Effects Of Taichiquan Exercise On Exercise Tolerance And Life Quality Of Patients With Chronic Obstructive Pulmonary Disease In Stable Phases

BackgroundChronic obstructive pulmonary disease (COPD) is a disease that characterized by airflow limitation and can be prevented and treated. Because of its slowly developing process and without obvious symptoms in early phases, many people take little attention to it, so the lung function usually has been severely impaired when patients have obvious symptoms and come to doctor. Therefore, in the past years, there was a general point of view that once the patients with COPD appears a symptom of respiratory failure , which means that patients, breathe compensatory capacity completely lost and lung function had no hope to be recovered, patients with COPD therefore also lose confidence to accept treatment. But for the common exercises such as abdominal breathing and reduce lip breathing, it is difficult to learn and most of them are just suitable for patients with severe COPD. And there is still lack of effective methods for COPD patients in early and stable phases .Pulmonary rehabilitation (pulmonary rehabilitation, PR) is a special multi-disciplinary treatment that be designed in accordance with the individualized principle for patients with chronic respiratory damage, its ultimate purpose is to improve the patients' athletic stamina and improve quality of life and health status. At present, PR includes rehabilitation measures of exercise, Health education, Nutrition support, Psychological and Behavioral intervention etc. the Exercise is the most important of the all. In the past years, some studies have pointed out that the rehabilitation exercises can elevate the patients' motor ability, improve their dyspnea symptoms and quality of lives .TaiChiquan is a traditional Chinese national sport, which also was a popular sport in the ancient time of our country. For centuries, practice have proved that TaiChiquan was a good method for fitness and disease prevention, and because of its unique entertaining it was favored by many people. And it is worthy to find out if TaiChiquan is an effective method of rehabilitation for patients with community stable COPD.ObjectiveThe aim of this study was to evaluate the effects of TaiChiquan trainning for tolerance and life quality of patients with COPD, and to seek a simple and effective rehabilitation treatment method suitable for Chinese communities of patients with COPD in stable phases.Methods1.A total of 70 COPD patients which recruited from the pre-screening out epidemiological investigation in different communities of Guangzhou City were enrolled in this study, and patients were divided into two groups , which contained TaiChiquan group of 35 patients and control group of 35 patients.2. All patients were required to complete the informed consent and participate in the baseline examination, including Lung function, The Six-minute Walking Test, the score of clinic COPD Questionnaire et al。3. The professional TaiChiquan master was hired to teach the experimental group patients to master the simplified 24 style TaiChiquan and the breathing techniques. After the training, all patients were required to do the TaiChiquan exercise for 60 minute three times per week at the supervision of the community health workers. Patients were encouraged to maintain the TaiChiquan exercise at their community alone or be together at the rest time until the end of the experiment. The community health workers checked the patients'diary cards per week.4. Throughout the intervention period, the patients of the control group did not receive any guidance about rehabilitation and exercise training. The community health workers conducted a telephone follow up to them monthly, which included whether went to the Emergence or Outpatient for COPD, hospitalization, drug used for the COPD and total costs.5. At the end of the experiment, all patients participated in the review of the baseline indicators.Results1.There is no a significant difference of baseline data such as age, sex and severity of COPD between the two groups. At last, 33 patients of TaiChiquan group and 30 patients of control group finished the experiment ,the missing rate of the two groups was 5.7% and 14.3%.2.Change of exercise tolerance: After 3 months of TaiChiquan excerise, the 6MWD of Tai Chi group increased 50m(446.7±93.5m_vs₄97.24±76.70m P<0.01)when compared with pre-rehabilitation,and there was a significant difference (P<0.01). There was nosignificant difference for the control group(414.3±100.10_vs₃95.62±91.9 P=0.086).Compared with the control group,the 6MWD of TaiChi group increased significantly(50.52±54.58m_vs_-18.70±57.67m P<0.01)。3.The Borg score: After 3 months, the score of bofore and after walking in TaiChi groupwas[0.00(0.75)_vs₀.00(0.00) P=0.070]and[2.00(2.50)_vs₁.00(1.50) P=0.05]; there was no significant difference in the control group,the score before and after walking was [0.00(1.00)_vs₀.00(0.50) P=0.083]and [1.00(2.50)_vs₁.50(1.50)P=0.890];there was no significant difference between the two groups,the score before and after waliking wans [0.00(0.00)_vs₀.00(0.50) P=0.426]and[1.00(1.50)_vs₁.50(1.50) P =0.151].4.The Quality of life: For pre-rehabilitation and post-rehabilitation of CCQ in TaiChiquan group, the total score, symptom score and activity score was (9.18±5.63_vs₅.39±4.25 P<0.01),(15.03±9.40_vs₉.21±5.75P P<0.01)and (5.39±4.25_vs₃.73±2.37 P<0.01 ) respectively, there was a significant decrease. Compared with control group, there was a significant decrease of total score(-5.81±9.41_vs₀.90±8.87 P<0.01), symptom score (-3.79±6.17_vs₁.07±5.48 P<0.01), and activity score (-2.09±3.98_vs_-0.13±3.85 P=0.052,corrected P=0.036),the TaiChiquan group patients, quality of life improved significantly..5.The Pulmonary function : When compared with pre-rehabilitation after 3 months'TaiChiquan exercise, there was somewhat elevation of FEV1,FVC and FEV1%pred in Tai Chi group, but there was no significant difference.ConclusionTaiChiquan can effectively improve the exercise capacity and quality of life in patients with COPD, and it is an .effective rehabilitation treatment of community COPD patients in stable phases.