Korean J Adult Nurs.  2013 Oct;25(5):515-526.

Effects of Tai Chi Exercises on Cardiovascular Risks, Recurrence Risk, and Quality of Life in Patients with Coronary Artery Disease

• Song RY
• Park MK
• Cheong JO
• Park JH
• Seong IW

Abstract

PURPOSE
The study aims to evaluate the effects of Tai Chi applied cardiac rehabilitation program(TCCRP) on cardiovascular risks, recurrence risk in ten years, and cardiac specific quality of life in individuals with coronary artery disease.
METHODS
The sample was comprised of individuals diagnosed with coronary artery disease within six months of the study who were referred by their primary physicians to participate in the TCCRP. The design was a pretest/posttest with non-equivalent groups with 30 in TCCRP program and 33 wait-listed comparison group.
RESULTS
The average age of all participants was sixty seven years. At the completion of the TCCRP, the Tai Chi group showed significant reduction in their ten year recurrent risk for coronary artery disease measured by Framingham's algorithm. The quality of life for the experimental group was reported as significantly higher than the comparison group, especially the area of general symptom.
CONCLUSION
The outpatient cardiac rehabilitation with Tai Chi was applied effectively and safely without any complication to individuals with coronary artery disease. Tai Chi can be useful as an alternative exercise for cardiac rehabilitation program which may provide more access to individuals for cardiovascular risk management in the community settings.

MeSH Terms

Coronary Artery Disease*
Coronary Vessels*
Exercise*
Humans
Outpatients
Quality of Life*
Recurrence*
Rehabilitation
Risk Factors
Risk Management
Tai Ji*

Figure

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  Figure 1 Flow of the patients enrollment.

Reference

1. Benzer W, Platter M, Oldridge NB, Schwann H, Machreich K, Kullich W, et al. Short-term patient-reported outcomes after different exercise-based cardiac rehabilitation programmes. European journal of cardiovascular prevention and rehabilitation. 2007; 14:441–447. DOI: 10.1097/HJR.0b013e32802bf7ae.

2. Center for Disease Control and Prevention. Receipt of outpatient cardiac rehabilitation among heart attack survivors-United States, 2005. MMWR: Morbidity and Mortality Weekly Report. 2008; 57:89–94.

3. D'Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General cardiovascular risk profile for use in primary care: The Framingham heart study. Circulation. 2008; 117:743–753. DOI: 10.1161/Circulationaha.107.699579.

4. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005; 365:1415–1428. DOI: 10.1016/S0140-6736(05)66378-7.

5. Erdfelder E, Faul F, Buchner A. GPOWER: A general power analysis program. Behavior Research Methods, Instruments, & Computers. 1996; 28:1–11.

6. Evenson KR, Fleury J. Barriers to outpatient cardiac rehabilitation participation and adherence. Journal of Cardiopulmonary Rehabilitation. 2000; 20:241–246.

7. Heyward VH. KT Jang DH Choi H Park YW Ko DT Lee SW Kim . Advanced fitness assessment and exercise prescription. Seoul: Hanmi Medical Publishing Co;2005. Original work published 2002.

8. Hong KP, Sung J. Cardiac rehabilitation in patients with coronary artery disease. Hanyang Medical Reviews. 2006; 26:75–79.

9. Jin YS. Guidelines for cardiac rehabilitation. Journal of the Korean Medical Association. 2005; 48:808–821. DOI: 10.5124/jkma.2005.48.9.808.

10. Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ, et al. Prevalence of conventional risk factors in patients with coronary heart disease. Journal of the American Medical Association. 2003; 290:898–904. DOI: 10.1001/jama.290.7.898.

11. Lam P. Tai Chi for diabetes handbook. Narwee, Australia: East Acton Tai Chi Productions;2005.

12. Lan C, Chen SY, Wong MK, Lai JS. Tai Chi training for patients with coronary heart disease. Medicine and Sport Science. 2008; 52:182–194. DOI: 10.1159/000134299.

13. Lan C, Su TC, Chen SY, Lai JS. Effect of T'ai chi chuan training on cardiovascular risk factors in dyslipidemic patients. Journal of Alternative and Complementary Medicine. 2008; 14:813–819. DOI: 10.1089/acm.2008.0143.

14. Lee EH, Tahk SJ, Shin JH, Lee YW, Song R. Development and a psychometric evaluation of cardiovascular disease-specific quality of life scale for Koreans. Journal of Korean Academy of Nursing. 2007; 37:313–323.

15. Marchionni N, Fattirolli F, Fumagalli S, Oldridge N, Del Lungo F, Morosi L, et al. Improved exercise tolerance and quality of life with cardiac rehabilitation of older patients after myocardial infarction: Results of a randomized controlled trial. Circulation. 2003; 107:2201–2206. DOI: 10.1161/?01.CIR.0000066322.21016.4A.

16. Munro BH. EH Lee YH Jung JS Kim R Song KY Hwang . Statistical methods for health care research. Seoul: Koonja;2002. Original work published 2001.

17. Park IS, Song R, Ahn S, So HY, Kim HL, Joo KO. Factors explaining quality of life in individual with coronary artery disease. Journal of Korean Academy of Nursing. 2008; 38:866–873. DOI: 10.4040/jkan.2008.38.6.866.

18. Shepherd CW, While AE. Cardiac rehabilitation and quality of life: A systematic review. International Journal of Nursing Studies. 2012; 49:755–771. DOI: 10.1016/j.ijnurstu.2011.11.019.

19. Song R, Ahn S, So HY, Park IS, Kim HL, Joo KO, et al. Effects of Tai Chi exercise on cardiovascular risk factors and qualityof life in post-menopausal women. Journal of Korean Academy of Nursing. 2009; 39:136–144. DOI: 10.4040/jkan.2009.39.1.136.

20. Song R, Lee H. Managing health habits for myocardial infarction (MI) patients. International Journal of Nursing Studies. 2001; 38:375–380.

21. Song R, Park IS, So HY, Kim HL, Ahn SH. Applicability and program effects of Tai chi exercise in outpatients with coronary artery disease. Journal of Korean Academy of Adult Nursing. 2008; 20:537–547.

22. Taylor-Piliae RE. Tai Chi as an adjunct to cardiac rehabilitation exercise training. Journal of Cardiopulmonary Rehabilitation. 2003; 23:90–96.

23. Taylor-Piliae RE, Haskell WL, Stotts NA, Froelicher ES. Improvement in balance, strength, and flexibility after 12 weeks of Tai chi exercise in ethnic Chinese adults with cardiovascular disease risk factors. Alternative Therapies in Health and Medicine. 2006; 12:50–58.

24. Thomas GN, Hong AW, Tomlinson B, Lau E, Lam CW, Sanderson JE, et al. Effects of Tai Chi and resistance training on cardiovascular risk factors in elderly Chinese subjects: A 12-month longitudinal, randomized, controlled intervention study. Clinical Endocrinology. 2005; 63:663–669. DOI: 10.1111/j.1365-2265.2005.02398.x.

25. Tsai JC, Wang WH, Chan P, Lin LJ, Wang CH, Tomlinson B, et al. The beneficial effects of Tai Chi Chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial. Journal of Alternative and Complementary Medicine. 2003; 9:747–754. DOI: 10.1089/107555303322524599.

26. Tsang T, Orr R, Lam P, Comino EJ, Singh MF. Effects of Tai Chi on glucose homeostasis and insulin sensitivity in older adults with type 2 diabetes: A randomised double-blind sham-exercise-controlled trial. Age and Ageing. 2008; 37:64–71. DOI: 10.1093/ageing/afm127.

27. Wolf SL, O'Grady M, Easley KA, Guo Y, Kressig RW, Kutner M. The influence of intense Tai Chi training on physical performance and hemodynamic outcomes in transitionally frail, older adults. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2006; 61:184–189.

28. Yeh GY, McCarthy EP, Wayne PM, Stevenson LW, Wood MJ, Forman D, et al. Tai chi exercise in patients with chronic heart failure: A randomized clinical trial. Archives of Internal Medicine. 2011; 171:750–757. DOI: 10.1001/archinternmed.2011.150.

29. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet. 2004; 364:937–952.

30. Zhuo D, Shephard RJ, Plyley MJ, Davis GM. Cardiorespiratory and metabolic responses during Tai Chi Chuan exercise. Canadian Journal of Applied Sport Sciences. 1984; 9:7–10.