Tai chi holds promise as cardiac rehab exercise

October 11, 2017
Credit: CC0 Public Domain

The slow and gentle movements of Tai Chi hold promise as an alternative exercise option for patients who decline traditional cardiac rehabilitation, according to preliminary research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

After a , more than 60 percent of patients decline participation in . Although the reasons include financial concerns and distance to a rehab center, many patients stay away because they perceive physical as unpleasant, painful or impossible given their current physical condition.

This is the first study suggesting that Tai Chi may improve exercise behaviors in this high-risk population.

"We thought that Tai Chi might be a good option for these people because you can start very slowly and simply and, as their confidence increases, the pace and movements can be modified to increase intensity," said Elena Salmoirago-Blotcher, M.D., Ph.D., lead author of the study and assistant professor of medicine at the Warren Alpert School of Medicine at Brown University. "Tai Chi exercise can reach low-to-moderate intensity levels. The emphasis on breathing and relaxation can also help with stress reduction and psychological distress."

Researchers adapted a Tai Chi routine for use in disease patients from a protocol previously used in patients with lung disease and heart failure. They compared the safety and compliance of two regimes: LITE, a shorter program with 24 classes over 12 weeks and PLUS, a longer program with 52 classes over 24 weeks. All participants received a DVD to use for home practice during and after receiving the classes.

The study was conducted at The Miriam Hospital in Providence, Rhode Island and included 29 physically inactive heart disease patients (8 women and 21 men, average age 67.9 years) who expressed an interest in a Tai Chi program. Although the majority had experienced a previous heart attack (58.6 percent) or procedure to open a blocked artery (PCI - 82.8 percent; CABG - 31 percent), all had declined cardiac rehabilitation and continued to have many high-risk characteristics, including current smoker (27.6 percent), diabetes (48.3 percent), high cholesterol (75.9 percent), and overweight (35 percent) or obese (45 percent). All had received physician clearance to undergo Tai Chi training and none had orthopedic problems (such as recent joint replacement surgery) that would preclude doing Tai Chi.

Researchers found Tai Chi:

  • was safe, with no adverse events related to the exercise program except for minor muscular pain at the beginning of training;
  • was well liked by participants (100 percent would recommend it to a friend);
  • was feasible, with attending about 66 percent of scheduled classes;
  • did not raise aerobic fitness on standard tests after 3 months of either the programs; and
  • did raise the weekly amount of moderate to vigorous physical activity (as measured by a wearable device) after three and six months in the group participating in the longer program, but not in those who took part in the shorter program.

"On its own, Tai Chi wouldn't obviously replace other components of traditional cardiac rehabilitation, such as education on risk factors, diet and adherence to needed medications," said Salmoirago-Blotcher. "If proven effective in larger studies, it might be possible to offer it as an exercise option within a rehab center as a bridge to more strenuous exercise, or in a community setting with the educational components of rehab delivered outside of a medical setting."

Explore further: 'Open gym' format shortens waiting time for cardiac rehab

More information: Journal of the American Heart Association (2017). DOI: 10.1161/JAHA.117.006603

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adave
not rated yet Oct 13, 2017
I have been teaching Tai Chi, baqua, hsing ie, etc. techniques for 20 years and learning for 44 years. All of the internal forms train from the inside out. Unify the will, breathing and movement. Unify means thoughts in your mind are not at war. Breathing creates a natural structure of the body. Your soft tissue and bones are in healthy positions. Your body will perform what pours out of your nervous system even to your organs and heart. 1,000 years of tai chi meditations kept what worked from the stone age to Wu Don mountain temple. What if you don't have arms and legs? You create a phantom body. Internal exercises uses real and phantom training. In the dark close your eyes and see if you can see your hands moving. Your mind fills your body like a hand fills a glove. Your mind is in intimate contact with the extreme reaches of your tissues. I have outlived my family at 68. All from heart disease. The relaxed intensity of your training causes chamge. You become what you practice.
adave
not rated yet Oct 13, 2017
During internal training brain metabolism increases without decrease until the set is over. Blood o2 increases because the shape of the lung changes. Nerve signal to the muscles increase in intensity until you bow at the end. Most of Taichi is balancing. The mind is split in two. The first challenge is mental. Metabolism increases because the mitochondria over the entire body is involved. Want more of a challenge? Bend your legs. 90 deg to the floor and don't come back up until your done. Extend the time to 45 min. or longer. Learn the small circle of heaven breathing. I have watched my bamboo grow 1/2 inch an hour. Slower is where you find benefit. Sustained brain metabolism causes permanent changes. What is the limit? Yang Lu Chan worked hard for 20 years before training the emperor, the prince and bodyguard. His Taichi was the emperors secret to powerful memory, creativity and health. Everything is in the chi raising position. What will modern medicine be like in 1000 years?

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