Safety and effectiveness of a Tai Chi-based cardiac rehabilitation programme for chronic coronary syndrom patients: study protocol for a randomised controlled trial

The impact of various mind-body exercises on cardiorespiratory function and quality of life in heart failure patients: A network meta-analysis

OBJECTIVE

This study aims to compare the relative effects of different mind-body exercises on cardiorespiratory function and quality of life in Heart failure (HF) patients, providing valuable insights for their rehabilitation.

METHODS

We conducted a search across seven Chinese and English databases, including China National Knowledge Infrastructure (CNKI) and Web of Science. A network meta-analysis was performed using STATA 14.0 within a frequentist framework.

RESULTS

A total of 38 studies were included, encompassing eight types of mind-body exercises. Ten studies reported peak VO2, indicating that dancing outperformed Tai Chi (MD:3.52, 95 % CI:6.74, -0.30) and Baduanjin (MD:2.34, 95 % CI:4.32, -0.36). Additionally, Pilates demonstrated greater effectiveness than Yijinjing, aside from Tai Chi (MD:5.10, 95 % CI:8.71, -1.49) and Baduanjin (MD:3.92, 95 % CI:6.50, -1.34). Twenty-one studies reported the six-minute walk test (6MTW), with only Tai Chi significantly improving 6MTW scores compared to the control group (MD: 50.77, 95 % CI: 8.12, 93.42). Twenty-three studies assessed left ventricular ejection fraction (LVEF), finding that Tai Chi (MD: 3.83, 95 % CI: 2.07, 5.59), Baduanjin (MD: 2.90, 95 % CI: 1.04, 4.76), and yoga (MD: 3.32, 95 % CI: 0.37, 6.27) significantly increased LVEF in HF patients. Nineteen studies evaluated quality of life, with the Liuzijue possibly being the most effective intervention (SUCRA: 98.9).

CONCLUSION

Different mind-body exercises have their own advantages in improving the heart function and quality of life of HF patients. In the future, higher-quality studies with larger samples are needed to further verify the validity of the results.

Comparative analysis of biomechanical characteristics between the new Tai Chi elastic band exercise for opening and closing movement and elastic band resistance training for the reverse fly movement

Background

The objective of this study was to compare and analyze the representative opening and closing movement of Tai Chi elastic band exercise with the reverse fly movement of elastic band resistance training. The aim was to explore the biomechanical differences between the two exercises and provide theoretical support for the application of Tai Chi elastic band exercise in health intervention.

Methods

A total of 26 male participants were recruited and randomly divided into two groups in a 1:1 ratio. There were 13 participants in each Tai Chi elastic band exercise group and elastic band resistance training group. Both groups of participants used an elastic band to perform movement in the experiment. Experimental data were collected using the Vicon infrared motion capture system and Delsys surface EMG system. The AnyBody software was utilized to simulate the creation of a musculoskeletal model for both exercises.

Result

The study found that the Tai Chi elastic band exercise group exhibited smaller horizontal abduction angle and flexion angle of the shoulder joint, as well as normalized RMS of the anterior deltoid and triceps brachii, compared to the elastic band resistance training group (P < 0.01); the Tai Chi elastic band exercise group exhibited greater elbow flexion angle, elbow flexion torque, and muscle strength of the infraspinatus, coracobrachialis, biceps brachii, brachialis and brachioradialis, compared to the elastic band resistance training group (P < 0.01); the Tai Chi elastic band exercise group exhibited smaller horizontal abduction angular velocity of the shoulder joint and a lower normalized RMS of the posterior deltoid, compared to the elastic band resistance training group (P < 0.05).

Conclusion

(1) The opening and closing movement of Tai Chi elastic band exercise is characterized by a large elbow flexion angle, a small shoulder joint horizontal angle and flexion angle, and a slow and uniform speed of movement. The reverse fly movement of elastic band resistance training is characterized by a large horizontal abduction angle of the shoulder joint, a large flexion angle of the shoulder joint, a small flexion angle of the elbow joint, and a fast and uneven speed. (2) The opening and closing movement exerts a greater torque on the elbow flexion, while the reverse fly movement exerts a greater torque on the shoulder joint horizontal abduction and external rotation. (3) The opening and closing movement provide greater stimulation to the infraspinatus, coracobrachialis, and elbow flexor, while the reverse fly movement provides greater stimulation to the posterior deltoid, anterior deltoid, subscapularis, and elbow extensor. In summary, the variation in joint angle, joint angular velocity, and hand position could be the factor contributing to the differences in joint torque and muscle activity between the opening and closing movement of Tai Chi elastic band exercise and the reverse fly movement of elastic band resistance training.

Effects of a Tai Chi rehabilitation program implemented using a hybrid online and offline mode on oxidative stress and inflammatory responses in patients with coronary heart disease: a randomized controlled trial

Background

Coronary heart disease (CHD) is the leading cause of death in both developed and many developing countries. Exercise training is a fundamental component of cardiac rehabilitation programs for patients with CHD. This study aims to investigate the effects of a Tai Chi rehabilitation program, which is provided through a hybrid online and offline mode, on oxidative stress and inflammatory responses in patients with CHD.

Methods

A total of 34 patients with coronary heart disease were randomly assigned to two groups: an experiment group (n = 14, age 62.07 ± 9.076 years) and a control group (n = 20, age 61.90 ± 9.700 years). The experiment group underwent a 12-week Tai Chi cardiac rehabilitation program (TCCRP), while the control group followed a conventional exercise rehabilitation program (CERP) consisting of 1-h sessions, 3 times per week, for a total of 36 sessions. Participants were studied at baseline and post-intervention. The main assessments include the levels of Malondialdehyde (MDA), Superoxide dismutase (SOD), Tumor necrosis factor (TNF-α) and Interleukin-10 (IL - 10) in blood samples. Pearson correlation analysis was used, and the differences between the two groups were subsequently tested using two-way repeated ANOVA. Statistical significance was defined as a two-sided p-value of <0.05.

Results

The key finding of the study reveals that MDA was significantly reduced by 1.027 nmoL/mL. Additionally, the TCCRP showed significant improvements in SOD and IL-10, with values of 10.110 U/mL and 2.441 pg./mL, respectively. Notably, a significant positive correlation was found between SOD and IL-10 (r = 0.689, p = 0.006), while MDA showed a significant positive correlation with TNF-a (r = 0.542, p = 0.045). In contrast, the ECRP group only showed a significant improvement in SOD.

Conclusion

The study conducted a 12-week program on TCCRP, which utilized a hybrid online and offline model for individuals with coronary heart disease. The program showed promising results in alleviating oxidative stress and inflammation, possibly by regulating the balance between oxidative and antioxidative factors, as well as pro-inflammatory and anti-inflammatory factors.

Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis

Objective

The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension.

Methods

Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software.

Results

According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.91)] and diastolic blood pressure (DBP) [MD = -4.68, 95% CI (-7.23, -2.12)], as well as increasing the content of nitric oxide (NO) [MD = 0.99, 95% CI (0.69, 1.28)]. The blood lipid metabolism ability may also be improved after more than 12 weeks of Tai Chi exercise, total cholesterol (TC) [SMD = -0.68, 95% CI (-0.89, -0.46), triglyceride (TG) [SMD = -0.84, 95% CI (-1.25, -0.43)], low-density lipoprotein cholesterol (LDL-C) [SMD = -1.58, 95% CI (-2.29, -0.86)]. However, the improvement of high-density lipoprotein cholesterol (HDL-C) [SMD = 0.54, 95% CI (0.28, 0.79)] was better with a less than 12 weeks exercise cycle. A subgroup analysis for exercise frequency and time showed that the exercise frequency should preferably be more than or equal to 5 times per week for patients with hypertension, and for patients with hypertension plus hyperlipidemia, the exercise frequency less than 5 times per week with exercise time less than 60 min each day may be more beneficial.

Conclusion

The meta-analysis indicated that a more than 12 weeks Tai Chi exercise cycle with less than 60 min each time and more than 5 times per week may be more beneficial in blood pressure reduction, NO level increasing and blood lipid metabolism improving in the comparison with the other exercise cycles. For patients with hypertension plus hyperlipidemia, exercise frequency of less than 5 times per week may be better.

Systematic Review Registration

[http://www.crd.york.ac.uk/prospero], identifier [CRD42022352035].

Effectiveness of an online/offline mixed-mode Tai Chi cardiac rehabilitation program on microcirculation in patients with coronary artery disease: A randomized controlled study

OBJECTIVE

We explored the effectiveness of an online/offline mixed-mode Tai Chi cardiac rehabilitation program on the microcirculation of patients with coronary artery disease (CAD).

DESIGN

Prospective, randomized controlled study.

SETTING

It was conducted in a tertiary hospital.

SUBJECTS

Twenty-six patients who met the diagnostic criteria for coronary artery disease were recruited.

INTERVENTIONS

Patients were randomized divided into a 12-week Tai Chi cardiac rehabilitation program(TCCRP) or a conventional exercise rehabilitation program(CERP) in a 1:1 fashion, 4 weeks of in-hospital rehabilitation and 8 weeks of online rehabilitation at home (a total of 12 weeks of intervention).

MAIN OUTCOME MEASURES

Nailfold microcirculation (Morphological integrals, Blood flow integrals, Periphery capillary loop integrals, Overall integrals).

MAIN OUTCOME MEASURES

Twenty patients completed the study. The Morphological integrals (baseline: 2.875±1.171 vs 12weeks: 1.863±0.414, t = 2.432, P = 0.045 < 0.05) and Overall integrals (baseline: 5.563±2.001 vs 12weeks: 3.688±1.167, t = 3.358, P = 0.012 < 0.05) decreased significantly in the TCCRP, The nailfold microcirculation integra decreased not significantly in the CERP (P > 0.05). The nailfold microcirculation integra was not significantly different between the two groups after the intervention (P > 0.05).

CONCLUSIONS

The TCCRP improved the microcirculation of patients with CAD.

Current role and future perspectives of cardiac rehabilitation in coronary heart disease

Ischaemic heart disease (IHD) is a major cause of morbidity and mortality worldwide. While there have been major advances in this field, these patients are still a higher risk subgroup. As such, strategies to mitigate risk and tailor secondary prevention measures are of the utmost relevance. Cardiac rehabilitation (CR), encompassing several domains including exercise training, cardiovascular risk factor optimization, nutritional and psychological assessments, as well as other ancillary interventions has shown to be one of the pillars in the contemporary management of patients with IHD. Indeed, CR is associated with several benefits in this population, ranging from functional capacity to improvements in outcomes. Whilst this, there are still several issues concerning the optimal application of CR which are still not fully ascertained, such as lack of referral and completion, as well as questions related to programme design (particularly among patients with multiple comorbidities). In this review, we aim at presenting a pragmatic overview on the current role of CR in the management of individuals with IHD, while also discussing some of the caveats in the current data, as well as future concepts which could help improve the uptake and personalization of this pivotal time-tested intervention.