Improve Cardiorespiratory Fitness in Coronary Disease Rehabilitation with Tai Chi

Improve Cardiorespiratory Fitness in Coronary Disease Rehabilitation with Tai Chi

 

By John M. de Castro, Ph.D.

 

“practicing tai chi may help to modestly lower blood pressure. It’s also proved helpful for people with heart failure, who tend to be tired and weak as a result of the heart’s diminished pumping ability. The slow movements involve both the upper and lower body, which safely strengthens the heart and major muscle groups without undue strain.” – Harvard Heart 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. Since Tai Chi is both a mindfulness practice and a gentle exercise, it may be an acceptable and effective treatment for coronary disease 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 research articles on the use of Tai Chi for the treatment of patients with coronary disease.

 

They found that in comparison to other gentle aerobic exercise practice Tai Chi produced significantly greater improvement in cardiorespiratory fitness, or aerobic capacity, which is reflected by VO2max, measured with a stress test. But, the effect was not as great as that produced by vigorous aerobic exercise. No adverse events were reported. Hence, Tai Chi practice was found to be safe and effective in improving cardiorespiratory fitness in patients with coronary disease.

 

Tai Chi practice was not as effective as vigorous aerobic exercise. But it is difficult to get patients with coronary disease to engage in and sustain vigorous exercise. It scares them and produces considerable discomfort. Tai Chi practice, on the other hand, is 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, 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, Tai Chi practice may be an ideal treatment for patients with coronary disease, not only one that is effective but also one that they will engage in and sustain.

 

So, improve cardiorespiratory fitness in coronary disease rehabilitation with Tai Chi.

 

“Both fear of exercise and the perception of cardiac rehabilitation as dangerous were the most commonly reported reasons for declining participation in cardiac rehabilitation. Tai chi can clearly overcome these barriers because it is a different form of exercise. During training, participants are constantly reminded they do not need to strive or struggle to achieve predetermined goals in terms of heart rate or exercise intensity. Instead, they are invited to focus their attention on the breath and/or on the movements of the body. As a result, participants do not see tai chi exercise as threatening, and this may result in improvements in exercise self-efficacy,” – Elena Salmoirago-Blotcher

 

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, Y., Wang, Y., Wang, S., Shi, P., & Wang, C. (2017). The Effect of Tai Chi on Cardiorespiratory Fitness for Coronary Disease Rehabilitation: A Systematic Review and Meta-Analysis. Frontiers in Physiology, 8, 1091. http://doi.org/10.3389/fphys.2017.01091

 

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 the Symptoms of COPD with Mindful Movement Practices

Improve the Symptoms of COPD with Mindful Movement Practices

 

By John M. de Castro, Ph.D.

 

“a low-cost exercise intervention is equivalent to formal pulmonary rehabilitation, and this may enable a greater number of patients to be treated. Physical activity is key to reducing symptoms in COPD. We do recommend [pulmonary rehabilitation], but our study shows that tai chi is a viable alternative when there is no local [pulmonary rehabilitation] service.” – Yuan-Ming Luo

 

Chronic obstructive pulmonary diseases (COPD) are progressive lung diseases that obstruct airflow. The two main types of COPD are chronic bronchitis and emphysema. COPD is very serious being the third leading cause of death in the United States, over 140,000 deaths per year and the number of people dying from COPD is growing. More than 11 million people have been diagnosed with COPD, but an estimated 24 million may have the disease without even knowing it. COPD causes serious long-term disability and early death. Symptoms develop slowly. Over time, COPD can interfere with the performance of routine tasks and is thus a major cause of disability in the United States. The most common cause of COPD is smoking. But, COPD also occurs with miners and is called black lung disease. COPD is not contagious. Most of the time, treatment can ease symptoms and slow progression.

 

There is no cure for COPD. Treatments include lifestyle changes, medicine, bronchodilators, steroids, pulmonary rehabilitation, oxygen therapy, and surgery. They all attempt to relieve symptoms, slow the progress of the disease, improve exercise tolerance, prevent and treat complications, and improve overall health. Gentle exercise such as Yoga practice could improve COPD symptoms as it has been shown to improve exercise tolerance and overall health and includes breathing exercises. Indeed, it has been shown that yoga practice improves the mental and physical health of patients with COPD. Mindful Movement practices such Tai Chi and qigong are ancient Chinese practices involving mindfulness and gentle movements. They are easy to learn, safe, and gentle. So, it may be appropriate for patients with COPD who lack the ability to engage in strenuous exercises to engage in these gentle practices.

 

In today’s Research News article “Effectiveness of meditative movement on COPD: 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/PMC5909800/ ), Wu and colleagues review and summarize the published literature on the use of yoga practice or Tai Chi and qigong (meditative movements) for the treatment of Chronic obstructive pulmonary diseases (COPD). They discovered 16 studies of which 7 evaluated yoga, 4 tai chi, 3 qigong, and 2 tai chi and qigong combined. The studies involved 1176 total COPD patients.

 

They found that the studies reported that COPD patients who engaged in meditative movements were able to walk further in 6 minutes than controls even when the control condition was walking exercise. Further meditative movement was reported to significantly improve lung function and quality of life with COPD and reduce fatigue. Hence the published literature supports the use of meditative movements, yoga, Tai Chi and Qigong, for the treatment of the symptoms of Chronic obstructive pulmonary diseases (COPD).

 

These findings are particularly important as mindful movement practices, are gentle and safe, having no appreciable side effects, they appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion, are inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, they can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, the mindful movement practices of yoga, Tai Chi and Qigong would appear to be almost ideal, safe and effective treatments for the symptoms of Chronic obstructive pulmonary diseases (COPD).

 

So, improve the symptoms of COPD with mindful movement practices.

 

“Finding a way to relieve stress when dealing with COPD is key to sustaining good health.  Tai Chi is an easy, graceful exercise that is highly effective for reducing stress levels.” – Lung Institute

 

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

 

Wu, L.-L., Lin, Z.-K., Weng, H.-D., Qi, Q.-F., Lu, J., & Liu, K.-X. (2018). Effectiveness of meditative movement on COPD: a systematic review and meta-analysis. International Journal of Chronic Obstructive Pulmonary Disease, 13, 1239–1250. http://doi.org/10.2147/COPD.S159042

 

Abstract

Background

The effectiveness of meditative movement (tai chi, yoga, and qigong) on COPD remained unclear. We undertook a systematic review and meta-analysis to determine the effectiveness of meditative movement on COPD patients.

Methods

We searched PubMed, Web of Science, EMBASE, and the Cochrane Center Register of Controlled Trials for relevant studies. The methods of standard meta-analysis were utilized for identifying relevant researches (until August 2017), quality appraisal, and synthesis. The primary outcomes were the 6-minute walking distance (6MWD), lung function, and dyspnea levels.

Results

Sixteen studies involving 1,176 COPD patients were included. When comparing with the control group, the 6MWD was significantly enhanced in the treatment group (3 months: mean difference [MD]=25.40 m, 95% CI: 16.25 to 34.54; 6 months: MD=35.75 m, 95% CI: 22.23 to 49.27), as well as functions on forced expiratory volume in 1 s (FEV1) (3 months: MD=0.1L, 95% CI: 0.02 to 0.18; 6 months: MD=0.18L, 95% CI: 0.1 to 0.26), and FEV1 % predicted (3 months: 4L, 95% CI: 2.7 to 5.31; 6 months: MD=4.8L, 95% CI: 2.56 to 7.07). Quality of life for the group doing meditative movement was better than the control group based on the Chronic Respiratory Disease Questionnaire dyspnea score (MD=0.9 units, 95% CI: 0.51 to 1.29) and fatigue score (MD=0.75 units, 95% CI: 0.42 to 1.09) and the total score (MD=1.92 units, 95% CI: 0.54 to 3.31).

Conclusion

Meditative movement may have the potential to enhance lung function and physical activity in COPD patients. More large-scale, well-designed, multicenter, randomized controlled trials should be launched to evaluate the long-range effects of meditative movement.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5909800/

 

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 Cardiopulmonary and Metabolic Condition and Body Weight with Yoga

Improve Cardiopulmonary and Metabolic Condition and Body Weight with Yoga

 

By John M. de Castro, Ph.D.

 

“Every time you practice yoga, you have the chance to reclaim part of yourself that you don’t always have easy access to. It might be physical, mental, or emotional, but the process of integration is quickened by yoga practice.” – Dinabandhu Sarley

 

Yoga practice has been shown to have a large number of beneficial effects on the psychological, emotional, and physical health of the individual and is helpful in the treatment of mental and physical illness, including cardiovascular disease and metabolic problems. This is important as cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. In addition, Metabolic Syndrome is a major risk factor for cardiovascular disease and diabetes. It generally results from overweight and abdominal obesity and includes high blood pressure, insulin resistance and elevation of plasma cholesterol and triglycerides. It is an important risk factor as it increases the risk of developing type-2 diabetes five-fold and heart attack or stroke three-fold.

 

A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. But the safest effective treatments are lifestyle changes. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Other safe and effective treatments are contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to be helpful for producing the kinds of lifestyle changes needed to prevent heart disease such as smoking cessationweight reduction, and stress reduction. Metabolic Syndrome can also be prevented or reverse the risk with exercise and weight loss.

 

Since, yoga is a mindfulness practice and an exercise it would seem to be ideally suited for the prevention of cardiovascular, pulmonary, or metabolic problems. In today’s Research News article “Cardiopulmonary and metabolic effects of yoga in healthy volunteers.” See summary below or view the full text of the study at: http://www.ijoy.org.in/article.asp?issn=0973-6131;year=2017;volume=10;issue=3;spage=115;epage=120;aulast=Divya, Divya and colleagues examine the effectiveness of yoga practice in improving cardiovascular and metabolic health in healthy adults. They recruited participants in a 41-day yoga training occurring 75 min/day, 6 days/week. Practice included meditation, breathing practice, mudras, postures, and relaxation. Before and after training they were measured for their lipid profile, thyroid function, cardiac and pulmonary function, and autonomic function.

 

They found that following the treatment there were significant improvements in cardiovascular function, including decreases resting heart rate and systolic and diastolic blood pressure, blood pressure response to standing, improvements in metabolic function, including decreases in body mass index, blood sugar, cholesterol, and blood fat, and increases in pulmonary function, including increases in lung size, expiratory volume, and peak expiratory flow rate. Hence, participation in the yoga training produced significant improvements in cardiopulmonary and metabolic health.

 

It should be noted that there wasn’t a control or comparison condition included in the study. The participants physical state prior to training was simply compared to that after training. But, the improvements were of such a magnitude that it would be unlikely to be produced by confounding factors, such as expectancy effects or the passage of time. Since the participants were healthy adults at the start of training, the improvements are even more striking. This suggests that participation in yoga practice promotes health and may delay or prevent the onset of cardiovascular disease and metabolic syndrome.

 

So, improve cardiopulmonary and metabolic condition and body weight with yoga.

 

“Yoga burns calories, tones your body and gives you a challenging routine to perform. Further, yoga increases flexibility, muscular strength, and muscular endurance. Physiologically, yoga has been shown to decrease resting heart rate, respiration and blood pressure and improve metabolic rate.” – Nikki Prosch

 

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

 

Divya T S, Vijayalakshmi M T, Mini K, Asish K, Pushpalatha M, Suresh V. Cardiopulmonary and metabolic effects of yoga in healthy volunteers. Int J Yoga 2017;10:115-20

 

Abstract

Background: Yoga the spiritual union of mind with the divine intelligence of the universe aims to liberate a human being from conflicts of body–mind duality. Beneficial cardiovascular and pulmonary effects of yoga are in par with aerobic exercise, even amounting to replace the exercise model. We conducted an interventional study in healthy volunteers, to analyze the impact of short-term yoga training on cardiovascular, pulmonary, autonomic function tests, lipid profile, and thyroid function tests. Materials and Methods: A sample of fifty new recruits attending the district yoga center was subject to 75 min yoga practice a day for 41 days. Basal values of cardiovascular, pulmonary, autonomic function tests, lipid profile, and thyroid function tests were recorded before yoga training and were reassessed for postyoga changes after 41 days. Results: After yoga practice there was a significant reduction in the resting heart rate, systolic blood pressure, diastolic blood pressure, and mean blood pressure of the participants. Effects on autonomic function tests were variable and inconclusive. There was a significant increase in forced vital capacity, forced expiratory volume in 1 s, and peak expiratory flow rate after yoga. A significant reduction in body mass index was observed. Effects on metabolic parameters were promising with a significant reduction in fasting blood sugar level, serum total cholesterol, serum triglycerides serum low-density lipoprotein levels, and significant increase in high-density lipoprotein. There was no significant change in thyroid function tests after yoga. Conclusion: Short-term yoga practice has no effect on thyroid functions. Yoga practice was found beneficial in maintaining physiological milieu pertaining to cardiovascular and other metabolic parameters.

 

http://www.ijoy.org.in/article.asp?issn=0973-6131;year=2017;volume=10;issue=3;spage=115;epage=120;aulast=Divya