Tai Chi for Chronic Obstructive Pulmonary Disease (COPD)
June 27, 2016 -
involves a series of slow and rhythmic circular motions. It emphasizes 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
The effect of Tai Chi on balance and muscle strength in the
elderly population has been reported; however, the effect of Tai Chi on dyspnea, exercise capacity,
pulmonary function and psychosocial status among people with chronic obstructive
pulmonary disease (COPD) remains unclear.
The Hong Kong Polytechnic University
performed a study to explore the effectiveness of Tai Chi in reducing dyspnea and improving
exercise capacity in people with COPD. It also aimed to determine the influence
of Tai Chi on physiological and psychosocial
functions among people with COPD.
They included randomized 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
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-program data and used it for analysis.
Main Results: A total of 984 participants from 12 studies (23 references) were
included in this analysis. Study sample size ranged from 10 to 206, and mean age
ranged from 61 to 74 years. Programs lasted for six weeks to one year. All
included studies were random clinical trials; 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
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 and better pulmonary function in post-program data. However, the
effects of Tai
Chi in reducing dyspnea 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.
Conclusions: No adverse
events were reported, implying that Tai Chi is
safe to practice in people with COPD. Evidence of very low to moderate quality
suggests better functional capacity and pulmonary function in post-program 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.