Xiankun Chen1,2,3, Gianluigi Savarese4, Yiyi Cai3,5, Liuling Ma3,5, Cecilia Stålsby Lundborg1, Wei Jiang3,5, Zehuai Wen2,6, Weihui Lu3,5,7, Gaetano Marrone1. 1. Department of Global Public Health, Health Systems and Policy, Karolinska Institute, 17177 Stockholm, Sweden. 2. Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, 510120 Guangzhou, China. 3. The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China. 4. Department of Medicine, Cardiology, Karolinska Institutet, 17176 Stockholm, Sweden. 5. Department of Cardiology, Guangdong Provincial Hospital of Chinese Medicine, 510120 Guangzhou, China. 6. National Centre for Design Measurement and Evaluation in Clinical Research, Guangzhou University of Chinese Medicine, 510405 Guangzhou, China. 7. Heart Failure Center/Department of Cardiology, Guangdong Provincial Hospital of Chinese Medicine, 510120 Guangzhou, China.
Abstract
BACKGROUND: Several randomized controlled trials (RCTs) have assessed the role of Tai Chi and Qigong Practices (TQPs) in managing chronic heart failure (CHF). They have included broad variations in comparators, sample sizes, and results. This study evaluates existing RCTs for evidence of TQPs rehabilitation effects for CHF. METHODS: Both English and Chinese databases were searched from their inception to October 23, 2019. RCTs were included if they compared the addition of TQPs into routine managements (RMs) to RMs alone or compared TQPs to general exercise, with RMs as a consistent cointervention in both groups. Data were screened and extracted independently using predesigned forms. RCT quality was assessed with the Cochrane tool. The primary outcomes were peak oxygen consumption (VO2peak), 6-minute walking distance (6MWD), and Minnesota Living with Heart Failure Questionnaire (MLHFQ). Mean differences (MDs) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed with an I 2 statistic. RESULTS: A total of 33 RCTs with 2,465 patients were included in the systematic review. Compared to the RMs alone, TQPs plus RMs improved VO2peak (MD: 1.24 mL/kg/min, 95% CI, 0.91 to 1.57; I 2 = 0%), 6MWD (MD: 59.63 meters, 95% CI, 43.35 to 75.90 I 2 = 88%), and MLHFQ (MD: -8.63 scores; 95% CI, -10.60 to -6.67; I 2 = 94%). Compared to general exercise, superior improvements were found in the TQP group; they were significant in MLHFQ (MD: -9.18 scores; 95% CI, -17.95 to -0.41; I 2 = 86%), but not in VO2peak or 6MWD. Evidence was also found of TQPs' safety and high adherence. CONCLUSIONS: Considering that there are low costs, multiple physical benefits, and no equipment required, TQPs are a promising rehabilitation therapy, as an adjunct to routine pharmacotherapies or as an alternative to conventional exercises, especially in home-based settings.
BACKGROUND: Several randomized controlled trials (RCTs) have assessed the role of Tai Chi and Qigong Practices (TQPs) in managing chronic heart failure (CHF). They have included broad variations in comparators, sample sizes, and results. This study evaluates existing RCTs for evidence of TQPs rehabilitation effects for CHF. METHODS: Both English and Chinese databases were searched from their inception to October 23, 2019. RCTs were included if they compared the addition of TQPs into routine managements (RMs) to RMs alone or compared TQPs to general exercise, with RMs as a consistent cointervention in both groups. Data were screened and extracted independently using predesigned forms. RCT quality was assessed with the Cochrane tool. The primary outcomes were peak oxygen consumption (VO2peak), 6-minute walking distance (6MWD), and Minnesota Living with Heart Failure Questionnaire (MLHFQ). Mean differences (MDs) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed with an I 2 statistic. RESULTS: A total of 33 RCTs with 2,465 patients were included in the systematic review. Compared to the RMs alone, TQPs plus RMs improved VO2peak (MD: 1.24 mL/kg/min, 95% CI, 0.91 to 1.57; I 2 = 0%), 6MWD (MD: 59.63 meters, 95% CI, 43.35 to 75.90 I 2 = 88%), and MLHFQ (MD: -8.63 scores; 95% CI, -10.60 to -6.67; I 2 = 94%). Compared to general exercise, superior improvements were found in the TQP group; they were significant in MLHFQ (MD: -9.18 scores; 95% CI, -17.95 to -0.41; I 2 = 86%), but not in VO2peak or 6MWD. Evidence was also found of TQPs' safety and high adherence. CONCLUSIONS: Considering that there are low costs, multiple physical benefits, and no equipment required, TQPs are a promising rehabilitation therapy, as an adjunct to routine pharmacotherapies or as an alternative to conventional exercises, especially in home-based settings.
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