Improve Chronic Obstructive Pulmonary Disease (COPD) with Tai Chi
By John M. de Castro, Ph.D.
“tai chi can help people with COPD boost their ability to walk and do other types of exercise, as well as improve their quality of life.” – Harvard Health
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.
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 mind-body exercise such as Tai Chi and Qigong practices have been found to improve COPD symptoms. The evidence is accumulating. So, it makes sense to examine what has been learned.
In today’s Research News article “Tai Chi for chronic obstructive pulmonary disease (COPD).” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504989/ ) Ngai and colleagues review, summarize and perform a meta-analysis of the published research studies of the effectiveness of Tai Chi practice for the treatment of Chronic Obstructive Pulmonary Diseases (COPD).They identified 12 published studies that included a total of 984 participants.
They report that the published research did not find any adverse events from Tai Chi practice. They found that in comparison to no-treatment or to usual care Tai Chi practice significantly improved pulmonary function and produced better walking performance. Some inconclusive evidence was available that Tai Chi lessened shortness of breath and improved quality of life. But when compared to other interventions there was no significant differences.
These results are interesting and suggest that Tai Chi practice is effective in improving the symptoms of Chronic Obstructive Pulmonary Diseases (COPD). But it is not superior to other treatments. Tai Chi practice, however, is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate the elderly. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. These advantages make Tai Chi practice an excellent choice in the treatment of COPD.
So, improve chronic obstructive pulmonary disease (COPD) with tai chi.
“after 12 weeks, researchers saw surprising differences . . . favoring tai chi, in breathlessness (dyspnea) scores, and in exercise capacity . . . We conclude that tai chi is equivalent to PR [pulmonary rehabilitation] and may confer more sustained benefit,” – Patricia Silva
CMCS – Center for Mindfulness and Contemplative Studies
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Ngai, S. P., Jones, A. Y., & Tam, W. W. (2016). Tai Chi for chronic obstructive pulmonary disease (COPD). The Cochrane database of systematic reviews, 2016(6), CD009953. https://doi.org/10.1002/14651858.CD009953.pub2
Tai Chi, a systematic callisthenic exercise first developed in ancient China, involves a series of slow and rhythmic circular motions. It emphasises use of ‘mind’ or concentration to control breathing and circular body motions to facilitate flow of internal energy (i.e. ‘qi’) within the body. Normal flow of ‘qi’ is believed to be essential to sustain body homeostasis, ultimately leading to longevity. The effect of Tai Chi on balance and muscle strength in the elderly population has been reported; however, the effect of Tai Chi on dyspnoea, exercise capacity, pulmonary function and psychosocial status among people with chronic obstructive pulmonary disease (COPD) remains unclear.
We included randomised controlled trials (RCTs) comparing Tai Chi (Tai Chi alone or Tai Chi in addition to another intervention) versus control (usual care or another intervention identical to that used in the Tai Chi group) in people with COPD. Two independent review authors screened and selected studies.
Data collection and analysis
Two independent review authors extracted data from included studies and assessed risk of bias on the basis of suggested criteria listed in the Cochrane Handbook for Systematic Reviews of Interventions. We extracted post‐programme data and entered them into RevMan software (version 5.3) for data synthesis and analysis.
We included a total of 984 participants from 12 studies (23 references) in this analysis. We included only those involved in Tai Chi and the control group (i.e. 811 participants) in the final analysis. Study sample size ranged from 10 to 206, and mean age ranged from 61 to 74 years. Programmes lasted for six weeks to one year. All included studies were RCTs; three studies used allocation concealment, six reported blinded outcome assessors and three studies adopted an intention‐to‐treat approach to statistical analysis. No adverse events were reported. Quality of evidence of the outcomes ranged from very low to moderate.
Analysis was split into three comparisons: (1) Tai Chi versus usual care; (2) Tai Chi and breathing exercise versus breathing exercise alone; and (3) Tai Chi and exercise versus exercise alone.
Comparison of Tai Chi versus usual care revealed that Tai Chi demonstrated a longer six‐minute walk distance (mean difference (MD) 29.64 metres, 95% confidence interval (CI) 10.52 to 48.77 metres; participants = 318; I2 = 59%) and better pulmonary function (i.e. forced expiratory volume in one second, MD 0.11 L, 95% CI 0.02 to 0.20 L; participants = 258; I2 = 0%) in post‐programme data. However, the effects of Tai Chi in reducing dyspnoea level and improving quality of life remain inconclusive. Data are currently insufficient for evaluating the impact of Tai Chi on maximal exercise capacity, balance and muscle strength in people with COPD. Comparison of Tai Chi and other interventions (i.e. breathing exercise or exercise) versus other interventions shows no superiority and no additional effects on symptom improvement nor on physical and psychosocial outcomes with Tai Chi.
No adverse events were reported, implying that Tai Chi is safe to practise in people with COPD. Evidence of very low to moderate quality suggests better functional capacity and pulmonary function in post‐programme data for Tai Chi versus usual care. When Tai Chi in addition to other interventions was compared with other interventions alone, Tai Chi did not show superiority and showed no additional effects on symptoms nor on physical and psychosocial function improvement in people with COPD. With the diverse style and number of forms being adopted in different studies, the most beneficial protocol of Tai Chi style and number of forms could not be commented upon. Hence, future studies are warranted to address these topics.