intense exercise. But, intense exercise may be dangerous for cardiac patients. The attractiveness of the low intensity, low cost, convenient, and socially fun nature of Tai Chi practice makes it a good choice for cardiac patients.

 

So, improve cardiorespiratory fitness with Tai Chi.

 

“The slow and gentle movements of Tai Chi hold promise as an alternative exercise option for patients who decline traditional cardiac rehabilitation.” – Science Daily

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Yang YL, Wang YH, Wang SR, Shi PS, Wang C. The Effect of Tai Chi on Cardiorespiratory Fitness for Coronary Disease Rehabilitation: A Systematic Review and Meta-Analysis. Front Physiol. 2018 Jan 4;8:1091. doi: 10.3389/fphys.2017.01091. eCollection 2017.

 

Abstract

Background: Tai Chi that originated in China as a martial art is an aerobic exercise with low-to-moderate intensity and may play a role in cardiac rehabilitation. Aim: To systematically review the effect of Tai Chi on cardiorespiratory fitness for coronary disease rehabilitation. Methods: We performed a search for Chinese and English studies in the following databases: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database. The search strategy included terms relating to or describing Tai Chi and coronary disease, and there were no exclusion criteria for other types of diseases or disorders. Further, bibliographies of the related published systematic reviews were also reviewed. The searches, data extraction, and risk of bias (ROB) assessments were conducted by two independent investigators. Differences were resolved by consensus. RevMan 5.3.0 was used to analyze the study results. We used quantitative synthesis if the included studies were sufficiently homogeneous and performed subgroup analyses for studies with different control groups. To minimize bias in our findings, we used GRADEpro to grade the available evidence. Results: Five studies were enrolled-two randomized controlled trials (RCTs) and three nonrandomized controlled trials (N-RCTs)-that included 291 patients. All patients had coronary disease. ROB assessments showed a relatively high selection and detection bias. Meta-analyses showed that compared to other types of low- or moderate-intensity exercise, Tai Chi could significantly improve VO2max [MD = 4.71, 95% CI (3.58, 5.84), P < 0.00001], but it seemed less effective at improving VO2max as compared to high-intensity exercise. This difference, however, was not statistically significant [MD = -1.10, 95% CI (-2.46, 0.26), P = 0.11]. The GRADEpro showed a low level of the available evidence. Conclusion: Compared to no exercise or other types of exercise with low-to-moderate intensity, Tai Chi seems a good choice for coronary disease rehabilitation in improving cardiorespiratory fitness. However, owing to the poor methodology quality, more clinical trials with large sample size, strict randomization, and clear description about detection and reporting processes are needed to further verify the evidence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758591/

Improve Activity and Quality of Life in High Risk Cardiac Patients with Tai Chi

Improve Activity and Quality of Life in High Risk Cardiac Patients with Tai Chi

 

By John M. de Castro, Ph.D.

 

“We thought that Tai Chi might be a good option for these people because you can start very slowly and simply and, as their confidence increases, the pace and movements can be modified to increase intensity.” – Elena Salmoirago-Blotcher

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” (Centers for Disease Control). A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Cardiac rehabilitation programs for patients recovering from a heart attack, emphasize these lifestyle changes. Unfortunately, for a variety of reasons, 60% of cardiac patients decline participation, making these patients at high risk for another attack.

 

Contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. In addition, mindfulness practices have also been shown to be helpful for producing the kinds of other lifestyle changes needed such as smoking cessation, weight reduction and stress reductionTai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Since Tai Chi is both a mindfulness practice and an exercise, it may be an acceptable and effective treatment for the 60% of cardiac patients who refuse participation in more traditional cardiac rehabilitation programs.

 

In today’s Research News article “Tai Chi Is a Promising Exercise Option for Patients with Coronary Heart Disease Declining Cardiac Rehabilitation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721863/ ), Salmoirago‐Blotcher and colleagues recruited cardiac patients who were physically inactive and offered them participation in group Tai Chi practices for 30 minutes per session. The participants were randomly assigned to one of two levels of practice, Lite and Plus. In the Lite condition practice occurred 2 times per week for 12 weeks. In the Plus condition practice occurred 3 times per week for 12 weeks followed by 4 weeks of twice a week practices and 8 weeks of once a week practice. Patients were measured before treatment and at 3, 6, and 9 months later. They were measured for acceptability and participation rates in the clinic and at home. They were also measured for physical activity and aerobic fitness with stress test, body size, anxiety, and depression.

 

Retention rates in the program were excellent with 90% of the Lite group and 84% of the Plus group still participating at the 9-month follow-up. There were no cardiac related adverse events during the study and most participants indicated that the program was acceptable and enjoyable. The Plus condition resulted in significant increases in the patients’ levels of physical activity and self-reported quality of life and decreases in body weight, but not improvement in aerobic fitness. Hence, the 6-month Plus Tai Chi program was safe and acceptable and produced measurable improvements in the patients activity levels and quality of life.

 

The high acceptability and retention rates are particularly important as these patients had declined participation in more traditional cardiac rehabilitation programs. They stated that they feared that the traditional programs would be too stressful and potentially harmful. But, Tai Ch practice was perceived as acceptable and not dangerous. Hence, the program was successful in getting these reluctant patients more physically active. The hope is that this would overcome their reluctance to engage in more strenuous programs and eventually lead to participation and improvement in aerobic fitness levels. This would be a breakthrough in the treatment of these very high-risk patients.

 

So, improve activity and quality of life in high risk cardiac patients with Tai Chi.

 

Tai chi may be a useful form of exercise for cardiac rehab programs, as it’s safe for high-risk patients. Findings also suggest that tai chi alone may be beneficial for patients who are unwilling to participate in a rehab program.” – CardioSmart

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Elena Salmoirago‐Blotcher, Peter M. Wayne, Shira Dunsiger, Julie Krol, Christopher Breault, Beth C. Bock, Wen‐Chih Wu, Gloria Y. Yeh, Tai Chi Is a Promising Exercise Option for Patients With Coronary Heart Disease Declining Cardiac Rehabilitation. J Am Heart Assoc. 2017 Oct; 6(10): e006603. Published online 2017 Oct 11. doi: 10.1161/JAHA.117.006603

 

Clinical Perspective

What Is New?

Compared with a shorter intervention, a 6‐month tai chi exercise intervention was safe, feasible, and enjoyable and increased moderate‐to‐vigorous physical activity among deconditioned patients with coronary heart disease who had declined enrollment in cardiac rehabilitation.

Other benefits included weight loss and improvements in quality of life.

This is the first study showing that tai chi may improve exercise behaviors in this high‐risk population.

What Are the Clinical Implications?

Tai chi is a promising and safe exercise alternative for patients with coronary heart disease who are unable or unwilling to attend traditional cardiac rehabilitation.

If proved effective in larger studies, tai chi could be offered as an alternative exercise option within existing cardiac rehabilitation programs or within the context of community‐based rehabilitation programs.

Abstract

Background

More than 60% of patients decline participation in cardiac rehabilitation after a myocardial infarction. Options to improve physical activity (PA) and other risk factors in these high‐risk individuals are limited. We conducted a phase 2 randomized controlled trial to determine feasibility, safety, acceptability, and estimates of effect of tai chi on PA, fitness, weight, and quality of life.

Methods and Results

Patients with coronary heart disease declining cardiac rehabilitation enrollment were randomized to a “LITE” (2 sessions/week for 12 weeks) or to a “PLUS” (3 sessions/week for 12 weeks, then maintenance classes for 12 additional weeks) condition. PA (accelerometry), weight, and quality of life (Health Survey Short Form) were measured at baseline and 3, 6, and 9 months after baseline; aerobic fitness (stress test) was measured at 3 months. Twenty‐nine participants (13 PLUS and 16 LITE) were enrolled. Retention at 9 months was 90% (LITE) and 88% (PLUS). No serious tai chi–related adverse events occurred. Significant mean between group differences in favor of the PLUS group were observed at 3 and 6 months for moderate‐to‐vigorous PA (100.33 min/week [95% confidence interval, 15.70–184.95 min/week] and 111.62 min/week; [95% confidence interval, 26.17–197.07 min/week], respectively, with a trend toward significance at 9 months), percentage change in weight, and quality of life. No changes in aerobic fitness were observed within and between groups.

Conclusions

In this community sample of patients with coronary heart disease declining enrollment in cardiac rehabilitation, a 6‐month tai chi program was safe and improved PA, weight, and quality of life compared with a 3‐month intervention. Tai chi could be an effective option to improve PA in this high‐risk population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721863/