HEALTH SERVICE RESEARCH POSTER PRESENTATION ABSTRACTS
Please note: All posters will be displayed in
Salons 10-12.
FRIDAY, 5:45-6:30 PM
Yeh GY, Wang C, Phillips RS, Wayne PM.
Tai chi mind-body exercise and cardiovascular physiology:
a systematic review.
Harvard Medical School, Osher Institute gloria_yeh@hms.harvard.edu
PURPOSE: To conduct a systematic review of the
literature on the effect of Tai Chi mind-body exercise on cardiovascular
(CV) physiology, and to evaluate the rationale and scientific support
for Tai Chi as an intervention for patients with CV disease. Research
METHODS: We searched Medline, CAB Alt HealthWatch,
BIOSIS previews, Science Citation Index, EMBASE, Social Science Citation
Index, Chinese Medical Database, China Hospital Knowledge, China National
Knowledge Infrastructure, and China Traditional Chinese Medicine Database
from inception through June 2005, and performed hand searches at the
medical libraries of Beijing and Nanjing Universities in China. Available
human clinical studies published in English and Chinese that examined
at least one outcome relevant to CV health were included. Data were
extracted in a standardized manner and two independent investigators
assessed methodological quality of randomized controlled trials using
the Jadad scale.
RESULTS: We identified 71 trials that met inclusion
criteria, including 14 randomized controlled trials (RCT), 24 non-randomized
studies (NRS), and 33 observational trials (OBS). Most studies included
<100 subjects (range 5-200). Study heterogeneity precluded formal meta-analyses.
Effects of Tai Chi in patients with specific CV conditions (hypertension,
coronary disease, and heart failure) were examined in 24 trials, while
47 trials examined CV effects in "healthy" volunteers or in individuals
with non-CV conditions (eg. rheumatoid arthritis). Nineteen long-term
studies (6 RCTs) reported decreases in systolic and diastolic blood
pressure, including seven in patients with hypertension (study duration
12 weeks to 3 years). Six studies (2 RCTs) reported improvements in
lipid profiles (study duration 12 weeks to 2 years). In patients with
coronary disease, two trials (1 RCT) reported improvements in exercise
capacity and blood pressure compared to conventional exercise. Three
12-week trials (2 RCTs) reported benefits in patients with heart failure,
including improvements in quality of life, exercise capacity, and ejection
fraction. Four OBS studies reported acute increases in time and frequency
domain measures of heart rate variability after single Tai Chi sessions.
Several NRS and OBS studies reported increases in peak oxygen uptake
with Tai Chi practice compared to sedentary controls. Tai Chi exercise
intensity was estimated to be 1.6-4.6 metabolic equivalents and 50-74%
maximal heart rate. Other reported measures included catecholamines,
pulmonary function, cardiac hemodynamic indices, blood viscosity, microvascular
perfusion, functional measures, and psychosocial well-being. Most studies
included at least one positive outcome related to CV health. Seven of
14 RCT's were of adequate methodological quality. Very few adverse effects
were reported.
CONCLUSION: Tai Chi mind-body exercise may beneficially
affect CV parameters. However, the effects in patients with specific
CV conditions needs further study.
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