Division for Research and Education in Complementary and Integrative Medical Therapies, Osher Research Center, Harvard Medical School, 401 Park Drive, Suite 22A, Boston, MA 02215, USA.
Respir Care. 2010 Nov;55(11):1475-82.
To determine the feasibility of a randomized controlled trial of the effect of a tai chi program on quality of life and exercise capacity in patients with COPD.
We randomized 10 patients with moderate to severe COPD to 12 weeks of tai chi plus usual care (n = 5) or usual care alone (n = 5). The tai chi training consisted of a 1-hour class, twice weekly, that emphasized gentle movement, relaxation, meditation, and breathing techniques. Exploratory outcomes included disease-specific symptoms and quality-of-life, exercise capacity, pulmonary function tests, mood, and self-efficacy. We also conducted qualitative interviews to capture patient narratives regarding their experience with tai chi.
The patients were willing to be randomized. Among 4 of the 5 patients in the intervention group, adherence to the study protocol was excellent. The cohort's baseline mean ± SD age, percent-of-predicted FEV₁, and ratio of FEV₁ to forced vital capacity were 66 ± 6 y, 50 ± 12%, and 0.63 ± 0.14, respectively. At 12 weeks there was significant improvement in Chronic Respiratory Questionnaire score among the tai chi participants (1.4 ± 1.1), compared to the usual-care group (-0.1 ± 0.4) (P = .03). There were nonsignificant trends toward improvement in 6-min walk distance (55 ± 47 vs -13 ± 64 m, P = .09), Center for Epidemiologic Studies Depression Scale (-9.0 ± 9.1 vs -2.8 ± 4.3, P = .20), and University of California, San Diego Shortness of Breath score (-7.8 ± 3.5 vs -1.2 ± 11, P = .40). There were no significant changes in either group's peak oxygen uptake.
A randomized controlled trial of tai chi is feasible in patients with moderate to severe COPD. Tai chi exercise as an adjunct to standard care warrants further investigation.
确定太极拳方案对 COPD 患者生活质量和运动能力影响的随机对照试验的可行性。
我们将 10 名中重度 COPD 患者随机分为 12 周的太极拳加常规护理组（n=5）或常规护理组（n=5）。太极拳训练包括每周两次，每次 1 小时的课程，强调柔和的动作、放松、冥想和呼吸技巧。探索性结果包括特定于疾病的症状和生活质量、运动能力、肺功能测试、情绪和自我效能。我们还进行了定性访谈，以捕捉患者对太极拳体验的叙述。
患者愿意接受随机分组。在干预组的 5 名患者中，有 4 名患者对研究方案的依从性非常好。该队列的基线平均±标准差年龄、预计 FEV₁的百分比和 FEV₁ 与用力肺活量的比值分别为 66±6 岁、50±12%和 0.63±0.14。在 12 周时，太极拳组的慢性呼吸系统问卷评分显著改善（1.4±1.1），而常规护理组则略有改善（-0.1±0.4）（P=0.03）。6 分钟步行距离（55±47 与-13±64 m，P=0.09）、流行病学研究中心抑郁量表（-9.0±9.1 与-2.8±4.3，P=0.20）和加利福尼亚大学圣地亚哥短气量表（-7.8±3.5 与-1.2±11，P=0.40）均有改善趋势，但无统计学意义。两组的峰值摄氧量均无显著变化。
在中重度 COPD 患者中进行太极拳的随机对照试验是可行的。太极拳运动作为标准护理的辅助手段值得进一步研究。
