Effectiveness of incorporating Tai Chi in a pulmonary rehabilitation program for Chronic Obstructive Pulmonary Disease (COPD) in primary care—A pilot randomized controlled trial

Abstract

Introduction: Studies have shown that pulmonary rehabilitation and Tai Chi are beneficial to patients with Chronic Obstructive Pulmonary Disease (COPD), which is a major public health problem. The aim of this single-blind randomized controlled study was to compare the self-efficacy and quality of life parameters of COPD patients who underwent pulmonary rehabilitation with or without Tai Chi elements incorporated in the exercise component.

Methodology: 192 COPD patients, recruited from four primary care clinics, satisfied the eligibility criteria and consented to randomization to either pulmonary rehabilitation program group (PRP) or the group with Tai Chi elements added to PRP (TC). Both groups received rehabilitation consisting of 2 sessions per week for 6 weeks with totally identical content except that Tai Chi exercises were added to TC group. Data collection was performed at baseline, 2 and 6-month post-intervention.

Results: Intention-to-treat analysis was performed for 192 subjects. Both groups did not differ in demographics and baseline variables except for COPD staging, mean FEV1, FEV1%-Pred, Saint George Respiratory Questionnaire SGRQ activity score and COPD-CSES self-efficacy score. Statistical improvements were seen in exercise capacity, health status and self-efficacy within both groups at 6-month post-intervention. Although more favorable improvements in physiological outcomes and health status were demonstrated in Tai Chi group, only the functional exercise capacity showed statistical improvement between groups at 6 months post-intervention (β = 12.786 m; 95% CI = 3.794, 21.777; p = 0.006).

Conclusion: The adjuvant effect of incorporating Tai Chi in pulmonary rehabilitation showed a modest complementary benefit in exercise capacity.