Tai chi holds promise as cardiac rehab exercise


October 11, 2017


American Heart


The slow and gentle movements of Tai Chi —
which can increase in pace — hold promise as an alternative exercise option
for patients who decline traditional cardiac rehabilitation. The study is the
first to suggest that Tai Chi may improve exercise behaviors in this high-risk



The slow and gentle
movements of Tai Chi hold promise as an alternative exercise option for
patients who decline traditional cardiac rehabilitation, according to
preliminary research in Journal of the American Heart Association, the
Open Access Journal of the American Heart Association/American Stroke

After a heart attack,
more than 60 percent of patients decline participation in cardiac
rehabilitation. Although the reasons include financial concerns and distance to
a rehab center, many patients stay away because they perceive physical exercise
as unpleasant, painful or impossible given their current physical condition.

This is the first study
suggesting that Tai Chi may improve exercise behaviors in this high-risk

“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,” said Elena Salmoirago-Blotcher, M.D.,
Ph.D., lead author of the study and assistant professor of medicine at the
Warren Alpert School of Medicine at Brown University. “Tai Chi exercise
can reach low-to-moderate intensity levels. The emphasis on breathing and
relaxation can also help with stress reduction and psychological

Researchers adapted a Tai
Chi routine for use in heart disease patients from a protocol previously used
in patients with lung disease and heart failure. They compared the safety and
compliance of two regimes: LITE, a shorter program with 24 classes over 12
weeks and PLUS, a longer program with 52 classes over 24 weeks. All
participants received a DVD to use for home practice during and after receiving
the classes.

The study was conducted
at The Miriam Hospital in Providence, Rhode Island and included 29 physically
inactive heart disease patients (8 women and 21 men, average age 67.9 years)
who expressed an interest in a Tai Chi program. Although the majority had
experienced a previous heart attack (58.6 percent) or procedure to open a
blocked artery (PCI — 82.8 percent; CABG — 31 percent), all had declined
cardiac rehabilitation and continued to have many high-risk characteristics,
including current smoker (27.6 percent), diabetes (48.3 percent), high
cholesterol (75.9 percent), and overweight (35 percent) or obese (45 percent).
All had received physician clearance to undergo Tai Chi training and none had
orthopedic problems (such as recent joint replacement surgery) that would
preclude doing Tai Chi.


Researchers found Tai

was safe, with no adverse events related to
the exercise program except for minor muscular pain at the beginning of

was well liked by participants (100 percent
would recommend it to a friend);

was feasible, with patients attending about
66 percent of scheduled classes;

did not raise aerobic fitness on standard
tests after 3 months of either the programs; and

did raise the weekly amount of moderate to
vigorous physical activity (as measured by a wearable device) after three and
six months in the group participating in the longer program, but not in those
who took part in the shorter program.

“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,” said Salmoirago-Blotcher. “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.”


Story Source:

Materials provided by American Heart Association. Note: Content may be edited
for style and length.


2.    Elena SalmoiragoBlotcher,
Peter M. Wayne, Shira Dunsiger, Julie Krol, Christopher Breault, Beth C. Bock,
Chih Wu, Gloria Y. Yeh. Tai Chi Is a
Promising Exercise Option for Patients With Coronary Heart Disease Declining
Cardiac Rehabilitation
. Journal of the American Heart Association,
2017; 6 (10): e006603 DOI: 10.1161/JAHA.117.006603