• Michael I Polkey, Zhi-Hui Qiu, Lian Zhou, Meng-Duo Zhu, Ying-Xin Wu, Yong-Yi Chen, Sheng-Peng Ye, Yu-Shan He, Mei Jiang, Bai-Ting He, Bhavin Mehta, Nan-Shan Zhong, and Yuan-Ming Luo.
• NIHR Respiratory Biomedical Research Unit at the Royal Brompton & Harefield NHS Foundation Trust and Imperial College, London, UK.
• Chest. 2018 May 1; 153 (5): 111611241116-1124.

BackgroundIn COPD, functional status is improved by pulmonary rehabilitation (PR) but requires specific facilities. Tai Chi, which combines psychological treatment and physical exercise and requires no special equipment, is widely practiced in China and is becoming increasingly popular in the rest of the world. We hypothesized that Tai Chi is equivalent (ie, difference less than ±4 St. George's Respiratory Questionnaire [SGRQ] points) to PR.MethodsA total of 120 patients (mean FEV1, 1.11 ± 0.42 L; 43.6% predicted) bronchodilator-naive patients were studied. Two weeks after starting indacaterol 150 μg once daily, they randomly received either standard PR thrice weekly or group Tai Chi five times weekly, for 12 weeks. The primary end point was change in SGRQ prior to and following the exercise intervention; measurements were also made 12 weeks after the end of the intervention.ResultsThe between-group difference for SGRQ at the end of the exercise interventions was -0.48 (95% CI PR vs Tai Chi, -3.6 to 2.6; P = .76), excluding a difference exceeding the minimal clinically important difference. Twelve weeks later, the between-group difference for SGRQ was 4.5 (95% CI, 1.9 to 7.0; P < .001), favoring Tai Chi. Similar trends were observed for 6-min walk distance; no change in FEV1 was observed.ConclusionsTai Chi is equivalent to PR for improving SGRQ in COPD. Twelve weeks after exercise cessation, a clinically significant difference in SGRQ emerged favoring Tai Chi. Tai Chi is an appropriate substitute for PR.Trial RegistryClinicalTrials.gov; No.: NCT02665130; URL: www.clinicaltrials.gov.Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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