COPD: Tai chi a 'viable alternative' to standard treatment

A new study published in the journal Chest has revealed that the ancient martial art is just as effective as pulmonary rehabilitation for treating chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is a collective term used to describe a range of respiratory diseases — including emphysema, chronic bronchitis, and some forms of asthma.

Worldwide, COPD is estimated to affect around 251 million people, with 3.17 million yearly deaths being caused by the condition.

In the United States, approximately 15.7 million people have been diagnosed with the disease, but the actual number of people living with the condition may be significantly higher.

There is no cure for COPD yet, but treatment can alleviate the symptoms and reduce the likelihood of dying from the disease.

The most commonly prescribed treatment for COPD is pulmonary rehabilitation, which is a program encompassing various interventions, such as breathing techniques, nutritional advice, and exercise training.

Can tai chi replace pulmonary rehabilitation?

However, to benefit from pulmonary rehabilitation, COPD patients need trained professionals and special facilities, which often makes the treatment costly and quite difficult to access.

The ancient martial arts practice of tai chi has been shown to have numerous health benefits. Not only does the practice improve balance and flexibility in seniors, but studies have also revealed that the practice can help to lower blood pressure and improve heart health.

Given these proven benefits, researchers led by Prof. Yuan-Ming Luo — of the State Key Laboratory of Respiratory Disease in Guangzhou, China — hypothesized that the practice would also help to improve respiratory health.

"Knowing the potential benefits of tai chi," explains new study co-author Dr. Nan-Shan Zhong, "we hypothesized that, in patients being treated with medication to manage their COPD symptoms, it could help improve the quality of life when compared to a course of classical Western style [pulmonary rehabilitation]."

How the effects of tai chi were tested

To test their hypothesis, Prof. Luo and his collagues evaluated the effects of tai chi on 120 Chinese participants who were living with COPD but had never used a bronchodilator.

Once the participants had started taking indacaterol — a drug commonly prescribed to treat COPD and other respiratory illnesses — they were randomly divided into groups that either received traditional pulmonary rehabilitation or tai chi training.

Participants in the tai chi group were taught the so-called 24-form Yang style, which they practiced for 5 hours every week for a period of 12 weeks.

Following these 12 weeks, participants were invited to continue the practice for another 12 weeks, if they wished to do so, and a final analysis was carried out 12 weeks after the formal training period ended.

The researchers evaluated the results of the two interventions using the Saint George's Respiratory Questionnaire (SGRQ), which is a standard tool used for measuring health outcomes in people with respiratory illnesses.

A 'viable alternative' to standard treatment

Prof. Luo summarizes these findings, explaining, "Tai chi is an appropriate substitute for [pulmonary rehabilitation]."

"While neither training approach," he goes on to explain, "differed from the other by more than the minimal clinically important difference of four SGRQ points at the end of this 12-week study, [after] an additional 12 weeks after discontinuation of formal training, improvements emerged in favor of tai chi in SGRQ score."

"We conclude that tai chi is equivalent to [pulmonary rehabilitation] and may confer more sustained benefit."

Prof. Yuan-Ming Luo

First author Michael I. Polkey, a researcher in respiratory illness at the National Institute for Health Research in Leicester, United Kingdom, also comments on the findings.

"This study," he says, "demonstrates that a low-cost exercise intervention is equivalent to formal pulmonary rehabilitation, and this may enable a greater number of patients to be treated."

"Physical activity is key to reducing symptoms in COPD," continues Polkey. "We do recommend [pulmonary rehabilitation], but our study shows that tai chi is a viable alternative when there is no local [pulmonary rehabilitation] service."

"We encourage," he concludes, "pulmonary rehabilitation providers to consider offering tai chi as an alternative therapy that patients would then be able to continue unsupervised in their own home."