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Welcome! Here we publish our views on new research and insights from the field of pulmonary medicine, most often focusing on topics related to exercise, nutrition, and other self-management techniques for those who suffer from chronic shortness of breath.

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Thursday, April 15, 2010

Tai chi for COPD – new study shows improvement in respiratory symptoms

A newly released study reported an 8% decline in self-recorded respiratory symptoms among study subjects with COPD who participated in a 3 month long tai chi program. By comparison, COPD participants in the study control group showed a 12% increase in self-reported respiratory symptoms over the same 3 month period - the control group subjects did not participate in a tai chi or other exercise program during the study duration. (Chan A, et al. Effectiveness of a Tai chi Qigong program in promoting health-related quality of life and perceived social support in chronic obstructive pulmonary disease clients. Quality of Life Research. 2010 Mar 15. [Epub ahead of print]).

While the research team concluded the comparative improvement in self-reported symptoms for the tai chi group was statistically significant, they would not go as far as to declare the results “clinically significant”. Apparently, the study results needed to show a 9% decline in self-reported symptoms in order to deem the results “clinically significant”. The main reason cited by the researchers for narrowly missing the “clinically significant” threshold was the short study duration of only 3 months (noting that other tai chi studies conducted over 6 month and 12 month periods demonstrated larger range of physical conditioning improvements).

As a result of falling short of the clinically significant milestone, you are unlikely to see this study’s results discussed widely elsewhere. But, in our view, given there was a significant improvement in self-reported symptoms between the control group and tai chi group, we think it is worth your exploration of tai chi as an alternative form of low intensity exercise for those with COPD. In fact, last month we wrote an article regarding the potential benefits of tai chi for COPD patients based on the strong and growing body of research surrounding tai chi for other chronic conditions such as heart disease, hypertension and arthritis. To read that article, click here.

In the Quality of Life Research study, the tai chi group practiced 13 movements of the 18 movements of the tai chi form known as qigong. The subjects met 2 times a week for 1 hour each session over the 3 month study period. The researchers selected the 13 movements used in the study based on those that are easy to learn and master in a short period of time. Study subjects were also asked to coordinate their breathing during each tai chi movement.

At the outset of the study, the control group and tai chi group were asked to rate their quality of life in three areas (distress caused by respiratory symptoms, how breathlessness limits their daily activities, and the overall psychological/social effects of COPD on their daily lives) using a survey tool known as the St. George’s Respiratory Questionnaire (SGRQ) – a widely used tool among respiratory care professionals to assess COPD patient quality of life. The study subjects then completed the SGRQ again at 6 weeks into the study and again at the end of the 3 month research project. Of the three areas probed in the SGRQ, the tai chi group showed significant improvement in the distress caused by respiratory symptoms section.

The Hong Kong based study team concluded, “During the 3-month TCQ (tai chi qigong) training, no exercise-related problems occurred; hence, this TCQ style appeared to be safe. In addition, the subjects enjoyed the training. Statistically, TCQ contributed toward improvements in health outcomes with respect to clients’ perception of their recent respiratory symptoms and decreased disturbances to their daily physical activities.”

In addition to tai chi’s known physical conditioning benefits, the ancient Chinese martial arts technique also promotes balance among the elderly and has been shown to improve exercise program compliance (i.e. tai chi is a lot less boring than walking on a treadmill so people are more inclined to continue a tai chi exercise program).

Many fitness and community centers offer tai chi classes – some particularly targeted to the elderly and people with limited mobility. There are also a wide range of DVD’s available online and in retail stores that demonstrate tai chi programs that can be practiced at home. We highlighted a few beginner oriented DVD’s on our Breathe Better Marketplace web site. To view our selections, click here. If you’d like to review a broader selection of tai chi DVD’s, we suggest you visit www.amazon.com and type in the search term “tai chi DVD”.

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