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 Association.
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 population.
“We thought that Tai Chi might be a good option for these people because they 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 distress.”
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.