Chinese Tai Chi shows effectiveness in heart disease

Tai Chi, a traditional Chinese practice involving slow and gentle movements, may help heart disease patients who decline traditional cardiac rehabilitation, according to preliminary research published Wednesday.

In a small study of 29 physically inactive heart disease patients, researchers found that Tai Chi may improve exercise behaviors in this high-risk population with no observable adverse events except for minor muscular pain at the beginning of training.

After a heart attack, more than 60 percent of patients decline participation in cardiac rehabilitation, often because they perceive physical exercise as unpleasant, painful or impossible given their current physical condition, according to the study published in the Journal of the American Heart Association.

"We thought that Tai Chi might be a good option for these people because you can start very slowly and simply and, as their confidence increases, the pace and movements can be modified to increase intensity," lead author Elena Salmoirago-Blotcher, assistant professor of medicine at the Warren Alpert School of Medicine at Brown University, said in a statement.

"Tai Chi exercise can reach low-to-moderate intensity levels. The emphasis on breathing and relaxation can also help with stress reduction and psychological distress," she said.

The study, conducted at The Miriam Hospital in Providence, Rhode Island, involved eight women and 21 men, whose average age was 67.9 years. Most of them had experienced a previous heart attack or procedure to open a blocked artery, and all had declined cardiac rehabilitation and continued to have many high-risk characteristics, including current smoker, diabetes, high cholesterol, and being overweight or obese.

For the study, they took part in a shorter program with 24 classes over 12 weeks or a longer program with 52 classes over 24 weeks. All participants received a DVD so that they could practice Tai Chi at home.

In addition to establishing safety, the results showed that Tai Chi was well liked by participants, who all said they would recommend it to a friend.

The exercise intervention was also proved feasible, with patients attending about 66 percent of scheduled classes. The results also showed that while Tai Chi did not raise aerobic fitness on standard tests after three months of either the programs, it did raise the weekly amount of moderate to vigorous physical activity after three and six months in the group participating in the longer program.

Salmoirago-Blotcher said in an email to Xinhua that there is a fair amount of literature supporting the benefit of Tai Chi for patients with heart disease.

For example, a recent meta-analysis published in 2016 showed that Tai Chi exercise can improve physical functioning, quality of life, depression, and blood pressure in patients with heart disease, she said. But Salmoirago-Blotcher noted that her study was only designed to study the feasibility and safety of Tai Chi, not the efficacy, as an exercise alternative for patients that don't attend cardiac rehabilitation.

A yoga practitioner, Salmoirago-Blotcher said she had tried Tai Chi herself to get a sense of how it feels before she designed this study and proposed it to her patients.

"On its own, Tai Chi wouldn't obviously replace other components of traditional cardiac rehabilitation, such as education on risk factors, diet and adherence to needed medications," she said.

"If proven effective in larger studies, it might be possible to offer it as an exercise option within a rehab center as a bridge to more strenuous exercise, or in a community setting with the educational components of rehab delivered outside of a medical setting," she said.