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Kaplan Serin E. Combating With COPD by QiGong Physical and Mental Exercise. Holist Nurs Pract 2024; 28:172-178. [PMID: 33116055 DOI: 10.1097/hnp.0000000000000416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Physical activity levels of patients with chronic obstructive pulmonary disease (COPD) are low due to the symptoms of COPD. The patients diagnosed with COPD are headed for complementary and alternative treatments to reduce the COPD symptoms, facilitate the treatment, and increase their physical activity. One of these treatments is QiGong, which is not yet common in our country. QiGong is a type of exercise based on ancient Chinese medicine, and mainly consists of active and passive exercises. These exercises open energy channels in the body, and thus prevent and/or heal diseases by establishing energy balance in the body through meditation, breath control, and bodily exercises. According to a literature review abroad, there are a small number of scientific studies related the therapeutic effect of QiGong exercises on symptom control, anxiety, reduction of stress and depression, increase in physical activity and quality of life, and the development of lung function of patients with COPD. By considering the educative role of nurses, it is important that the nurse has adequate knowledge of the treatment and care of patients with COPD. Therefore, this review is compiled to be informative about the effects of QiGong in the treatment of COPD, and assistance to subsequent studies.
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Affiliation(s)
- Emine Kaplan Serin
- Author Affiliation: Department of Nursing, Faculty of Health Sciences, Munzur University, Tunceli, Turkey
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2
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Zhu Z, Muhamad AS, Omar N, Ooi FK, Pan X, Ong MLY. Efficacy of exercise treatments for chronic obstructive pulmonary disease: A systematic review. J Bodyw Mov Ther 2024; 38:106-127. [PMID: 38763549 DOI: 10.1016/j.jbmt.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/24/2023] [Accepted: 01/13/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE To review the efficacy of exercise treatments on chronic obstructive pulmonary disease (COPD). DATA SOURCES PubMed, Scopus, Science Direct, Ebscohost, SPORTDiscus, ProQuest, Web of Science. REVIEW METHODS A systematic review was performed to identify the relevant studies published from 2011 to 2023. Studies were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 5170 articles were retrieved and assessed using the Physiotherapy Evidence Database (PEDro) scale. The risk of bias in individual studies was assessed with the Cochrane risk of bias tool. RESULTS A total of 38 eligible studies were included. Eight studies evaluated the effects of Tai Chi, followed by Liuzijue (five studies) and yoga (three studies). The duration of the exercise programmes ranged from 8 weeks to 3 years, and the frequency was between 2 and 7 times a week. Exercise sessions lasted between 20 and 90 min. Low-intensity exercise improved lung function after six months. Whole-body exercise improved dyspnea more than local exercise. Water-based exercise improved physical endurance more than land exercise, and quality of life was unaffected by long-term exercise. CONCLUSION This systematic review highlights the benefit of exercise treatments as a potential adjunct treatment for COPD patients.
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Affiliation(s)
- Zhenggang Zhu
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Ayu Suzailiana Muhamad
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Norsuhana Omar
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Foong Kiew Ooi
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Xiaoyan Pan
- School of Nursing, Hunan University of Chinese Medicine, Yuelu District, Changsha, Hunan, China
| | - Marilyn Li Yin Ong
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
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Priego-Jiménez S, Cavero-Redondo I, Pascual-Morena C, Martínez-García I, Martínez-Vizcaíno V, Álvarez-Bueno C. Effect of different exercise programs on lung function in people with chronic obstructive pulmonary disease: A network meta-analysis of RCTs. Ann Phys Rehabil Med 2024; 67:101792. [PMID: 38128349 DOI: 10.1016/j.rehab.2023.101792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/24/2023] [Accepted: 07/29/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) has systemic consequences and causes structural abnormalities throughout the respiratory system. It is associated with a high clinical burden worldwide. AIM A network meta-analysis was performed to determine the effects of exercise programs on lung function measured by forced expiratory volume in the first second (FEV1), FEV1 as a percentage of the predicted value (FEV1%) and forced vital capacity in people with COPD. METHODS A literature search was performed to March 2023. Randomized controlled trials on the effectiveness of exercise programs on lung function in people with COPD were included. A standard pairwise meta-analysis and a network meta-analysis for direct and indirect comparisons between intervention and control/nonintervention groups were carried out to calculate the standardized mean difference and 95 % CI. The risk of bias was assessed using the Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation tool was used to assess the quality of the evidence. RESULTS 35 studies with a total sample of 2909 participants were included in this network meta-analysis. The highest standardized mean difference was for active mind body movement therapy programs versus control for FEV1 and FEV1% (0.71; 95 % CI 0.32 to1.09; and 0.36; 95 % CI 0.15 to 0.58, respectively), and pulmonary rehabilitation+active mind body movements therapies versus control for forced vital capacity (0.45; 95 % CI 0.07 to 0.84). CONCLUSIONS active mind body movement therapy programs were the most effective type of exercise program to improve lung function measured by FEV1 and FEV1%; pulmonary rehabilitation+active mind body movements therapies had the greatest effects on FVC in people with COPD. Exercise programs in which the abdominal muscles are strengthened could improve lung emptying, helping to overcome airway resistance in people with COPD.
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Affiliation(s)
| | - Iván Cavero-Redondo
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 340000, Chile; Health and Social Research Center, Universidad de Castilla La Mancha, 16071 Cuenca, Spain.
| | - Carlos Pascual-Morena
- Health and Social Research Center, Universidad de Castilla La Mancha, 16071 Cuenca, Spain
| | - Irene Martínez-García
- Health and Social Research Center, Universidad de Castilla La Mancha, 16071 Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 340000, Chile; Health and Social Research Center, Universidad de Castilla La Mancha, 16071 Cuenca, Spain
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla La Mancha, 16071 Cuenca, Spain; Universidad Politécnica y Artística del Paraguay, Asunción 2024, Paraguay
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Singh S, Nguyen T, Deleemans J, Oberoi D, Piedalue KA, Carlson LE. A Phenomenological Qualitative Exploration of Mind-Body Therapy Use and Effectiveness Among Young, Middle, and Older Adult Cancer Survivors. Integr Cancer Ther 2024; 23:15347354241253847. [PMID: 38767143 PMCID: PMC11107309 DOI: 10.1177/15347354241253847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/13/2024] [Accepted: 04/24/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Having been diagnosed with and treated for cancer can have negative psychosocial repercussions that may differ across the lifespan. Mind-body therapies (MBTs), such as tai-chi/qigong (TCQ) or mindfulness-based cancer recovery (MBCR), have shown promise in decreasing negative psychosocial outcomes in cancer survivors, but few studies have explored potential differences in MBT use and effectiveness across age groups. METHODS A descriptive phenomenological qualitative design was used. Participants included young (18-39), middle (40-64), and older (65+) adult cancer survivors who were diagnosed with any type of cancer and had participated in Mindfulness-Based Cancer Recovery (MBCR) or Tai Chi/Qigong (TCQ) MBTs. Semi-structured qualitative interviews explored participants' experiences in MBTs and these were analyzed using descriptive phenomenological analysis. RESULTS Among the interviews (n = 18), young (n = 6), middle-aged (n = 8), and older (n = 4) adults participated. 5 themes emerged: influences in joining the program, unique lifestyles, positive class experiences, use of media, and program impacts. Though all age groups benefitted from MBT participation, variations between age groups with respect to the benefits received and motivations for joining the program were observed. DISCUSSION MBTs had beneficial physical and mental health effects on survivors of all age groups. These benefits were particularly connected to the ongoing life stresses common to each age cohort, such as relief from work and family roles for young adults or support during retirement transition for older adults. Hence, access to MBT programs may be beneficial as part of the survivorship plan for patients and the recruitment strategies or content can be adapted by MBT providers to better target and support age-specific groups. More research is required with a larger sample.
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Affiliation(s)
- Sarthak Singh
- Cumming School of Medicine, Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB, Canada
| | - Tina Nguyen
- Cumming School of Medicine, Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB, Canada
| | - Julie Deleemans
- Cumming School of Medicine, Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB, Canada
| | - Devesh Oberoi
- Cumming School of Medicine, Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB, Canada
| | - Katherine-Ann Piedalue
- Department of Science, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Linda E. Carlson
- Cumming School of Medicine, Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB, Canada
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Jiang L, Li P, Shi J, Bao Y, Wang Z, Wu W, Liu X. Effects of pulmonary-based Qigong exercise in stable patients with chronic obstructive pulmonary disease: a randomized controlled trial. BMC Complement Med Ther 2023; 23:418. [PMID: 37985995 PMCID: PMC10662926 DOI: 10.1186/s12906-023-04238-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Physical exercise training is the central component of pulmonary rehabilitation. This study aimed to further investigate the rehabilitative effects of pulmonary-based Qigong exercise (PQE) in stable patients with chronic obstructive pulmonary disease (COPD). METHODS In this randomized, assessor-blinded clinical trial, 44 participants with stable COPD were randomly assigned to 2 groups in a 1:1 ratio. Participants in the control group received usual care for 3 months. Participants in the intervention group received usual care combined with PQE (60 min each time, 2 times per day, 7 days per week, for 3 months). The outcome included exercise capacity, lung function test, skeletal muscle strength, dyspnea, and quality of life were measured before and after intervention. RESULTS A total of 37 participants completed the trial. Compared to the control group, after 3 months of PQE, the mean change in exercise capacity, skeletal muscle strength, and quality of life were statistically significant (P < 0.05, for each), but no significant differences were observed in lung function (except for the forced expiratory volume in one second) and dyspnea (P > 0.05, for each). CONCLUSION The findings of study suggest that the proposed program of 3 months of PQE intervention has significant improvement in exercise capacity, skeletal muscle strength, and quality of life of COPD-stable patients. TRIAL REGISTRATION This study was registered in the Chinese Clinical Trial Registry (Trial ID: ChiCTR-1800017405 on 28 July 2018; available at https://www.chictr.org.cn/showproj.html?proj=28343 ).
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Affiliation(s)
- Linhong Jiang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, P.R. China
| | - Peijun Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, P.R. China
| | - Jiacheng Shi
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, P.R. China
| | - Yidie Bao
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, P.R. China
| | - Zhenwei Wang
- Department of Respiratory Medicine, Shanghai University of Traditional Chinese Medicine Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai, 200437, P.R. China
| | - Weibing Wu
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, 200438, P.R. China.
| | - Xiaodan Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, P.R. China.
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, 201203, P.R. China.
- Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, P.R. China.
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Liu W, Liu XM, Huang YL, Yu PM, Zhang XW, Zhao C, Mao B, Min J, Jiang HL. Tai Chi as a complementary exercise for pulmonary rehabilitation in chronic obstructive pulmonary disease: A randomised controlled trial. Complement Ther Med 2023; 78:102977. [PMID: 37625624 DOI: 10.1016/j.ctim.2023.102977] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVES With the characteristics of mindfulness and breathing techniques, Tai Chi has been recommended with therapeutic values in chronic obstructive pulmonary disease (COPD). However, its strengths as a complementary exercise for conventional pulmonary rehabilitation (PR) remain unclear. DESIGN AND SETTING This single-blinded randomised controlled trial recruited patients with mild to severe stable COPD. Eligible participants were randomly assigned to the group with usual care (control), total body recumbent stepper (TBRS) exercise, Tai Chi (TC), or combined TBRS exercise and Tai Chi (TBRS-TC). Patients received a two-month hospital-based supervised exercise, followed by a ten-month community- or home-based rehabilitation program. RESULTS A total of 120 participants were recruited, and 102 were included in the per-protocol analysis. The mean changes in St George's Respiratory Questionnaire (SGRQ) total score from baseline to the post-hospital exercise in the control group, TBRS group, TC group, and TBRS-TC group was 2.62 (95 % CI -8.99 to 8.99), -9.28 (95 % CI -13.96 to -4.60), -10.19 (95 % CI -13.72 to -6.67), and -16.75 (95 % CI -20.25 to -13.24), respectively, with a statistically significant difference between groups in favor of the TBRS-TC exercise (P < 0.001). The remarkable effect of TBRS-TC exercise in improving the quality of life maintained until the end of the community- or home-based rehabilitation training (P < 0.001). Besides, a statistically better effect with the TBRS-TC exercise was also observed in the outcomes regarding exercise capacity, pulmonary function, symptom burden, and systemic inflammation after the whole process of 12-month integrative PR exercise programme. CONCLUSIONS Based on the results, a novel integrated exercise modality combining Tai Chi and conventional pulmonary rehabilitation was developed. It might contribute to more positive effects in patients with stable COPD. REGISTRATION The study was registered with the Chinese Clinical Trial Registry (ChiCTR-IOR-15006874) prior to commencing recruitment.
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Affiliation(s)
- Wei Liu
- Group of Pulmonary Disease, Insitute of Integrated Traditional and Western Medicine, West China Hospital of Sichuan University, Chengdu, PR China.
| | - Xue-Mei Liu
- Group of Pulmonary Disease, Insitute of Integrated Traditional and Western Medicine, West China Hospital of Sichuan University, Chengdu, PR China; Division of Pulmonary Diseases, State Key Laboratory of Biotherapy, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, PR China.
| | - Ya-Ling Huang
- Group of Pulmonary Disease, Insitute of Integrated Traditional and Western Medicine, West China Hospital of Sichuan University, Chengdu, PR China.
| | - Peng-Ming Yu
- Department of Rehabilitation, West China Hospital of Sichuan University, Chengdu, PR China.
| | - Xia-Wei Zhang
- Respiratory Medicine Unit and National Institute for Health Research, Nuffield, Department of Medicine Experimental Medicine, Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
| | - Chen Zhao
- Department of Oral Medicine, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China.
| | - Bing Mao
- Group of Pulmonary Disease, Insitute of Integrated Traditional and Western Medicine, West China Hospital of Sichuan University, Chengdu, PR China.
| | - Jie Min
- Group of Pulmonary Disease, Insitute of Integrated Traditional and Western Medicine, West China Hospital of Sichuan University, Chengdu, PR China.
| | - Hong-Li Jiang
- Group of Pulmonary Disease, Insitute of Integrated Traditional and Western Medicine, West China Hospital of Sichuan University, Chengdu, PR China.
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Yang Y, Yang L, Yang X, Tian Y. Effects of Tai Chi on Lung Function, Exercise Capacity and Psychosocial Outcomes in Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-analysis of Randomized Controlled Trials. Biol Res Nurs 2023; 25:635-646. [PMID: 37210672 DOI: 10.1177/10998004231178318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Objectives: To explore whether tai chi can improve lung function, exercise capacity, and health-related outcomes in patients with chronic obstructive pulmonary disease (COPD). Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure (CNKI), Wanfang, and China Science and Technology Journal Database (VIP) databases were searched from inception to January 5, 2023. The methodological quality of the included studies was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions criteria. Results: A total of 1430 participants from 20 randomized controlled trials were included in this review. The results indicated significant effects of tai chi on FEV1, 6WMD, anxiety, and quality of life (p < 0.01), but not on FEV1%, FEVI/FVC, depression, and social support. Conclusions: Tai chi might be a potential alternative therapy to improve FEV1, 6WMD, anxiety, and quality of life for patients with COPD.
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Affiliation(s)
- Ying Yang
- Department of Respiratory Medicine, Tianjin Chest Hospital, Tianjin, China
| | - Li Yang
- Department of Respiratory Medicine, Tianjin Chest Hospital, Tianjin, China
| | - Xuejin Yang
- Department of Respiratory Medicine, Tianjin Chest Hospital, Tianjin, China
| | - Yuqi Tian
- Department of Respiratory Medicine, Tianjin Chest Hospital, Tianjin, China
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Tonga KO, Oliver BG. Effectiveness of Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease Therapy: Focusing on Traditional Medical Practices. J Clin Med 2023; 12:4815. [PMID: 37510930 PMCID: PMC10381859 DOI: 10.3390/jcm12144815] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/06/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a complex and serious disease that is characterized by dyspnea, fatigue, decreased exercise tolerance, peripheral muscle dysfunction, and mood disorders. These manifestations are successfully treated with pulmonary rehabilitation, a comprehensive intervention and holistic approach designed to improve the physical and psychological condition of people with COPD. Exercise is a big component of pulmonary rehabilitation programs, but the efficacy of non-traditional forms of exercise as used in alternative medicine is poorly understood. Here, we aim to address this gap in knowledge and summarize the clinical evidence for the use of traditional exercise regimens in the pulmonary rehabilitation of COPD patients.
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Affiliation(s)
- Katrina O Tonga
- Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, Macquarie University, Glebe, NSW 2037, Australia
- Saint Vincent's Hospital Sydney, Darlinghurst, NSW 2010, Australia
| | - Brian G Oliver
- Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, Macquarie University, Glebe, NSW 2037, Australia
- School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
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Effects of an Exercise for Well-Being and Physical Training Programme on Muscle Strength, Range of Movement, Respiratory Capacity and Quality of Life in Women with Fibromyalgia: A Randomized Controlled Trial. J Clin Med 2023; 12:jcm12030774. [PMID: 36769424 PMCID: PMC9918138 DOI: 10.3390/jcm12030774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/08/2023] [Accepted: 01/15/2023] [Indexed: 01/20/2023] Open
Abstract
The objective of this study was to assess the efficacy of an active exercise physiotherapy programme versus an exercise for well-being programme improving muscle strength, range of movement, respiratory capacity and quality of life of women with fibromyalgia. A randomized, assessor-blind, controlled trial was conducted. A total of 141 women diagnosed with fibromyalgia were randomized to a physiotherapy exercise group (n = 47), an exercise for well-being group (n = 47) and a control group (n = 47). The study lasted 4 weeks and the experimental groups received 45 min sessions performed twice a week on alternate days. The primary outcome measures were range of movement and muscle strength. The secondary outcome measures were respiratory capacity and quality of life. The results showed statistically significant improvements in the exercise for well-being and physiotherapy groups vs. the control group at week 5 in relation to joint range of movement (p = 0.004), muscle strength (p = 0.003) and quality of life (p = 0.002). The changes found in all the spirometry parameters seem to be associated to some of the changes in joint range of movement and muscle strength as well as quality of life. Physiotherapy and exercise for well-being improved upper limb and lower limb range of movement and the muscle strength of women with fibromyalgia.
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Zhang H, Hu D, Xu Y, Wu L, Lou L. Effect of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials. Ann Med 2022; 54:262-273. [PMID: 35037535 PMCID: PMC8765243 DOI: 10.1080/07853890.2021.1999494] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE The present systematic review and meta-analysis of randomized clinical trials (RCTs) aimed to investigate the effects of pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease (COPD). METHODS The RCTs of pulmonary rehabilitation programs published between 1999 and 2021 were retrieved from electronic databases (PubMed, Cochrane Library, and Embase). Two reviewers independently assessed the topical relevance and trial quality and extracted data for meta-analysis using the Stata software version 14.0. RESULTS A total of 39 trials involving 2,397 participants with COPD were evaluated. We found that patients who received pulmonary rehabilitation program had significant improvement in the 6-min walk test (6MWT), St. George Respiratory Questionnaire score, and the modified British Medical Research Council score as compared to those who received usual care. Yoga and Tai Chi showed significant improvement in the forced expiratory volume (FEV1)% in 1 s predicted value. However, no significant difference was detected in the modified Borg score, forced vital capacity (FVC), and FEV1/FVC predicted value between the pulmonary rehabilitation and usual care groups. CONCLUSION Yoga and Tai Chi showed a significant improvement in the FEV1% predicted value. Also, pulmonary rehabilitation program improved the exercise capacity, the quality of life, and dyspnoea in patients with COPD.Key messagesA total of 39 trials involving 2,397 participants with COPD were evaluated.We found that patients who received pulmonary rehabilitation program had significant improvement in the 6MWT, St. George Respiratory Questionnaire score, and the modified British Medical Research Council score as compared to those who received usual care.Yoga and Tai Chi showed significant improvement in the FEV1% predicted value.No significant difference was detected in the modified Borg score, FVC, and FEV1/FVC predicted value between the pulmonary rehabilitation and usual care groups.
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Affiliation(s)
- Hong Zhang
- Department of Respiratory Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Dandan Hu
- Department of Respiratory Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yikai Xu
- Department of Respiratory Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Lixia Wu
- Department of Respiratory Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Liming Lou
- Department of Respiratory Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Priego-Jiménez S, Torres-Costoso A, Guzmán-Pavón MJ, Lorenzo-García P, Lucerón-Lucas-Torres MI, Álvarez-Bueno C. Efficacy of Different Types of Physical Activity Interventions on Exercise Capacity in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Network Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14539. [PMID: 36361418 PMCID: PMC9656092 DOI: 10.3390/ijerph192114539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
AIM A network meta-analysis (NMA) was performed to determine the effects on the exercise capacity, measured by the 6 MWT, of patients with COPD of (i) different physical activity interventions and (ii) supervised or unsupervised programs. METHODS A literature search was carried out from inception to April 2022. Randomized controlled trials of the effectiveness of physical activity on exercise capacity in patients with COPD were included. The risk of bias was assessed using the Cochrane Risk of Bias (RoB 2.0) tool, and the Grading of Recommendations, Assessment, Development, and Evaluation tool (GRADE) was used to assess the quality of the evidence. A pairwise meta-analysis for direct and indirect effects was carried out. RESULTS A total of 41 studies were included in this NMA. The highest effects were for urban training pulmonary rehabilitation (PR) programs (ES, 1.50; 95% CI: 0.46 and 2.55) versus the control group. For supervised and unsupervised PR and home-based PR programs, the highest effects were found for supervised PR (ES, 0.85; 95% CI: 0.46 to 1.23) versus the control group. CONCLUSIONS PR implemented with urban circuit training should be considered the most effective strategy to improve exercise capacity in patients with COPD. Supervision of the programs improves exercise capacity.
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Affiliation(s)
| | - Ana Torres-Costoso
- Health and Social Research Center, Universidad de Castilla La Mancha, 16071 Cuenca, Spain
- Faculty of Physiotherapy and Nursing, University of Castilla La Mancha, 45071 Toledo, Spain
| | - María José Guzmán-Pavón
- Health and Social Research Center, Universidad de Castilla La Mancha, 16071 Cuenca, Spain
- Faculty of Physiotherapy and Nursing, University of Castilla La Mancha, 45071 Toledo, Spain
| | - Patricia Lorenzo-García
- Health and Social Research Center, Universidad de Castilla La Mancha, 16071 Cuenca, Spain
- Faculty of Physiotherapy and Nursing, University of Castilla La Mancha, 45071 Toledo, Spain
| | - María Isabel Lucerón-Lucas-Torres
- Health and Social Research Center, Universidad de Castilla La Mancha, 16071 Cuenca, Spain
- Facultad de Enfermería de Cuenca, Edificio Melchor Cano, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla La Mancha, 16071 Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción 2024, Paraguay
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Mendo B, Gonçalves M, Lopes L, Matos LC, Machado J. Can Yoga, Qigong, and Tai Chi Breathing Work Support the Psycho-Immune Homeostasis during and after the COVID-19 Pandemic? A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10101934. [PMID: 36292380 PMCID: PMC9601556 DOI: 10.3390/healthcare10101934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/04/2022] Open
Abstract
Breathing is crucial in life; nevertheless, the healthcare community often overlooks the health potential of breathing techniques. Conscious manipulation of breathing to achieve specific health goals is found in yoga, Qigong and Tai Chi. This paper reviews the value of breathing exercises as a foremost mechanism for promoting, recuperating and maintaining health. Practices involving breathing techniques are described, and their prophylactic or therapeutic characteristics are explored. The main goals of this review are: (i) to summarize the evidence supporting the hypothesis that breathing practices have a significant beneficial impact on human health; (ii) to provide a deeper understanding of traditional biofeedback practices, particularly yoga, Qigong and Tai Chi, and outline their focus on breathing techniques; (iii) to outline specific immune-related responses, relevant for COVID-19 disorders; and (iv) to call for committed attention and action from the scientific community and health agencies in promoting the implementation of a practical and costless health program based on breathing techniques. This review shows the health potentials of breathing practices and exercises, which, by having a high benefit-cost ratio, could be selected and implemented as a primary standard routine in public health programs.
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Affiliation(s)
- Bruno Mendo
- ICBAS–Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
- CBSin–Center of BioSciences in Integrative Health, 4250-105 Porto, Portugal
- Correspondence:
| | - Mário Gonçalves
- ICBAS–Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
- CBSin–Center of BioSciences in Integrative Health, 4250-105 Porto, Portugal
| | - Lara Lopes
- ICBAS–Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
- CBSin–Center of BioSciences in Integrative Health, 4250-105 Porto, Portugal
| | - Luís Carlos Matos
- CBSin–Center of BioSciences in Integrative Health, 4250-105 Porto, Portugal
- Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal
- CTEC–Centro Transdisciplinar de Estudos da Consciência, Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | - Jorge Machado
- ICBAS–Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
- CBSin–Center of BioSciences in Integrative Health, 4250-105 Porto, Portugal
- LABIOMEP–Porto Biomechanics Laboratory, University of Porto, 4200-450 Porto, Portugal
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Farver-Vestergaard I, Danielsen JTT, Løkke A, Zachariae R. Psychosocial Intervention in Chronic Obstructive Pulmonary Disease: Meta-Analysis of Randomized Controlled Trials. Psychosom Med 2022; 84:347-358. [PMID: 35067652 DOI: 10.1097/psy.0000000000001043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Many patients with chronic obstructive pulmonary disease (COPD) experience persistent interrelated psychological and physical symptoms despite optimal treatment. Several studies of psychosocial intervention in COPD have been published in recent years. The present study aimed to conduct a quantitative summary of the efficacy of such interventions on psychological and physical outcomes. METHODS Two independent raters screened PubMed, PsycINFO, Embase, Web of Science, Cochrane Library, and CINAHL for eligible studies. In all, 35 independent, randomized controlled trials with a total of 3,120 patients with COPD were included, assessed for their methodological quality, and subjected to meta-analytic evaluation. RESULTS Meta-analyses revealed small, statistically significant effects of psychosocial intervention on combined psychological (Hedges's g = 0.28; 95%CI: 0.16-0.41) and physical outcomes (g = 0.21; 95%CI: 0.07-0.35) with no indications of publication bias. Supplementary Bayesian meta-analyses provided strong evidence for a non-zero overall effect on psychological outcomes (Bayes factor (BF) = 305) and moderate support for physical outcomes (BF = 6.1). Exploring sources of heterogeneity with meta-regression indicated that older age of patients and longer duration of interventions were associated with smaller effects on psychological outcomes. CONCLUSIONS The results support psychosocial intervention as an additional, useful tool in multidisciplinary respiratory care with the potential to improve both psychological and physical outcomes. Future studies are recommended to monitor adverse effects, apply blinding of active control conditions, and determine sample sizes with a priori power calculations. REGISTRATION Registered with Prospero (www.crd.york.ac.uk/prospero/) prior to initiation of the literature search (Reg. ID: CRD42020170083).
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Affiliation(s)
- Ingeborg Farver-Vestergaard
- From the Department of Medicine (Farver-Vestergaard, Løkke), Vejle Hospital, Lillebaelt Hospital, Vejle, Denmark; and Unit for Psychooncology and Health Psychology (Tingdal Taube Danielsen, Zachariae), Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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Schrijver J, Lenferink A, Brusse-Keizer M, Zwerink M, van der Valk PD, van der Palen J, Effing TW. Self-management interventions for people with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2022; 1:CD002990. [PMID: 35001366 PMCID: PMC8743569 DOI: 10.1002/14651858.cd002990.pub4] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Self-management interventions help people with chronic obstructive pulmonary disease (COPD) to acquire and practise the skills they need to carry out disease-specific medical regimens, guide changes in health behaviour and provide emotional support to enable them to control their disease. Since the 2014 update of this review, several studies have been published. OBJECTIVES Primary objectives To evaluate the effectiveness of COPD self-management interventions compared to usual care in terms of health-related quality of life (HRQoL) and respiratory-related hospital admissions. To evaluate the safety of COPD self-management interventions compared to usual care in terms of respiratory-related mortality and all-cause mortality. Secondary objectives To evaluate the effectiveness of COPD self-management interventions compared to usual care in terms of other health outcomes and healthcare utilisation. To evaluate effective characteristics of COPD self-management interventions. SEARCH METHODS We searched the Cochrane Airways Trials Register, CENTRAL, MEDLINE, EMBASE, trials registries and the reference lists of included studies up until January 2020. SELECTION CRITERIA Randomised controlled trials (RCTs) and cluster-randomised trials (CRTs) published since 1995. To be eligible for inclusion, self-management interventions had to include at least two intervention components and include an iterative process between participant and healthcare provider(s) in which goals were formulated and feedback was given on self-management actions by the participant. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies for inclusion, assessed trial quality and extracted data. We resolved disagreements by reaching consensus or by involving a third review author. We contacted study authors to obtain additional information and missing outcome data where possible. Primary outcomes were health-related quality of life (HRQoL), number of respiratory-related hospital admissions, respiratory-related mortality, and all-cause mortality. When appropriate, we pooled study results using random-effects modelling meta-analyses. MAIN RESULTS We included 27 studies involving 6008 participants with COPD. The follow-up time ranged from two-and-a-half to 24 months and the content of the interventions was diverse. Participants' mean age ranged from 57 to 74 years, and the proportion of male participants ranged from 33% to 98%. The post-bronchodilator forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) ratio of participants ranged from 33.6% to 57.0%. The FEV1/FVC ratio is a measure used to diagnose COPD and to determine the severity of the disease. Studies were conducted on four different continents (Europe (n = 15), North America (n = 8), Asia (n = 1), and Oceania (n = 4); with one study conducted in both Europe and Oceania). Self-management interventions likely improve HRQoL, as measured by the St. George's Respiratory Questionnaire (SGRQ) total score (lower score represents better HRQoL) with a mean difference (MD) from usual care of -2.86 points (95% confidence interval (CI) -4.87 to -0.85; 14 studies, 2778 participants; low-quality evidence). The pooled MD of -2.86 did not reach the SGRQ minimal clinically important difference (MCID) of four points. Self-management intervention participants were also at a slightly lower risk for at least one respiratory-related hospital admission (odds ratio (OR) 0.75, 95% CI 0.57 to 0.98; 15 studies, 3263 participants; very low-quality evidence). The number needed to treat to prevent one respiratory-related hospital admission over a mean of 9.75 months' follow-up was 15 (95% CI 8 to 399) for participants with high baseline risk and 26 (95% CI 15 to 677) for participants with low baseline risk. No differences were observed in respiratory-related mortality (risk difference (RD) 0.01, 95% CI -0.02 to 0.04; 8 studies, 1572 participants ; low-quality evidence) and all-cause mortality (RD -0.01, 95% CI -0.03 to 0.01; 24 studies, 5719 participants; low-quality evidence). We graded the evidence to be of 'moderate' to 'very low' quality according to GRADE. All studies had a substantial risk of bias, because of lack of blinding of participants and personnel to the interventions, which is inherently impossible in a self-management intervention. In addition, risk of bias was noticeably increased because of insufficient information regarding a) non-protocol interventions, and b) analyses to estimate the effect of adhering to interventions. Consequently, the highest GRADE evidence score that could be obtained by studies was 'moderate'. AUTHORS' CONCLUSIONS Self-management interventions for people with COPD are associated with improvements in HRQoL, as measured with the SGRQ, and a lower probability of respiratory-related hospital admissions. No excess respiratory-related and all-cause mortality risks were observed, which strengthens the view that COPD self-management interventions are unlikely to cause harm. By using stricter inclusion criteria, we decreased heterogeneity in studies, but also reduced the number of included studies and therefore our capacity to conduct subgroup analyses. Data were therefore still insufficient to reach clear conclusions about effective (intervention) characteristics of COPD self-management interventions. As tailoring of COPD self-management interventions to individuals is desirable, heterogeneity is and will likely remain present in self-management interventions. For future studies, we would urge using only COPD self-management interventions that include iterative interactions between participants and healthcare professionals who are competent using behavioural change techniques (BCTs) to elicit participants' motivation, confidence and competence to positively adapt their health behaviour(s) and develop skills to better manage their disease. In addition, to inform further subgroup and meta-regression analyses and to provide stronger conclusions regarding effective COPD self-management interventions, there is a need for more homogeneity in outcome measures. More attention should be paid to behavioural outcome measures and to providing more detailed, uniform and transparently reported data on self-management intervention components and BCTs. Assessment of outcomes over the long term is also recommended to capture changes in people's behaviour. Finally, information regarding non-protocol interventions as well as analyses to estimate the effect of adhering to interventions should be included to increase the quality of evidence.
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Affiliation(s)
- Jade Schrijver
- Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, Netherlands
- Section Cognition, Data and Education, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Anke Lenferink
- Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, Netherlands
- Section Health Technology and Services Research, Faculty of Behavioural, Management and Social sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Marjolein Brusse-Keizer
- Section Health Technology and Services Research, Faculty of Behavioural, Management and Social sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
- Medical School Twente, Medisch Spectrum Twente, Enschede, Netherlands
| | - Marlies Zwerink
- Value-Based Health Care, Medisch Spectrum Twente, Enschede, Netherlands
| | | | - Job van der Palen
- Section Cognition, Data and Education, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
- Medical School Twente, Medisch Spectrum Twente, Enschede, Netherlands
| | - Tanja W Effing
- College of Medicine and Public Health, School of Medicine, Flinders University, Adelaide, Australia
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
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Larkey L, Kim W, James D, Kishida M, Vizcaino M, Huberty J, Krishnamurthi N. Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement. Integr Cancer Ther 2021; 19:1534735420949677. [PMID: 32783546 PMCID: PMC7425257 DOI: 10.1177/1534735420949677] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Advancements in early detection and treatment of cancer have led to increased survival rates and greater need to identify effective supportive care options for resolving symptoms of survivorship. Many non-pharmacological approaches to symptom management during and after cancer treatment involve emotional self-regulation as a central strategy for improving well-being. Identifying commonalities among these strategies’ mechanisms of action may facilitate understanding of what might be useful for optimizing intervention effects. Heart rate variability (HRV) parameters are indicative of improved autonomic nervous system (ANS) balance and resiliency and reduced emotional distress and are thus identified as a mechanism to discuss as a marker of potential for intervention efficacy and a target for optimization. Methods: HRV data from 2 studies, 1 examining a mind-body intervention and 1 examining a psychosocial intervention, are presented as a point of discussion about preliminary associations between the interventions, change in HRV, and emotional distress reduction. Results: HRV significantly decreased in sympathetic activity in response to a mind-body intervention (Qigong/Tai Chi), and increased vagal tone in response to a psychosocial (storytelling) intervention. In both, these changes in HRV parameters were associated with improved emotional states. Conclusion: Our preliminary data suggest that HRV may serve as an important marker of underlying changes that mediate emotional regulation; this observation deserves further investigation. If identified as a worthy target, focusing on interventions that improve HRV within the context of interventions for cancer patients may be important to key outcomes and clinical practice.
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Affiliation(s)
- Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Wonsun Kim
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Dara James
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Moé Kishida
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | | | - Jennifer Huberty
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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Dong X, Wang X, Jia N, Chen X, Ding M. A comparison between Qigong exercise and cycle ergometer exercise for the rehabilitation of chronic obstructive pulmonary disease: A pilot randomized controlled trial (CONSORT). Medicine (Baltimore) 2021; 100:e26010. [PMID: 34032718 PMCID: PMC8154450 DOI: 10.1097/md.0000000000026010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 04/30/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a common respiratory disease that is associated with significant morbidity and mortality. Exercise training confers health benefits to people with COPD. The purpose of this study was to compare differences in the rehabilitation of COPD between Qigong exercise (QE) and aerobic exercise using a cycle ergometer (CE). METHODS This study was a randomized single-blind controlled trial. Twenty six participants were recruited and randomized to either the Qigong group or the cycle ergometer group. Both interventions lasted 12 weeks and comprised a 30 minutes supervised training session performed twice a week, that is, 24 sessions in total. The primary outcome measure was the endurance capacity measured by the six-minute walk test (6MWT). The secondary outcome measures were the results of the St. George's Hospital Respiratory Questionnaire (SGRQ) and the COPD assessment test (CAT). RESULTS Participants in the group that performed aerobic exercise using a cycle ergometer had significantly improved 6MWT (P = .005), SGRQ (P = .029), and CAT (P = .018) results. Participants in the Qigong exercise group had significant changes in 6MWT (P = .033). However, the differences in 6MWT and SGRQ were not statistically significant between the 2 groups. The changes in CAT scores before and after the intervention were significantly different between the 2 groups (P = .020). There were no reports of adverse events during the course of the trial. CONCLUSIONS There was no difference in the primary outcome between groups. In particular, QE and cycle ergometer exercise had similar rehabilitation effects on the improvement of the cardiopulmonary endurance and quality of life of chronic obstructive pulmonary disease patients. In addition, cycle ergometer exercise may lead to a better trend of improvement in the quality of life and can improve the severity of the clinical symptoms of chronic obstructive pulmonary disease. TRIAL REGISTRATION ChiCTR-TRC-14004404.
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Affiliation(s)
- Xiaosheng Dong
- College of Physical Education, Shandong Normal University
- College of Physical Education, Shandong University, Jinan
| | - Xiangyu Wang
- Capital Institute of Physical Education, Beijing
| | - Ningxin Jia
- College of Physical Education, Shandong Normal University
| | - Xianhai Chen
- Affiliated Hospital of Shandong, University of Traditional Chinese Medicine, Jinan, China
| | - Meng Ding
- College of Physical Education, Shandong Normal University
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Gryffin PA, Diaz RE. Effects of Tai Chi and running on blood oxygen saturation: a pilot study. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 18:821-825. [PMID: 33793144 DOI: 10.1515/jcim-2020-0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 10/21/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Large drops in blood oxygen saturation (SpO2) to levels as low as 84% was observed following Tai Chi practice, during a study on the effects of Tai Chi on SpO2. The objectives of the current pilot study were to determine if this was a statistically significant drop, and how SpO2 levels compared to an aerobic activity such as running, in pre, concurrent, and post measurements. METHODS Repeated measures of blood oxygen saturation (SpO2) were taken of a 50-year-old male before, during and for 1 min after TC and running. RESULTS Measurements of SpO2 before, during, and after TC resulted in a statistically significant increase in SpO2 during TC (p=1.69e-06), and a statistically significant (p=1.71e-06) brief momentary drop from resting levels, as low as 87% SpO2. Running showed no significant change in pre and post levels, with a significant change and decrease in SpO2 during running (p=1.1e-08), suggesting increased oxygen use by the large muscle groups during exercise. SpO2 returned to normal resting levels following running with no post drop. Results suggest a higher rate of oxygen metabolism during TC, with a potential effect on hypoxic (oxygen deficient) areas of the body. CONCLUSIONS Findings suggest direct and unique effects on enhanced blood oxygen saturation and oxygen metabolism, which may underlie benefits for conditions complicated by hypoxia, including cardiopulmonary disease, immunity, chronic pain, and arthritis.
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Affiliation(s)
| | - Rafael E Diaz
- California State University Sacramento, Sacramento, CA, USA
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Perloff J, Thomas CP, Macklin E, Gagnon P, Tsai T, Isaza I, Wayne PM, Lipsitz L. The Impact of Tai Chi Exercise on Health Care Utilization and Imputed Cost in Residents of Low-Income Senior Housing. Glob Adv Health Med 2021; 10:2164956120985479. [PMID: 33598365 PMCID: PMC7841657 DOI: 10.1177/2164956120985479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study was designed to test the impact of Tai Chi (TC) on healthcare utilization and cost in older adults living in low-income senior housing. We hypothesized that TC would improve overall health enough to reduce the use of emergency department (ED) and inpatient services. DESIGN Cluster randomized controlled trial with randomization at the housing site level. SETTING Greater Boston, Massachusetts. PARTICIPANTS The study includes 6 sites with 75 individuals in the TC treatment condition and 6 sites with 67 individuals in the health education control condition. INTERVENTION Members of the treatment group received up to a year-long intervention with twice weekly, in-person TC exercise sessions along with video-directed exercises that could be done independently at home. The comparison group received monthly, in-person healthy aging education classes (HE). Study recruitment took place between August, 2015 and October, 2017. Key outcomes included acute care utilization (inpatient stays, observation stays and emergency department visits). In addition, the cost of utilization was estimated using the age, sex and race adjusted allowed amount from Medicare claims for a geographically similar population aged ≥ 65. RESULTS The results suggested a possible reduction in the rate of ED visits in the TC group vs. controls (rate ratio = 0.476, p-value = 0.06), but no findings achieved statistical significance. Adjusted estimates of imputed costs of ED and hospital care were similar between TC and HE, averaging approximately $3,000 in each group. CONCLUSION ED utilization tended to be lower over 6 to 12 months of TC exercises compared to HE in older adults living in low-income housing, although estimated costs of care were similar.
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Affiliation(s)
- Jennifer Perloff
- The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Cindy Parks Thomas
- The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Eric Macklin
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Peggy Gagnon
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
| | - Timothy Tsai
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
| | - Ilean Isaza
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
| | - Peter M Wayne
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Lewis Lipsitz
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Beth Israel Deaconess Medical Center Division of Gerontology, Boston, Massachusetts
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Toneti BF, Barbosa RFM, Mano LY, Sawada LO, Oliveira IGD, Sawada NO. Benefits of Qigong as an integrative and complementary practice for health: a systematic review. Rev Lat Am Enfermagem 2020; 28:e3317. [PMID: 32696918 PMCID: PMC7365612 DOI: 10.1590/1518-8345.3718.3317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 04/06/2020] [Indexed: 02/07/2023] Open
Abstract
Objective: to analyze, in the literature, evidence about the benefits of the integrative
and complementary practice of Qigong with regard to the
health of adults and the elderly. Method: a systematic review by searching for studies in the PubMed, CINAHL, LILACS,
EMBASE and Cochrane Library databases. Randomized and non-randomized
clinical trials were included; in Portuguese, English and Spanish; from 2008
to 2018. The Preferred Reporting Items for Systematic Reviews and
Meta-Analyses strategy was adopted, as well as the recommendation of the
Cochrane Collaboration for assessing the risk of bias in the clinical trials
analyzed. Results: 28 studies were selected that indicated the benefit of the practice to the
target audience, which can be used for numerous health conditions, such as:
cancer; fibromyalgia; Parkinson’s disease; Chronic Obstructive Pulmonary
Disease; Burnout; stress; social isolation; chronic low back pain; cervical
pain; buzz; osteoarthritis; fatigue; depression; and cardiovascular
diseases. However, there was a great risk of bias in terms of the blinding
of the research studies. Conclusion: the practice of Qigong produces positive results on health,
mainly in the medium and long term. This study contributes to the
advancement in the use of integrative and complementary practices in
nursing, since it brings together the scientific production in the area from
the best research results available.
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Affiliation(s)
- Bruna Francielle Toneti
- PAHO/WHO Collaborating Centre at the Nursing Research Development, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Rafael Fernando Mendes Barbosa
- PAHO/WHO Collaborating Centre at the Nursing Research Development, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Leandro Yukio Mano
- Instituto de Ciências Matemáticas e de Computação, Universidade de São Paulo, São Carlos, SP, Brazil
| | - Luana Okino Sawada
- School of Computing and Information Science, Florida International University, Miami, FL, United States of America
| | - Igor Goulart de Oliveira
- Centro de Ciências Tecnológicas, Universidade Estadual do Norte do Paraná, Bandeirantes, PR, Brazil
| | - Namie Okino Sawada
- Escola de Enfermagem, Universidade Federal de Alfenas, Alfenas, MG, Brazil
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Abstract
Breath, the ephemeral materialization of air at the interface of body and world, engages with and alters the quality of both. As a process of inhalation and exhalation that signals its physiological universality, breath is an invisible prerequisite for life, an automated and functional necessity. Yet it is more than simply a reflexive action and can at times be controlled or manipulated. It can also affect or be affected by experiences, environments and relationships. In this essay, like the contributors to the special issue it prefaces, we aim to address the lacuna that exists in the examination of the meanings and embodiment of breath as a central theme in the humanitics and social sciences. Interdisciplinary perspectives that explore breath as a multifaceted phenomenon, both intrinsically shared and contextually distinct, open new directions in the field of breath and body studies.
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Guo C, Xiang G, Xie L, Liu Z, Zhang X, Wu Q, Li S, Wu Y. Effects of Tai Chi training on the physical and mental health status in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. J Thorac Dis 2020; 12:504-521. [PMID: 32274117 PMCID: PMC7139037 DOI: 10.21037/jtd.2020.01.03] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Tai Chi is a systematic whole body movement developed in ancient China. It plays an increasingly important role in the field of pulmonary rehabilitation for patients with chronic obstructive pulmonary disease (COPD). Our review aimed to explore the impact of Tai Chi on the physical and mental health of patients with COPD. Methods We searched several English and Chinese databases and used the combination of subject words and free words to search for available literature from the establishment of the library until August 28, 2018. Two researchers screened studies and collected the data independently. The study inclusion criteria included: (I) patients diagnosed with COPD; (II) Tai Chi or Tai Chi Qigong as an intervention in addition to routine treatment; (III) routine treatment with or without exercises as control group. The primary outcomes were lung function, exercise capacity and health status; (IV) randomized controlled trials. Results Sixteen articles were included from 2009 to 2018 (n=1,096). The average time duration of Tai Chi program was 53.4 minutes each session, 4.13 sessions a week for a total of 4.13 months. Comparing with control group, Tai Chi group improved some lung function (forced volume capacity: mean difference =0.12, 95% CI: 0.03–0.21), (forced expiratory volume in 1s: mean difference =0.15, 95% CI: 0.08–0.21), enhanced 6-minute walking distance score (mean difference =30.78, 95% CI: 15.15–46.42), decreased COPD Assessment Test score (mean difference =−5.00, 95% CI: −7.51 to −2.50), decreased St. George’s Respiratory Questionnaire score (mean difference =−8.66, 95% CI: −14.60 to −2.72), enhanced Chronic Respiratory Disease Questionnaire score (mean difference =2.16, 95% CI: 1.49–2.83), decreased Hospital Anxiety and Depression Scale score(anxiety: mean difference =−1.04, 95% CI: −1.58 to −0.51; depression: mean difference =−1.25, 95% CI: −1.77 to −0.73). Comparing with exercise group, Tai Chi group statistically enhanced 6-minute walking distance score (mean difference =7.77, 95% CI: 2.63–12.91). Conclusions Tai Chi may represent an appropriate alternative or complement to standard rehabilitation programs. However, whether Tai Chi is better than pulmonary rehabilitation exercise has not been determined.
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Affiliation(s)
- Chengyao Guo
- Nursing Department, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Guiling Xiang
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Liang Xie
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zilong Liu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Xiaomin Zhang
- Nursing Department, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Qinhan Wu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Shanqun Li
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yan Wu
- Nursing Department, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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22
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Dong J, Li Z, Luo L, Xie H. Efficacy of pulmonary rehabilitation in improving the quality of life for patients with chronic obstructive pulmonary disease: Evidence based on nineteen randomized controlled trials. Int J Surg 2020; 73:78-86. [DOI: 10.1016/j.ijsu.2019.11.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/25/2019] [Accepted: 11/30/2019] [Indexed: 12/11/2022]
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Wang L, Wu K, Chen X, Liu Q. The Effects of Tai Chi on Lung Function, Exercise Capacity and Health Related Quality of Life for Patients With Chronic Obstructive Pulmonary Disease: A Pilot Study. Heart Lung Circ 2019; 28:1206-1212. [DOI: 10.1016/j.hlc.2018.05.204] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/12/2018] [Accepted: 05/25/2018] [Indexed: 11/28/2022]
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Viveiros J, Chamberlain B, O’Hare A, Sethares KA. Meditation interventions among heart failure patients: An integrative review. Eur J Cardiovasc Nurs 2019; 18:720-728. [DOI: 10.1177/1474515119863181] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: There has been growing interest in meditation techniques as an intervention in chronic disease populations. Little is known of the effect meditation practice has on outcomes among patients with heart failure. Purpose: To identify and examine current literature on meditation interventions on heart failure outcomes. Method: The review utilized methods described by Whittemore and Knafl. Three electronic databases were searched through March 2018. Terms used were “mindfulness OR meditation” and “heart failure” in combination, generating 58 articles after duplicates were removed. After inclusion and exclusion criteria were applied, six studies qualified for review, including four articles with samples from the United States and two with samples from Brazil and Sweden, respectively. Results: Among the six studies in the final sample, the total number of participants was 320 heart failure patients. Interventional design and length varied among the studies, and 20 different dependent variables were identified. This study distinguished four categories of outcome measures with significant findings: psychosocial, biophysical, quality of life and heart failure symptom burden. Compared with controls meditation practice significantly improved depression ( p<.05), social support ( p<.05), biophysical factors and quality of life ( p<.05), in addition to reducing heart failure symptom burden. Across-study comparisons were limited due to variation in intervention definitions and designs. Additionally, the intervention dose and reporting method varied, limiting comparisons. The sample size in five out of six studies was fewer than 50 participants. Over 20 different measures were used across the six studies to measure outcome variables. Conclusion: Meditation may offer a patient-driven practice to reduce heart failure symptoms as well as improve psychosocial wellness and quality of life. Future research among heart failure patients should include the following: rigorous definition of meditation interventions, consistency in intervention characteristics, larger controlled trials, and standardized outcome instruments.
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Affiliation(s)
| | | | - Aminda O’Hare
- College of Arts and Sciences University of Massachusetts Dartmouth, USA
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Wu JJ, Zhang YX, Du WS, Jiang LD, Jin RF, Yu HY, Liu JM, Han M. Effect of Qigong on self-rating depression and anxiety scale scores of COPD patients: A meta-analysis. Medicine (Baltimore) 2019; 98:e15776. [PMID: 31145299 PMCID: PMC6708806 DOI: 10.1097/md.0000000000015776] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To explore the clinical efficacy and safety of Qigong in reducing the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) scores of patients with chronic obstructive pulmonary disease (COPD). METHODS We searched CNKI, Wan fang, Chongqing VIP, China Biology Medicine disc, PubMed, Cochrane Library, and EMBASE for studies published as of Dec 31, 2018. All randomized controlled trials of Qigong in COPD patients, which met the inclusion criteria were included. The Cochrane bias risk assessment tool was used for literature evaluation. RevMan 5.3 software was used for meta-analysis. RESULTS Six studies (combined n = 415 patients) met the inclusion criteria. Compared with conventional therapy alone, Qigong in combination with conventional therapy significantly improved the following outcome measures: SDS score [mean difference (MD) -3.99, 95% CI (-6.17, -1.82), P < .001, I = 69%]; SAS score[MD -4.57, 95% CI (-5.67, -3.48), P < .001, I = 15%]; forced expiratory volume in one second/prediction (FEV1% pred) [MD 3.77, 95% CI (0.97,6.58), P < .01, I = 0]; forced expiratory volume in one second (FEV1) [MD 0.21, 95% CI (0.13, 0.30), P < .001, I = 0%]; forced vital capacity (FVC) [MD 0.28, 95% CI (0.16, 0.40), P < .001, I = 0]; 6-minute walk test (6MWT) distance [MD 39.31, 95% CI (18.27, 60.34), P < .001, I = 32%]; and St. George's Respiratory Questionnaire (SGRQ) total score [MD -11.42, 95% CI (-21.80, -1.03), P < .05, I = 72%]. CONCLUSION Qigong can improve the SDS and SAS scores of COPD patients, and has auxiliary effects on improving lung function, 6MWT distance, and SGRQ score.
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Affiliation(s)
- Jian-jun Wu
- The Third Affiliated Hospital of Beijing University of Chinese Medicine
| | - Ying-xue Zhang
- The Third Affiliated Hospital of Beijing University of Chinese Medicine
| | - Wei-sha Du
- The Third Affiliated Hospital of Beijing University of Chinese Medicine
| | | | - Rui-feng Jin
- The Third Affiliated Hospital of Beijing University of Chinese Medicine
| | - Hui-yong Yu
- The Third Affiliated Hospital of Beijing University of Chinese Medicine
| | - Jin-min Liu
- Dongfang Hospital Beijing University of Chinese Medicine
| | - Mei Han
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Reychler G, Poncin W, Montigny S, Luts A, Caty G, Pieters T. Efficacy of yoga, tai chi and qi gong on the main symptoms of chronic obstructive pulmonary disease: A systematic review. Respir Med Res 2019; 75:13-25. [PMID: 31235453 DOI: 10.1016/j.resmer.2019.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/19/2019] [Accepted: 04/08/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this systematic review was to summarize the effects of yoga, qi gong or tai chi in COPD patients. METHODS Studies evaluating effects of the selected complementary therapies on lung function, dyspnea, quality of life or functional exercise capacity in COPD patients were identified and reviewed from three databases. RESULTS Eighteen studies were included. Six studies evaluated the effects of yoga and the others focused on tai chi or qi gong separately or combined. The duration of the programs ranged from 6 weeks to 6 months and the frequency from 2 to 7 times a week. Each session reached 30 to 90 minutes. Benefits were observed on lung function and functional exercise capacity but benefit was clearly stated neither on quality of life nor on dyspnea. CONCLUSION This systematic review highlights the potential of these therapies as complementary therapeutic approach in COPD patients.
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Affiliation(s)
- G Reychler
- Institut de recherche expérimentale et clinique (irec), pôle de pneumologie, ORL & dermatologie, université Catholique de Louvain, Brussels, Belgium; Service de pneumologie, cliniques universitaires Saint-Luc, Brussels, Belgium; Haute école Leonard de Vinci-institut d'enseignement supérieur Parnasse-Deux Alice, Brussels, Belgium.
| | - W Poncin
- Institut de recherche expérimentale et clinique (irec), pôle de pneumologie, ORL & dermatologie, université Catholique de Louvain, Brussels, Belgium; Service de pneumologie, cliniques universitaires Saint-Luc, Brussels, Belgium.
| | - S Montigny
- Haute école Leonard de Vinci-institut d'enseignement supérieur Parnasse-Deux Alice, Brussels, Belgium.
| | - A Luts
- Département de psychiatrie adulte, cliniques universitaires Saint Luc, Brussels, Belgium.
| | - G Caty
- Service de médecine physique et réadaptation, cliniques universitaires Saint-Luc, Brussels, Belgium.
| | - T Pieters
- Institut de recherche expérimentale et clinique (irec), pôle de pneumologie, ORL & dermatologie, université Catholique de Louvain, Brussels, Belgium; Service de pneumologie, cliniques universitaires Saint-Luc, Brussels, Belgium.
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Kantatong T, Panpanich R, Deesomchok A, Sungkarat S, Siviroj P. Effects of the tai chi qigong programme on functional capacity, and lung function in chronic obstructive pulmonary disease patients: A ramdomised controlled trial. J Tradit Complement Med 2019; 10:354-359. [PMID: 32695652 PMCID: PMC7365785 DOI: 10.1016/j.jtcme.2019.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 11/18/2022] Open
Abstract
Although the beneficial effect of exercise on the health of Chronic Obstructive Pulmonary Disease (COPD) patients has been widely demonstrated, that of Tai Chi Qigong (TCQ), as an alternative exercise, has been inconclusive. Therefore, this study aimed to evaluate the effects of combined center-and home-based TCQ on functional capacity and lung function in patients with mildly and moderately severe COPD. A total of 50 patients, with a mild and moderate degree of COPD, were recruited and randomly assigned to either the TCQ (n = 25) or control group (n = 25). The TCQ group completed 12-week center-and 12-week home-based training. The control group attended a meeting class once a week for 12 weeks. Outcome measures were assessed at baseline, and the 6th, 12th and 24th week. The primary outcomes were functional capacity (6-min walk test; 6MWT) and lung function. The secondary outcomes were dyspnea score and quality of life. The TCQ group demonstrated significant improvement in functional capacity at week 12 and 24 (p < 0.05) and dyspnea score and quality of life at week 6, 12 and 24 (p < 0.05) when compared to baseline. Functional capacity, forced expiratory volume in 1st second (FEV1), dyspnea score, and quality of life were significantly better in the TCQ group from week 6 to week 24 when compared to the control group (p < 0.05). Combined center-and home-based TCQ training for patients with mildly and moderately severe COPD is effective in improving functional capacity, dyspnea score, and quality of life. This intervention was combind center-and home-base TCQ long term training. The participants are included the more homogeneity of COPD participants (mild and moderate degree of COPD). TCQ practice could be applied at home in mild or moderate degree of COPD. The benefical effect of TCQ training was demonstrated on outcomes only after 6 weeks of training.
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Affiliation(s)
- Tassawan Kantatong
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ratana Panpanich
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Athavudh Deesomchok
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Somporn Sungkarat
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Penprapa Siviroj
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Yilmaz Gokmen G, Akkoyunlu ME, Kilic L, Algun C. The Effect ofT'ai ChiandQigongTraining on Patients with Obstructive Sleep Apnea: A Randomized Controlled Study. J Altern Complement Med 2019; 25:317-325. [DOI: 10.1089/acm.2018.0197] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Gulhan Yilmaz Gokmen
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Bandirma, Turkey
| | - Muhammed Emin Akkoyunlu
- Sleep Disorders Center, Department of Pulmonology, Medical School, Bezmialem Vakif University, Istanbul, Turkey
| | - Lutfiye Kilic
- Pulmonary Rehabilitation Center, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Candan Algun
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Medipol University, Istanbul, Turkey
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Payne P, Fiering S, Zava D, Gould TJ, Brown A, Hage P, Gaudet C, Crane-Godreau M. Digital Delivery of Meditative Movement Training Improved Health of Cigarette-Smoke-Exposed Subjects. Front Public Health 2018; 6:282. [PMID: 30406067 PMCID: PMC6202937 DOI: 10.3389/fpubh.2018.00282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 09/12/2018] [Indexed: 12/11/2022] Open
Abstract
Many FA who flew prior to the ban on smoking in commercial aircraft exhibit an unusual pattern of long-term pulmonary dysfunction. This randomized controlled study tested the hypothesis that digitally delivered meditative movement (MM) training improves chronic obstructive pulmonary disease (COPD)-related symptoms in flight attendants (FA) who were exposed to second-hand cigarette smoke (SHCS) while flying. Phase I of this two-phase clinical trial was a single-arm non-randomized pilot study that developed and tested methods for MM intervention; we now report on Phase II, a randomized controlled trial comparing MM to a control group of similar FA receiving health education (HE) videos. Primary outcomes were the 6-min walk test and blood levels of high sensitivity C-reactive protein (hs-CRP). Pulmonary, cardiovascular, autonomic and affective measures were also taken. There were significant improvements in the 6-min walk test, the Multidimensional Assessment of Interoceptive Awareness (MAIA) score, and the COPD Assessment Test. Non-significant trends were observed for increased dehydroepiandrosterone sulfate (DHEAS) levels, decreased anxiety scores and reduced blood hs-CRP levels, and increased peak expiratory flow (PEF). In a Survey Monkey questionnaire, 81% of participants who completed pre and post-testing expressed mild to strong positive opinions of the study contents, delivery, or impact, while 16% expressed mild negative opinions. Over the course of the year including the study, participant adoption of the MM practices showed a significant and moderately large correlation with overall health improvement; Pearson's R = 0.62, p < 0.005. These results support the hypothesized benefits of video-based MM training for this population. No adverse effects were reported. Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT02612389
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Affiliation(s)
- Peter Payne
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, PA, United States
| | - Steven Fiering
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, PA, United States
| | - David Zava
- ZRT Laboratory, Beaverton, OR, United States
| | - Thomas J Gould
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, United States
| | - Anthony Brown
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Paul Hage
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Carole Gaudet
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, PA, United States
| | - Mardi Crane-Godreau
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, PA, United States
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Gendron LM, Nyberg A, Saey D, Maltais F, Lacasse Y. Active mind-body movement therapies as an adjunct to or in comparison with pulmonary rehabilitation for people with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2018; 10:CD012290. [PMID: 30306545 PMCID: PMC6517162 DOI: 10.1002/14651858.cd012290.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Active mind-body movement therapies (AMBMTs), including but not limited to yoga, tai chi, and qigong, have been applied as exercise modalities for people with chronic obstructive pulmonary disease (COPD). AMBMT strategies have been found to be more effective than usual care; however, whether AMBMT is inferior, equivalent, or superior to pulmonary rehabilitation (PR) in people with COPD remains to be determined. OBJECTIVES To assess the effects of AMBMTs compared with, or in addition to, PR in the management of COPD. SEARCH METHODS We searched the Cochrane Airways Group Specialised Register of trials and major Chinese databases, as well as trial registries from inception to July 2017. In addition, we searched references of primary studies and review articles. We updated this search in July 2018 but have not yet incorporated these results. SELECTION CRITERIA We included (1) randomised controlled trials (RCTs) comparing AMBMT (i.e. controlled breathing and/or focused meditation/attention interventions for which patients must actively move their joints and muscles for at least four weeks with no minimum intervention frequency) versus PR (any inpatient or outpatient, community-based or home-based rehabilitation programme lasting at least four weeks, with no minimum intervention frequency, that included conventional exercise training with or without education or psychological support) and (2) RCTs comparing AMBMT + PR versus PR alone in people with COPD. Two independent review authors screened and selected studies for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, extracted outcome data, and assessed risk of bias. We contacted study authors if necessary to ask them to provide missing data. We calculated mean differences (MDs) using a random-effects model. MAIN RESULTS We included in the meta-analysis 10 studies with 762 participants across one or more comparisons. The sample size of included studies ranged from 11 to 206 participants. Nine out of 10 studies involving all levels of COPD severity were conducted in China with adults from 55 to 88 years of age, a higher proportion of whom were male (78%). Nine out of 10 studies provided tai chi and/or qigong programmes as AMBMT, and one study provided yoga. Overall, the term 'PR' has been uncritically applied in the vast majority of studies, which limits comparison of AMBMT and PR. For example, eight out of 10 studies considered walking training as equal to PR and used this as conventional exercise training within PR. Overall study quality for main comparisons was moderate to very low mainly owing to imprecision, indirectness (exercise component inconsistent with recommendations), and risk of bias issues. The primary outcomes for our review were quality of life, dyspnoea, and serious adverse events.When researchers compared AMBMT versus PR alone (mainly unstructured walking training), statistically significant improvements in disease-specific quality of life (QoL) (St. George's Respiratory Questionnaire (SGRQ) total score) favoured AMBMT: mean difference (MD) -5.83, 95% confidence interval (CI) -8.75 to -2.92; three trials; 249 participants; low-quality evidence. The common effect size, but not the 95% CI around the pooled treatment effect, exceeded the minimal clinically important difference (MCID) of minus four. The COPD Assessment Test (CAT) also revealed statistically significant improvements favouring AMBMT over PR, with scores exceeding the MCID of three, with an MD of 6.58 units (95% CI -9.16 to - 4.00 units; one trial; 74 participants; low-quality evidence). Results show no between-group differences with regard to dyspnoea measured by the modified Medical Research Council Scale (MD 0.00 units, 95% CI -0.37 to 0.37; two trials; 127 participants; low-quality evidence), the Borg Scale (MD 0.44 units, 95% CI -0.88 to 0.00; one trial; 139 participants; low-quality evidence), or the Chronic Respiratory Questionnaire (CRQ) Dyspnoea Scale (MD -0.21, 95% CI -2.81 to 2.38; one trial; 11 participants; low-quality evidence). Comparisons of AMBMT versus PR alone did not include assessments of generic quality of life, adverse events, limb muscle function, exacerbations, or adherence.Comparisons of AMBMT added to PR versus PR alone (mainly unstructured walking training) revealed significant improvements in generic QoL as measured by Short Form (SF)-36 for both the SF-36 general health summary score (MD 5.42, 95% CI 3.82 to 7.02; one trial; 80 participants; very low-quality evidence) and the SF-36 mental health summary score (MD 3.29, 95% CI 1.45 to 4.95; one trial; 80 participants; very low-quality evidence). With regard to disease-specific QoL, investigators noted no significant improvement with addition of AMBMT to PR versus PR alone (SGRQ total score: MD -2.57, 95% CI -7.76 to 2.62 units; one trial; 192 participants; moderate-quality evidence; CRQ Dyspnoea Scale score: MD 0.04, 95% CI -2.18 to 2.26 units; one trial; 80 participants; very low-quality evidence). Comparisons of AMBMT + PR versus PR alone did not include assessments of dyspnoea, adverse events, limb muscle function, exacerbations, or adherence. AUTHORS' CONCLUSIONS Given the quality of available evidence, the effects of AMBMT versus PR or of AMBMT added to PR versus PR alone in people with stable COPD remain inconclusive. Evidence of low quality suggests better disease-specific QoL with AMBMT versus PR in people with stable COPD, and evidence of very low quality suggests no differences in dyspnoea between AMBMT and PR. Evidence of moderate quality shows that AMBMT added to PR does not result in improved disease-specific QoL, and evidence of very low quality suggests that AMBMT added to PR may lead to better generic QoL versus PR alone. Future studies with adequate descriptions of conventional exercise training (i.e. information on duration, intensity, and progression) delivered by trained professionals with a comprehensive understanding of respiratory physiology, exercise science, and the pathology of COPD are needed before definitive conclusions can be drawn regarding treatment outcomes with AMBMT versus PR or AMBMT added to PR versus PR alone for patients with COPD.
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Affiliation(s)
- Louis McCusky Gendron
- Université LavalInstitut Universitaire de Cardiologie et de Pneumologie de QuébecQuébecQCCanada
| | - Andre Nyberg
- Université LavalInstitut Universitaire de Cardiologie et de Pneumologie de QuébecQuébecQCCanada
| | - Didier Saey
- Université LavalInstitut Universitaire de Cardiologie et de Pneumologie de QuébecQuébecQCCanada
| | - François Maltais
- Université LavalInstitut Universitaire de Cardiologie et de Pneumologie de QuébecQuébecQCCanada
| | - Yves Lacasse
- Université LavalInstitut Universitaire de Cardiologie et de Pneumologie de QuébecQuébecQCCanada
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Li P, Liu J, Lu Y, Liu X, Wang Z, Wu W. Effects of long-term home-based Liuzijue exercise combined with clinical guidance in elderly patients with chronic obstructive pulmonary disease. Clin Interv Aging 2018; 13:1391-1399. [PMID: 30122911 PMCID: PMC6080664 DOI: 10.2147/cia.s169671] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Purpose This study was designed to investigate the effects of long-term home-based Liuzijue exercise combined with clinical guidance in elderly patients with chronic obstructive pulmonary disease (COPD). Methods Forty patients with COPD at stages II–III of the Global Initiative for Chronic Obstructive Lung Disease were enrolled. The subjects were randomly allocated to the Liuzijue exercise group (LG) or control group (CG) in a 1:1 ratio. Participants in the LG performed six Liuzijue training sessions, including 4 days at home and 2 days in the hospital with clinical guidance for 60 minutes/day for 6 months. Participants in the CG conducted no exercise intervention. In addition, lung function test, 6-minute walking test (6MWT), 30-second sit-to-stand test (30 s SST), and the St George’s Respiratory Questionnaire (SGRQ) were conducted at the baseline and at the end of the intervention. Results Thirty-six patients completed the study. The patients’ lung function improved significantly (p < 0.05) in the LG as well as the 6MWT, 30 s SST, and SGRQ score (p < 0.01). While the SGRQ total score, activity, and impact scores increased significantly (p < 0.05) in the CG. In addition, there were significant differences between the groups (p < 0.01) in regard to the values of forced expiratory volume in 1 second as a percentage of the predicted volume, 6MWT, 30 s SST, and SGRQ. Conclusions Long-term home-based Liuzijue exercise combined with clinical guidance can effectively improve the pulmonary function, exercise capacity, and quality of life of elderly patients with moderate to severe COPD.
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Affiliation(s)
- Peijun Li
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, People's Republic of China,
| | - Jingxin Liu
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, People's Republic of China,
| | - Yufan Lu
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, People's Republic of China,
| | - Xiaodan Liu
- School of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Zhenwei Wang
- Department of Respiratory Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, People's Republic of China
| | - Weibing Wu
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, People's Republic of China,
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Wu W, Liu X, Li P, Li N, Wang Z. Effect of Liuzijue Exercise Combined with Elastic Band Resistance Exercise on Patients with COPD: A Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:2361962. [PMID: 29991952 PMCID: PMC6016162 DOI: 10.1155/2018/2361962] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/24/2018] [Accepted: 04/30/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study aimed to investigate the effect of Liuzijue exercise combined with elastic band resistance exercise on patients with chronic obstructive pulmonary disease (COPD) to provide a convenient, safe, and cost-effective exercise. METHODS Subjects were randomly divided into the control group (CG), the Liuzijue exercise group (LG), and the Liuzijue exercise combined with elastic band resistance exercise group (LEG), with 20 patients in each group. The LG performed Liuzijue exercise six times a week (two exercise sessions in the hospital and four exercise sessions at home). The LEG includes Liuzijue exercise similar to the LG and elastic band resistance exercise three times a week, with elastic band exercise implemented after Liuzijue exercise. Spirometry, 6-minute walking test (6MWT), 30-second sit-to-stand test (30 s SST), handgrip strength test, and St. George's Respiratory Questionnaire (SGRQ) were performed at baseline and at the end of intervention. RESULTS After six-month intervention, the forced expiratory volume in 1 second (% predicted), 6-minute walking distance (6MWD), 6MWD%pred, 30 s SST, and SGRQ were significantly improved in the intervention groups (p < 0.01) and handgrip strength was increased significantly in the LG and LEG (p = 0.03 and p = 0.001, respectively). Furthermore, improvements in 6MWD and SGRQ were distinguished in the intervention groups compared with the CG (p < 0.01). No difference was significant in all of the outcomes between the LG and the LEG. CONCLUSIONS The intervention program of Liuzijue exercise combined with elastic band resistance exercise and Liuzijue exercise only has beneficial effects on COPD patients especially in the aspect of exercise capacity and quality of life.
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Affiliation(s)
- Weibing Wu
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Xiaodan Liu
- School of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Peijun Li
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Ning Li
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Zhenwei Wang
- Department of Respiratory Medicine, Yue-Yang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
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Wu W, Liu X, Liu J, Li P, Wang Z. Effectiveness of water-based Liuzijue exercise on respiratory muscle strength and peripheral skeletal muscle function in patients with COPD. Int J Chron Obstruct Pulmon Dis 2018; 13:1713-1726. [PMID: 29872289 PMCID: PMC5973471 DOI: 10.2147/copd.s165593] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objects The purpose of this study was to quantitatively assess the effects of water-based Liuzijue exercise on patients with COPD and compare it with land-based Liuzijue exercise. Materials and methods Participants were randomly allocated to one of three groups: the water-based Liuzijue exercise group (WG), the land-based Liuzijue exercise group (LG), and the control group (CG). CG participants accepted no exercise intervention, while training groups performed Liuzijue exercise according to Health Qigong Liuzijue (People's Republic of China) in different environments for 60-min sessions twice a week for 3 months. Results Of the 50 patients enrolled, 45 (90%) completed the 3-month intervention. The CG showed decreased expiratory muscle strength, extensor and flexor endurance ratio (ER) of the elbow joints and flexor peak torque (PT), total work (TW), and ER of the knee joints (p<0.05). Both training groups showed improved respiratory muscle strength, which differed from the CG (p<0.001). In addition, extensor and flexor TW of the elbow joints in the training groups were increased (p<0.01), and the WG differed from the CG in extensor TW and ER and flexor TW (p<0.01), while the LG differed from the CG in flexor TW and extensor ER (p<0.05). PT, PT/body weight (BW), and TW in the knee joint extensor in the training groups were increased as well (PT and PT/BW: p<0.05, TW: p<0.01), and the WG differed from the CG in terms of knee joints outcomes, while the LG differed from the CG in flexor TW only (p<0.05). Conclusion Water-based Liuzijue exercise has beneficial effects on COPD patients' respiratory muscle strength and peripheral skeletal muscle function, and additional benefits may exist in endurance of upper limbs and strength and endurance of lower limbs when compared with land-based Liuzijue exercise.
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Affiliation(s)
- Weibing Wu
- Department of Sports Medicine, Shanghai University of Sport
| | - Xiaodan Liu
- School of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine
| | - Jingxin Liu
- Department of Sports Medicine, Shanghai University of Sport
| | - Peijun Li
- Department of Sports Medicine, Shanghai University of Sport
| | - Zhenwei Wang
- Department of Respiratory Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, People’s Republic of China
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Zhu S, Shi K, Yan J, He Z, Wang Y, Yi Q, Huang H. A modified 6-form Tai Chi for patients with COPD. Complement Ther Med 2018; 39:36-42. [PMID: 30012390 DOI: 10.1016/j.ctim.2018.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 04/30/2018] [Accepted: 05/16/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE 24-form Tai Chi is a traditional exercise popular among old people in China, but it has some complex movements beyond of capabilities of patients with COPD. This study was to modify and simplify 24-form Tai Chi and evaluate effects of the modified Tai Chi on lung function, exercise capacity, dyspnea symptom and health status in patients with COPD. METHODS A two-step procedure was applied: an initial qualitative research module consisting of focus group discussion, expert consultation and patient interviews was conducted to simplified and modified 24-form Tai Chi for patients with COPD. Then, a randomized controlled trial consisting of 60 patients with II to IV COPD was conducted to evaluate effects of the modified Tai Chi on lung function (FEV1%), exercise capacity (Six minutes walking distance,6MWD), dyspnea symptom (Modified Medical Research Council Scale, mMRC) and health status (COPD Assessment Test, CAT). All measures were obtained at baseline, 3-month follow-up and 9-month follow-up. RESULTS A new simpler 6-form Tai Chi that combining characteristics of COPD, the experts' wisdom and patients' needs was developed. Patients with COPD can grasp it in about 3 h and participants showed 86.0% adherence to the Tai Chi training and no negative accidents occurred. Generalized estimating equations (GEE) showed that there were significant differences in FEV1%, 6MWD and CAT scores between modified Tai Chi (MTC) group and the control group over time (model group × time interaction χ2 = 13.68, P < 0.001; χ2 = 192.39, P < 0.001;χ2 = 6.05, P = 0.014, respectively), however, no statistical significance in mMRC scores was found between the 2 groups over time (model group × time interaction χ2 = 3.54, P = 0.06). The baseline of FEV1%,6MWD, mMRC scores and CAT scores are significant covariates for lung function, exercise capacity, dyspnea symptom and health status, respectively (χ2 = 149.43, P < 0.001; χ2 = 5.78, P = 0.016; χ2 = 66.71, P < 0.001; χ2 = 81.83, P < 0.001, respectively). CONCLUSIONS This modified 6-form Tai Chi routine is easy to grasp, easy to adhere to, safe to practice and effective to improve lung function, exercise capacity, health status and to prevent dyspnea symptom from getting worse for patients with COPD and it can be recommended as a suitable exercise therapy for them.
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Affiliation(s)
- Sucui Zhu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Kun Shi
- Interpreter Services Michigan Medicine University of Michigan, Ann Arbor, USA
| | - Jin Yan
- The Third Xiangya Hospital, Central South University, Changsha, China.
| | - Zhiping He
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yan Wang
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qifeng Yi
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hui Huang
- The Third Xiangya Hospital, Central South University, Changsha, China
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Salcedo PA, Lindheimer JB, Klein-Adams JC, Sotolongo AM, Falvo MJ. Effects of Exercise Training on Pulmonary Function in Adults With Chronic Lung Disease: A Meta-Analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2018; 99:2561-2569.e7. [PMID: 29678450 DOI: 10.1016/j.apmr.2018.03.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/28/2018] [Accepted: 03/17/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To quantify the effect of exercise training on indices of pulmonary function in adults with chronic lung disease using meta-analytic techniques. DATA SOURCES Eligible trials were identified using a systematic search of MEDLINE, Web of Science, Physiotherapy Evidence Database, and GoogleScholar databases. STUDY SELECTION Randomized controlled trials that evaluated pulmonary function before and after whole-body exercise training among adult patients (aged ≥19y) with chronic lung disease were included. DATA EXTRACTION Data were independently extracted from each study by 3 authors. Random-effects models were used to aggregate a mean effect size (Hedges' d; Δ) and 95% confidence interval (CI), and multilevel linear regression with robust maximum likelihood estimation was used to adjust for potential nesting effects. DATA SYNTHESIS Among 2923 citations, a total of 105 weighted effects from 21 randomized controlled trials were included. After adjusting for nesting effects, exercise training resulted in a small (Δ=.18; 95% CI, .07-.30) and significant (P=.002) improvement in a composite measure of pulmonary function. Tests of heterogeneity of the mean effect size were nonsignificant. CONCLUSIONS Contrary to prior assumptions, whole-body exercise training is effective for improving pulmonary function in adults with chronic lung disease, particularly spirometric indices. Subsequent studies are necessary to determine the optimal exercise training characteristics to maximize functional improvement.
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Affiliation(s)
- Pablo A Salcedo
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ; New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ
| | - Jacob B Lindheimer
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ; Department of Kinesiology, University of Wisconsin-Madison, Madison, WI
| | - Jacquelyn C Klein-Adams
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ
| | - Anays M Sotolongo
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ
| | - Michael J Falvo
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ; New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ.
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Wu LL, Lin ZK, Weng HD, Qi QF, Lu J, Liu KX. Effectiveness of meditative movement on COPD: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis 2018; 13:1239-1250. [PMID: 29713157 PMCID: PMC5909800 DOI: 10.2147/copd.s159042] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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.
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Affiliation(s)
- Lu-Ling Wu
- Department of Respiratory Medicine, Fuzhou Pulmonary Hospital, Fuzhou, People's Republic of China
| | - Zheng-Kun Lin
- Department of Rehabilitation, No. 175 Hospital of PLA, Zhangzhou, Fujian, People's Republic of China
| | - Hui-Dan Weng
- Postgraduate Institute of Fujian Medical University, Fuzhou, People's Republic of China
| | - Qiao-Fang Qi
- Department of Respiratory Medicine, Fuzhou Pulmonary Hospital, Fuzhou, People's Republic of China
| | - Jun Lu
- Department of Medical Oncology, Fuzhou Pulmonary Hospital, Fuzhou, People's Republic of China
| | - Kai-Xiong Liu
- Department of Respiratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
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Wayne PM, Gagnon MM, Macklin EA, Travison TG, Manor B, Lachman M, Thomas CP, Lipsitz LA. The Mind Body-Wellness in Supportive Housing (Mi-WiSH) study: Design and rationale of a cluster randomized controlled trial of Tai Chi in senior housing. Contemp Clin Trials 2017; 60:96-104. [PMID: 28694204 PMCID: PMC5639896 DOI: 10.1016/j.cct.2017.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/28/2017] [Accepted: 07/03/2017] [Indexed: 02/08/2023]
Abstract
Supporting the health of growing numbers of frail older adults living in subsidized housing requires interventions that can combat frailty, improve residents' functional abilities, and reduce their health care costs. Tai Chi is an increasingly popular multimodal mind-body exercise that incorporates physical, cognitive, social, and meditative components in the same activity and offers a promising intervention for ameliorating many of the conditions that lead to poor health and excessive health care utilization. The Mind Body-Wellness in Supportive Housing (Mi-WiSH) study is an ongoing two-arm cluster randomized, attention-controlled trial designed to examine the impact of Tai Chi on functional indicators of health and health care utilization. We are enrolling participants from 16 urban subsidized housing facilities (n=320 participants), conducting the Tai Chi intervention or education classes and social calls (attention control) in consenting subjects within the facilities for one year, and assessing these subjects at baseline, 6months, and 1year. Physical function (quantified by the Short Physical Performance Battery), and health care utilization (emergency visits, hospitalizations, skilled nursing and nursing home admissions), assessed at 12months are co-primary outcomes. Our discussion highlights our strategy to balance pragmatic and explanatory features into the study design, describes efforts to enhance site recruitment and participant adherence, and summarizes our broader goal of post study dissemination if effectiveness and cost-effectiveness are demonstrated, by preparing training and protocol manuals for use in housing facilities across the U.S.
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Affiliation(s)
- Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States.
| | - Margaret M Gagnon
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States.
| | - Eric A Macklin
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
| | - Thomas G Travison
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States.
| | - Bradley Manor
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States.
| | - Margie Lachman
- Department of Psychology, Brandeis University, Waltham, MA, United States.
| | - Cindy P Thomas
- The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States.
| | - Lewis A Lipsitz
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States.
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Zhang HL, Li JS, Yu XQ, Li SY, Halmurat U, Xie Y, Wang YF, Li FS, Wang MH. An evaluation of activity tolerance, patient-reported outcomes and satisfaction with the effectiveness of pulmonary daoyin on patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2017; 12:2333-2342. [PMID: 28831250 PMCID: PMC5552142 DOI: 10.2147/copd.s117461] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Pulmonary Daoyin (PD) (evolved from ancient Chinese daoyin skills), is a rehabilitation technology that combines specially designed movements of the arms and body and controlled breathing exercises, to improve the physiological and psychological status of patients with chronic respiratory disease. Pulmonary rehabilitation is effective for patients with chronic obstructive pulmonary disease (COPD), and the efficacy of PD is unknown. The aim of this study is to investigate the effect of a PD program in enhancing activity tolerance, patient-reported outcomes and satisfaction with the effectiveness on patients with COPD. MATERIALS AND METHODS The multi-center, randomized controlled trial was conducted from November 2011 to June 2012 in local communities in cities of the 11 research centers in China. It included COPD patients (moderate to very severe) who were recruited from an outpatient clinic. A randomized controlled study included 464 COPD patients who were randomly allocated either to the PD group, participating in a 3-month, ten times-weekly supervised PD-based pulmonary rehabilitation program, or to a control group continuing with regular medical treatment alone. Data were gathered using the 6-minute walking distance (6MWD) test, COPD patient-reported outcomes (COPD-PRO) and Effectiveness Satisfaction Questionnaire for COPD (ESQ-COPD), which was filled out at baseline and 3 months post-intervention. SAS 9.2 was used for statistical analysis. RESULTS Of the 464 patients in the study, 461 were included in the full analysis set (FAS); 429 were in the per-protocol analysis set (PPS). After 3-month intervention, there was a significant difference between the two groups in 6MWD (FAS; P=0.049; PPS; P=0.041), total score and all domains of COPD-PRO (FAS; P=0.014; PPS; P=0.003) and ESQ-COPD (FAS; P=0.038; PPS; P<0.001). CONCLUSIONS The PD program was able to improve the activity tolerance level and satisfaction of COPD patients because of its effectiveness.
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Affiliation(s)
- Hai-Long Zhang
- Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese Medicine Development of Henan Province, Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China.,Department of Respiratory, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China
| | - Jian-Sheng Li
- Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese Medicine Development of Henan Province, Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China.,The Geriatric Department, Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China
| | - Xue-Qing Yu
- Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese Medicine Development of Henan Province, Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China.,Department of Respiratory, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China
| | - Su-Yun Li
- Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese Medicine Development of Henan Province, Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China.,Department of Respiratory, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China
| | - Upur Halmurat
- Department of Traditional Uygur Medicine, Xinjiang Medical University, Urumqi, People's Republic of China
| | - Yang Xie
- Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese Medicine Development of Henan Province, Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China.,Department of Respiratory, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China
| | - Yan-Fang Wang
- Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese Medicine Development of Henan Province, Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China.,Department of Respiratory, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China
| | - Feng-Sen Li
- Laboratory of Pulmonary Physiology and Pathology, Traditional Chinese Medicine Hospital affiliated with Xinjiang Medical University, Urumqi, People's Republic of China
| | - Ming-Hang Wang
- Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese Medicine Development of Henan Province, Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China.,Department of Respiratory, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China
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Payne P, Fiering S, Leiter JC, Zava DT, Crane-Godreau MA. Effectiveness of a Novel Qigong Meditative Movement Practice for Impaired Health in Flight Attendants Exposed to Second-Hand Cigarette Smoke. Front Hum Neurosci 2017; 11:67. [PMID: 28270757 PMCID: PMC5318411 DOI: 10.3389/fnhum.2017.00067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 02/01/2017] [Indexed: 12/12/2022] Open
Abstract
This single-arm non-randomized pilot study explores an intervention to improve the health of flight attendants (FA) exposed to second-hand cigarette smoke prior to the smoking ban on commercial airlines. This group exhibits an unusual pattern of long-term pulmonary dysfunction. We report on Phase I of a two-phase clinical trial; the second Phase will be a randomized controlled trial testing digital delivery of the intervention. Subjects were recruited in the Northeastern US; testing and intervention were administered in 4 major cities. The intervention involved 12 h of training in Meditative Movement practices. Based on recent research on the effects of nicotine on fear learning, and the influence of the autonomic nervous system on immune function, our hypothesis was that this training would improve autonomic function and thus benefit a range of health measures. Primary outcomes were the 6-min walk test and blood levels of C-reactive protein. Pulmonary, cardiovascular, autonomic, and affective measures were also taken. Fourteen participants completed the training and post-testing. There was a 53% decrease in high sensitivity C-Reactive Protein (p ≤ 0.05), a 7% reduction in systolic blood pressure (p ≤ 0.05), a 13% increase in the 6-min walk test (p ≤ 0.005), and significant positive changes in several other outcomes. These results tend to confirm the hypothesized benefits of MM training for this population, and indicate that autonomic function may be important in the etiology and treatment of their symptoms. No adverse effects were reported. This trial is registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT02612389/), and is supported by a grant from the Flight Attendant Medical Research Institute (FAMRI).
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Affiliation(s)
- Peter Payne
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth Lebanon, NH, USA
| | - Steven Fiering
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth Lebanon, NH, USA
| | - James C Leiter
- Department of Molecular and System Biology, Geisel School of Medicine at Dartmouth Lebanon, NH, USA
| | | | - Mardi A Crane-Godreau
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth Lebanon, NH, USA
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A comparison of the effects of medical Qigong and standard exercise therapy on symptoms and quality of life in patients with advanced cancer. Support Care Cancer 2017; 25:1749-1758. [PMID: 28102437 DOI: 10.1007/s00520-017-3579-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 01/09/2017] [Indexed: 02/05/2023]
Abstract
PURPOSE Patients with advanced cancer frequently experience anxiety, depression and poor quality of life (QOL), as well as physical symptoms such as fatigue and weakness. Physical exercise has potential to help control these symptoms but the optimal training prescription is still not clear. We performed a study comparing medical Qigong (QG) and standard endurance and strength training (SET) in patients with advanced stage non-small cell lung (NSCLC) and gastrointestinal (GI) cancers. METHODS A randomized, cross-over study was performed in patients with advanced NSCLC and GI cancers receiving or eligible for chemotherapy. Patients received supervised QG or SET twice-weekly for 6 weeks. Psychological functioning, QOL, symptoms and physical functioning were assessed before and after each intervention period. RESULTS Nineteen patients completed both interventions. Comparing interventions revealed no difference between QG and SET on change in anxiety or depression scores or QOL. However, SET treatment was better at improving perceived strength (P = 0.05) and walking distance (P = 0.02). The order in which interventions were performed had a significant impact on the improvement in certain symptoms (sleep quality, breathlessness, P < 0.05), QOL (P = 0.01) and walking distance (P = 0.008). In all cases, the beneficial effects of the exercise interventions were markedly reduced during the second interval. CONCLUSIONS QG and SET are equivalent in their impact on many aspects of psychological function in cancer patients. However, SET leads to greater improvements in exercise capacity and helps reduce some symptoms. The reduction in beneficial effect of SET on exercise function when offered as the second intervention is a new finding that warrants further study.
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Luo X, Zhang J, Castelberg R, Wu T, Yu P, He C, Wang P. The Effects of Traditional Chinese Exercise in Patients with Chronic Obstructive Pulmonary Disease: A Meta-Analysis. PLoS One 2016; 11:e0161564. [PMID: 27589054 PMCID: PMC5010221 DOI: 10.1371/journal.pone.0161564] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 08/08/2016] [Indexed: 02/05/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. However, several studies that have assessed the role of traditional Chinese exercise in the management of this disease include broad variations in sample sizes and results. Therefore, this meta-analysis was conducted to assess the effects of traditional Chinese exercise on patients with COPD. Methods Two investigators independently identified and extracted data from selected articles. A computerized search of electronic databases through August 2015 was conducted. Mean differences (MDs) and 95% confidence intervals (CIs) were calculated to analyze the combined data. The methodological quality was evaluated using the Cochrane risk-of-bias tool. Heterogeneity was assessed with the I2 test. Results Ten randomized, controlled trials (RCTs) involving 622 patients met the inclusion criteria. There were significant improvements in the 6-minute walking distance test (6 MWD;MWD = 12.10 m; 95% CI, 7.56–16.65 m; p<0.001); forced expiratory volume in one second (FEV1% predicted; WMD = 9.02; 95% CI, 6.80–11.23; p<0.00001); forced expiratory volume in 1 second/forced vital capacity (FEV(1)/FVC) ratio (Tiffenau Index; WMD = 6.67; 95% CI, 5.09–8.24; p<0.00001); and quality of life, as evaluated by the Chronic Respiratory Disease Questionnaire (CRDQ; WMD = 0.85 score; 95% CI, 0.52–1.18; p<0.00001). Conclusions Traditional Chinese exercise could provide an effective alternative method for managing COPD. Larger and higher-quality trials are required.
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Affiliation(s)
- Xiaotian Luo
- Department of Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
- Department of Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan, PR China
| | - Jifeng Zhang
- Department of General surgery Medicine, Datong Second People’s Hospital, Datong, Shanxi, PR China
| | - Rachel Castelberg
- Department of Physical Therapy, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, United States of America
| | - Tao Wu
- Department of Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
| | - Pengming Yu
- Department of Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
| | - Chengqi He
- Department of Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
- Department of Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan, PR China
- * E-mail: (PW); (CQH)
| | - Pu Wang
- Department of Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
- Department of Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan, PR China
- * E-mail: (PW); (CQH)
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Fu JJ, Min J, Yu PM, McDonald VM, Mao B. Study design for a randomised controlled trial to explore the modality and mechanism of Tai Chi in the pulmonary rehabilitation of chronic obstructive pulmonary disease. BMJ Open 2016; 6:e011297. [PMID: 27491669 PMCID: PMC4985849 DOI: 10.1136/bmjopen-2016-011297] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/22/2016] [Accepted: 07/13/2016] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Although pulmonary rehabilitation (PR) is associated with significant clinical benefits in chronic obstructive pulmonary disease (COPD) and has been recommended by guidelines, PR with conventional exercise training has not been widely applied in the clinic because of its inherent limitations. Alternative exercise such as Tai Chi has been investigated and the results are promising. However, the strengths and weaknesses of the exercise modality of Tai Chi, conventional PR and a combination of Tai Chi and conventional PR and the possible mechanisms underlying Tai Chi exercise remain unclear. This study aims to address the above research gaps in a well-designed clinical trial. METHODS AND ANALYSIS This study is a single-blind, randomised controlled trial. Participants with stable COPD will be recruited and randomly assigned to one of four groups receiving Tai Chi exercise, conventional PR using a total body recumbent stepper (TBRS), combined Tai Chi and TBRS, or usual care (control) in a 1:1:1:1 ratio. Participants will perform 30 min of supervised exercise three times a week for 8 weeks; they will receive sequential follow-ups until 12 months after recruitment. The primary outcome will be health-related quality of life as measured by the St George's Respiratory Questionnaire. Secondary outcomes will include 6 min walking distance, pulmonary function, the modified Medical Research Council Dyspnoea Scale, the COPD Assessment Test, the Hospital Anxiety and Depression Scale, the Berg Balance Scale, exacerbation frequency during the study period, and systemic inflammatory and immune markers. ETHICS AND DISSEMINATION Ethics approval has been granted by the Clinical Trial and Biomedical Ethics Committee of West China Hospital of Sichuan University (No TCM-2015-82). Written informed consent will be obtained from each participant before any procedures are performed. The study findings will be published in peer-reviewed journals and presented at national and international conferences. TRIAL REGISTRATION NUMBER ChiCTR-IOR-15006874; Pre-results.
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Affiliation(s)
- Juan-Juan Fu
- Respiratory Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Min
- Respiratory Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Peng-Ming Yu
- Department of Rehabilitation, West China Hospital, Sichuan University, Chengdu, China
| | - Vanessa M McDonald
- Priority Research Centre for Asthma and Respiratory Diseases, University of Newcastle, Newcastle, New South Wales, Australia
- Faculty of Health, School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| | - Bing Mao
- Respiratory Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
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Zhang M, Xv G, Luo C, Meng D, Ji Y. Qigong Yi Jinjing Promotes Pulmonary Function, Physical Activity, Quality of Life and Emotion Regulation Self-Efficacy in Patients with Chronic Obstructive Pulmonary Disease: A Pilot Study. J Altern Complement Med 2016; 22:810-817. [PMID: 27487437 DOI: 10.1089/acm.2015.0224] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The purpose of this pilot study was to examine the effect of a Chinese traditional exercise program, Qigong Yi Jinjing (QYJJ), on patients with chronic obstructive pulmonary disease (COPD). METHODS One hundred and thirty eligible COPD patients were randomly divided into three groups: the QYJJ group (n = 42), the self-management exercise group (n = 43), and the control group (n = 45). Data were collected and analyzed at baseline and again at one, three, and six months. A pulmonary rehabilitation index, consisting of pulmonary function, six-minute walk test, Regulatory Emotion Self-Efficacy questionnaire, and exercise of the COPD Assessment Test widely used to evaluate health-related quality of life (HRQL) in participants with COPD, was measured. RESULTS Compared with the other groups, participants in QYJJ group had significantly better lung function (forced expiratory volume in one second: F = 8.96, p = 0.000; forced expiratory volume in one second/forced vital capacity: F = 11.55, p = 0.000; the percentage of forced expiratory volume in one second in prediction: F = 24.27, p = 0.000); walked a longer distance (F = 152.52, p = 0.000), and had more satisfactory HRQL (F = 14.08, p = 0.000). QYJJ training also contributed to improving the ability of emotion regulation (F = 36.56, p = 0.000). There were significant positive changes in expressing positive affect (F = 56.25, p = 0.000) and managing despondency/distress (F = 21.58, p = 0.000), apart from the ability to regulate anger/irritation (F = 1.20, p = 0.305). The longer QYJJ is practiced, the more effective the influence is on the pulmonary rehabilitation-related index measures. CONCLUSIONS These results indicate that QYJJ exercise produced positive effects on pulmonary function, physical activity, emotion regulation self-efficiency (modulating the expression of despondency or distress and experiencing and expressing positive affect), and HRQL in patients with COPD.
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Affiliation(s)
- Min Zhang
- 1 Nursing College, Nanjing University of Chinese Medicine , Nanjing, China .,2 Department of Nursing, Medical College of Jiangsu University , Zhenjiang, China
| | - Guihua Xv
- 1 Nursing College, Nanjing University of Chinese Medicine , Nanjing, China
| | - Caifeng Luo
- 2 Department of Nursing, Medical College of Jiangsu University , Zhenjiang, China
| | - DiJuan Meng
- 1 Nursing College, Nanjing University of Chinese Medicine , Nanjing, China
| | - Yan Ji
- 3 Nursing College, Nanjing Medical University , Nanjing, China
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Abstract
BACKGROUND 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. OBJECTIVES • To explore the effectiveness of Tai Chi in reducing dyspnoea and improving exercise capacity in people with COPD.• To determine the influence of Tai Chi on physiological and psychosocial functions among people with COPD. SEARCH METHODS We searched the Cochrane Airways Group Specialised Register of trials (which included the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED) and PsycINFO); handsearched respiratory journals and meeting abstracts; and searched Chinese medical databases including Wanfang Data, Chinese Medical Current Contents (CMCC), Chinese Biomedical Database (CBM), China Journal Net (CJN) and China Medical Academic Conference (CMAC), from inception to September 2015. We checked the reference lists of all primary studies and review articles for relevant additional references. SELECTION CRITERIA 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. MAIN RESULTS 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; I(2) = 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; I(2) = 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. AUTHORS' CONCLUSIONS 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.
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Affiliation(s)
- Shirley PC Ngai
- The Hong Kong Polytechnic UniversityDepartment of Rehabilitation SciencesHong KongChina
| | - Alice YM Jones
- The University of SydneyFaculty of Health SciencesSydneyAustralia
| | - Wilson Wai San Tam
- National University of SingaporeAlice Lee Centre for Nursing Studies, Yong Loo Lin School of MedicineSingaporeSingapore
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Zhang LL, Wang SZ, Chen HL, Yuan AZ. Tai Chi Exercise for Cancer-Related Fatigue in Patients With Lung Cancer Undergoing Chemotherapy: A Randomized Controlled Trial. J Pain Symptom Manage 2016; 51:504-11. [PMID: 26721747 DOI: 10.1016/j.jpainsymman.2015.11.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 10/31/2015] [Accepted: 11/09/2015] [Indexed: 11/20/2022]
Abstract
CONTEXT Tai Chi is a traditional Chinese health-promoting exercise. It has been shown to enhance mental health and improve psychological condition. OBJECTIVES We aimed to assess the effectiveness of Tai Chi exercise for cancer-related fatigue in patients with lung cancer undergoing chemotherapy. METHODS We conducted a randomized trial of Tai Chi exercise as compared with low-impact exercise as a control intervention. Exercises were practiced every other day, a one-hour session for 12 weeks for each of the study groups. The primary end point was a change in total score of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Secondary end points were changes in five subscale scores of the MFSI-SF. All assessments were repeated at three time points, T0: before first course of chemotherapy; T1: before third course of chemotherapy; and T2: at the end of the fourth course of chemotherapy. RESULTS Between January 2012 and December 2014, 96 patients were enrolled in this trial. At six and 12 weeks, the Tai Chi group had a lower MFSI-SF total score compared with the control group (59.5 ± 11.3 vs. 66.8 ± 11.9, P < 0.05; 53.3 ± 11.8 vs. 59.3 ± 12.2, P < 0.05). At six weeks, the Tai Chi group had lower MFSI-SF general subscale scores (18.1 ± 4.6 vs. 20.4 ± 4.5, P < 0.05) and physical subscale scores (17.5 ± 4.4 vs. 19.1 ± 4.5, P < 0.05), and higher MFSI-SF vigor subscale scores (14.5 ± 3.3 vs. 11.6 ± 3.4, P < 0.05), compared with the control group. But no significant differences were found in emotional subscale (20.2 ± 3.6 vs. 20.0 ± 3.5, P > 0.05) and mental subscale (18.2 ± 4.0 vs. 18.9 ± 3.9, P > 0.05) scores between the Tai Chi group and the control group. At 12 weeks, the MFSI-SF subscale scores showed the same trends as at six weeks. CONCLUSION Tai Chi is an effective intervention for managing cancer-related fatigue in patients with lung cancer undergoing chemotherapy, especially for decreasing general fatigue and physical fatigue, and increasing vigor.
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Affiliation(s)
- Li-Li Zhang
- Department of Respiratory Medicine, Taizhou People's Hospital, Taizhou, Jiangsu, China
| | - Su-Zhen Wang
- Department of Nursing, Taizhou People's Hospital, Taizhou, Jiangsu, China
| | | | - A-Zhen Yuan
- Department of Nursing, Taizhou People's Hospital, Taizhou, Jiangsu, China.
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Jordan RE, Majothi S, Heneghan NR, Blissett DB, Riley RD, Sitch AJ, Price MJ, Bates EJ, Turner AM, Bayliss S, Moore D, Singh S, Adab P, Fitzmaurice DA, Jowett S, Jolly K. Supported self-management for patients with moderate to severe chronic obstructive pulmonary disease (COPD): an evidence synthesis and economic analysis. Health Technol Assess 2016; 19:1-516. [PMID: 25980984 DOI: 10.3310/hta19360] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Self-management (SM) support for patients with chronic obstructive pulmonary disease (COPD) is variable in its coverage, content, method and timing of delivery. There is insufficient evidence for which SM interventions are the most effective and cost-effective. OBJECTIVES To undertake (1) a systematic review of the evidence for the effectiveness of SM interventions commencing within 6 weeks of hospital discharge for an exacerbation for COPD (review 1); (2) a systematic review of the qualitative evidence about patient satisfaction, acceptance and barriers to SM interventions (review 2); (3) a systematic review of the cost-effectiveness of SM support interventions within 6 weeks of hospital discharge for an exacerbation of COPD (review 3); (4) a cost-effectiveness analysis and economic model of post-exacerbation SM support compared with usual care (UC) (economic model); and (5) a wider systematic review of the evidence of the effectiveness of SM support, including interventions (such as pulmonary rehabilitation) in which there are significant components of SM, to identify which components are the most important in reducing exacerbations, hospital admissions/readmissions and improving quality of life (review 4). METHODS The following electronic databases were searched from inception to May 2012: MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Science Citation Index [Institute of Scientific Information (ISI)]. Subject-specific databases were also searched: PEDro physiotherapy evidence database, PsycINFO and the Cochrane Airways Group Register of Trials. Ongoing studies were sourced through the metaRegister of Current Controlled Trials, International Standard Randomised Controlled Trial Number database, World Health Organization International Clinical Trials Registry Platform Portal and ClinicalTrials.gov. Specialist abstract and conference proceedings were sourced through ISI's Conference Proceedings Citation Index and British Library's Electronic Table of Contents (Zetoc). Hand-searching through European Respiratory Society, the American Thoracic Society and British Thoracic Society conference proceedings from 2010 to 2012 was also undertaken, and selected websites were also examined. Title, abstracts and full texts of potentially relevant studies were scanned by two independent reviewers. Primary studies were included if ≈90% of the population had COPD, the majority were of at least moderate severity and reported on any intervention that included a SM component or package. Accepted study designs and outcomes differed between the reviews. Risk of bias for randomised controlled trials (RCTs) was assessed using the Cochrane tool. Random-effects meta-analysis was used to combine studies where appropriate. A Markov model, taking a 30-year time horizon, compared a SM intervention immediately following a hospital admission for an acute exacerbation with UC. Incremental costs and quality-adjusted life-years were calculated, with sensitivity analyses. RESULTS From 13,355 abstracts, 10 RCTs were included for review 1, one study each for reviews 2 and 3, and 174 RCTs for review 4. Available studies were heterogeneous and many were of poor quality. Meta-analysis identified no evidence of benefit of post-discharge SM support on admissions [hazard ratio (HR) 0.78, 95% confidence interval (CI) 0.52 to 1.17], mortality (HR 1.07, 95% CI 0.74 to 1.54) and most other health outcomes. A modest improvement in health-related quality of life (HRQoL) was identified but this was possibly biased due to high loss to follow-up. The economic model was speculative due to uncertainty in impact on readmissions. Compared with UC, post-discharge SM support (delivered within 6 weeks of discharge) was more costly and resulted in better outcomes (£683 cost difference and 0.0831 QALY gain). Studies assessing the effect of individual components were few but only exercise significantly improved HRQoL (3-month St George's Respiratory Questionnaire 4.87, 95% CI 3.96 to 5.79). Multicomponent interventions produced an improved HRQoL compared with UC (mean difference 6.50, 95% CI 3.62 to 9.39, at 3 months). Results were consistent with a potential reduction in admissions. Interventions with more enhanced care from health-care professionals improved HRQoL and reduced admissions at 1-year follow-up. Interventions that included supervised or unsupervised structured exercise resulted in significant and clinically important improvements in HRQoL up to 6 months. LIMITATIONS This review was based on a comprehensive search strategy that should have identified most of the relevant studies. The main limitations result from the heterogeneity of studies available and widespread problems with their design and reporting. CONCLUSIONS There was little evidence of benefit of providing SM support to patients shortly after discharge from hospital, although effects observed were consistent with possible improvement in HRQoL and reduction in hospital admissions. It was not easy to tease out the most effective components of SM support packages, although interventions containing exercise seemed the most effective. Future work should include qualitative studies to explore barriers and facilitators to SM post exacerbation and novel approaches to affect behaviour change, tailored to the individual and their circumstances. Any new trials should be properly designed and conducted, with special attention to reducing loss to follow-up. Individual participant data meta-analysis may help to identify the most effective components of SM interventions. STUDY REGISTRATION This study is registered as PROSPERO CRD42011001588. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Rachel E Jordan
- Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Saimma Majothi
- Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Nicola R Heneghan
- School of Sport, Exercise & Rehabilitation Science, University of Birmingham, Edgbaston, Birmingham, UK
| | - Deirdre B Blissett
- Health Economics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Richard D Riley
- Research Institute of Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - Alice J Sitch
- Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Malcolm J Price
- Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Elizabeth J Bates
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Alice M Turner
- School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
| | - Susan Bayliss
- Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - David Moore
- Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Sally Singh
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK
| | - Peymane Adab
- Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - David A Fitzmaurice
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Susan Jowett
- Health Economics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Kate Jolly
- Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK
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Payne P, Zava D, Fiering S, Crane-Godreau M. Meditative Movement as a Treatment for Pulmonary Dysfunction in Flight Attendants Exposed to Second-Hand Cigarette Smoke: Study Protocol for a Randomized Trial. Front Psychiatry 2016; 7:38. [PMID: 27047398 PMCID: PMC4801846 DOI: 10.3389/fpsyt.2016.00038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/29/2016] [Indexed: 12/03/2022] Open
Abstract
A study protocol is presented for the investigation of meditative movement (MM) as a treatment for pulmonary dysfunction in flight attendants (FA) who were exposed to second-hand cigarette smoke while flying before the smoking ban. The study will have three parts, some of which will run concurrently. The first is a data gathering and screening phase, which will gather data on pulmonary and other aspects of the health of FA, and will also serve to screen participants for the other phases. Second is an exercise selection phase, in which a variety of MM exercises will be taught, over a 16-week period, to a cohort of 20 FA. A subset of these exercises will be selected on the basis of participant feedback on effectiveness and compliance. Third is a 52-week randomized controlled trial to evaluate the effectiveness of a digitally delivered form of the previously selected exercises on a group of 20 FA, as compared with an attention control group. Outcome measures to be used in all three parts of the study include the 6-min walk test as a primary measure, as well as a range of biomarkers, tests, and questionnaires documenting hormonal, cardio-respiratory, autonomic, and affective state. This study is registered at ClinicalTrials.gov. Identifier: NCT02612389.
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Affiliation(s)
- Peter Payne
- Microbiology and Immunology, Geisel School of Medicine at Dartmouth , Hanover, NH , USA
| | | | - Steven Fiering
- Microbiology and Immunology, Geisel School of Medicine at Dartmouth , Hanover, NH , USA
| | - Mardi Crane-Godreau
- Microbiology and Immunology, Geisel School of Medicine at Dartmouth , Hanover, NH , USA
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Vooijs M, Siemonsma PC, Heus I, Sont JK, Rövekamp TA, van Meeteren NL. Therapeutic validity and effectiveness of supervised physical exercise training on exercise capacity in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Clin Rehabil 2015; 30:1037-1048. [PMID: 26451006 DOI: 10.1177/0269215515609413] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Our aim was to determine the effectiveness of supervised physical exercise training on exercise capacity in patients with chronic obstructive pulmonary disease taken into consideration indices such as therapeutic validity of interventions, methodological quality of studies, and exercise volume. DATA RESOURCES MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, and PEDro databases were searched from inception until 17 July 2015 for randomized controlled trials comparing the effect of supervised exercise training vs. usual care in patients with chronic obstructive pulmonary disease. The references of included studies and review articles were hand searched for additional references and key authors of included trials were crosschecked in PubMed for any missed references. REVIEW METHODS Two reviewers independently assessed therapeutic validity of exercise training and methodological quality of included studies. Overall effects were calculated using a random effects model. RESULTS A total of 13 studies involving 756 patients with chronic obstructive pulmonary disease were included. Significant differences in maximal exercise capacity (standardized mean difference 0.52, 95% CI 0.31 to 0.74) and endurance exercise capacity (standardized mean difference 0.73, 95% CI 0.50 to 0.96) in favor of physical exercise training were found. The volume of physical exercise per week, the total volume of physical exercise, or their associations did not significantly influence the effect of training. CONCLUSION Effects of supervised physical exercise was not significantly altered by therapeutic validity. A combination of aerobic exercise and strength training was found to be more effective than strength training or endurance training alone in increasing the 6-minute walking distance.
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Affiliation(s)
- Martijn Vooijs
- 1 Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands.,2 Rijnlands Rehabilitation Centre, Leiden, The Netherlands.,3 TNO Healthy Living, Leiden, The Netherlands
| | | | - Inge Heus
- 2 Rijnlands Rehabilitation Centre, Leiden, The Netherlands
| | - Jacob K Sont
- 1 Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Nico Lu van Meeteren
- 4 Department of Epidemiology and CAPHRI Research School, Maastricht University Medical Center, Maastricht, The Netherlands.,5 Health~Holland, Topsector Life Sciences and Health, The Hague, The Netherlands
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Chen YW, Hunt MA, Campbell KL, Peill K, Reid WD. The effect of Tai Chi on four chronic conditions—cancer, osteoarthritis, heart failure and chronic obstructive pulmonary disease: a systematic review and meta-analyses. Br J Sports Med 2015; 50:397-407. [DOI: 10.1136/bjsports-2014-094388] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2015] [Indexed: 01/15/2023]
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Farver-Vestergaard I, Jacobsen D, Zachariae R. Efficacy of psychosocial interventions on psychological and physical health outcomes in chronic obstructive pulmonary disease: a systematic review and meta-analysis. PSYCHOTHERAPY AND PSYCHOSOMATICS 2015; 84:37-50. [PMID: 25547641 DOI: 10.1159/000367635] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/07/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Psychosocial intervention has been suggested as a potentially effective supplement to medical treatment in chronic obstructive pulmonary disease (COPD), but no reviews so far have quantified the existing research in terms of both psychological and physical health outcomes. We therefore conducted a systematic review and meta-analysis of controlled trials evaluating the effects of psychosocial interventions on psychological and physical health outcomes in COPD. METHODS Two independent raters screened 1,491 references for eligibility. Twenty independent studies investigating a total of 1,361 patients were included, assessed for their methodological quality, and subjected to meta-analytic evaluation. RESULTS After adjusting for potential publication bias, a statistically significant overall effect was found for psychological (Hedges' g = 0.38, 95% confidence interval, CI = 0.19-0.58; p < 0.001) outcomes. When analyzing individual intervention types, cognitive behavioral therapy appeared to be effective (g = 0.39, CI = 0.15-0.62; p = 0.001) for improving psychological outcomes. In contrast, for physical outcomes, only mind-body interventions (e.g. mindfulness-based therapy, yoga, and relaxation) revealed a statistically significant effect (g = 0.40; CI = 0.01-0.79; p = 0.042). CONCLUSIONS Taken together, the results lend support to psychosocial intervention as a tool in the management of COPD. However, due to indications of possible publication bias towards positive findings, the results should be interpreted with some caution, and more high quality research is needed.
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Affiliation(s)
- Ingeborg Farver-Vestergaard
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital and Department of Psychology and Behavioral Science, Aarhus University, Aarhus, Denmark
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