PURPOSE: To study changes of pulmonary function tests, exercise performances and quality of life following modified Tai Chi Qigong exercise training in a group of moderate to severe COPD.
METHODS: COPD patients, FEV1 <65% predicted with no exacerbation for >1 month, were enrolled for exercise training. A 30-minute-modified Tai Chi Qigong exercise protocol was created which composed of 9 individual graceful body movements integrated with pursed-lip breathing. Patients attended supervised Tai Chi Qigong training once-weekly, and exercised at home daily following the provided audio-visual guide for 6 weeks. Assessments done at pre- and post-exercise training program included: spirometry and lung volumes; symptom limited cycle ergometer tests for maximum exercise capacity(incremental exercise, 5 or 10 W/min) and maximum exercise endurance time(constant work rate exercise, 75% pre-training peak work rate); functional exercise capacity by 6-minute walking test(6-MWD, meters); negative inspiratory pressure(NIP, cmH2O); and quality of life(QoL) using Saint George's Respiratory Questionnaires(SGRQ).
RESULTS: 18 COPD patients (mean age 68.56±8.31 years, FEV1 48.99±13.5 %predicted) were recruited. After Tai Chi Qigong training, most spirometric values and lung volumes remained unchanged. However, there were significant improvements of NIP, 6-MWD and QoL(89.72±18.45 vs 78.78±21.20, p=0.017; 424.81±84.55 vs 391.17±86.33, p=0.028; and 19.59±11.53 vs 29.44±14.62, p= 0.001 respectively). Cycle ergometer tests revealed following significant changes: 1)increased maximum work rate(W) and oxygen consumption(VO2max, L/min)[66.33±34.64 vs 59.22±33.73, p=0.01 and 0.857±0.401 vs 0.808±0.348, p=0.025]; 2)increased maximum exercise endurance time(min)[9.57±6.14 vs 5.29±2.74, p=0.000]; 3)increased isotime inspiratory capacity(IC, L)[1.517±0.337 vs 1.407±0.447, p=0.023]; 4)decreased isotime VO2, VCO2, minute ventilation and respiratory rate[0.689±0.347 vs 0.808±0.348, p=0.000; 0.663±0.372 vs 0.792±0.401, p=0.000; 32.91±12.23 vs 36.67±13.47, p=0.000; and 27.72±6.4 vs 29.94±6.63, p=0.041 respectively].
CONCLUSION: Modified Tai Chi Qigong training improved both maximum and functional exercise capacities in COPD, as a result of decreased dynamic hyperinflation and more efficient cost of breathing during exercise. These, combined with the improved respiratory muscle strength, contributed to the overall improvement of QoL.
CLINICAL IMPLICATIONS: Modified Tai Chi Qigong training could be an effective, yet in-expensive and non-traumatic, primarily-home-based exercise training program for COPD rehabilitation.
DISCLOSURE: Sumalee Kiatboonsri, No Financial Disclosure Information; No Product/Research Disclosure Information