Chest
Volume 153, Issue 5, May 2018, Pages 1116-1124
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Original Research: COPD
Tai Chi and Pulmonary Rehabilitation Compared for Treatment-Naive Patients With COPD: A Randomized Controlled Trial

https://doi.org/10.1016/j.chest.2018.01.053Get rights and content
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Background

In COPD, functional status is improved by pulmonary rehabilitation (PR) but requires specific facilities. Tai Chi, which combines psychological treatment and physical exercise and requires no special equipment, is widely practiced in China and is becoming increasingly popular in the rest of the world. We hypothesized that Tai Chi is equivalent (ie, difference less than ±4 St. George’s Respiratory Questionnaire [SGRQ] points) to PR.

Methods

A total of 120 patients (mean FEV1, 1.11 ± 0.42 L; 43.6% predicted) bronchodilator-naive patients were studied. Two weeks after starting indacaterol 150 μg once daily, they randomly received either standard PR thrice weekly or group Tai Chi five times weekly, for 12 weeks. The primary end point was change in SGRQ prior to and following the exercise intervention; measurements were also made 12 weeks after the end of the intervention.

Results

The between-group difference for SGRQ at the end of the exercise interventions was –0.48 (95% CI PR vs Tai Chi, –3.6 to 2.6; P = .76), excluding a difference exceeding the minimal clinically important difference. Twelve weeks later, the between-group difference for SGRQ was 4.5 (95% CI, 1.9 to 7.0; P < .001), favoring Tai Chi. Similar trends were observed for 6-min walk distance; no change in FEV1 was observed.

Conclusions

Tai Chi is equivalent to PR for improving SGRQ in COPD. Twelve weeks after exercise cessation, a clinically significant difference in SGRQ emerged favoring Tai Chi. Tai Chi is an appropriate substitute for PR.

Trial Registry

ClinicalTrials.gov; No.: NCT02665130; URL: www.clinicaltrials.gov.

Key Words

COPD
indacaterol
pulmonary rehabilitation
Tai Chi

Abbreviations

6MWD
6-min walk distance
MCID
minimal clinically important difference
mMRC
modified Medical Research Council dyspnea score
PR
pulmonary rehabilitation
SGRQ
St. George’s Respiratory Questionnaire

Cited by (0)

Drs Zhong and Luo contributed equally to the study.

FUNDING/SUPPORT: The study was in part funded by Novartis China as an investigator-initiated trial; the State Key Laboratory of Respiratory Disease (Guangzhou Medical University) was the sponsor. The study drug (indacaterol) was provided by Novartis China. Both the Key State Laboratory (Guangzhou) and the NIHR Respiratory Biomedical Unit provided in-kind support, the latter through partial salary support of M. I. P. Space for the study was made available by the governors of Xing-Ning People’s Hospital. Y.-M. L. was also partially supported by the National Key Research and Development Program of China (Project No. 2016YFC1304200).