Tai Chi after Pulmonary Rehabilitation in Patients with COPD: A Randomized Trial

慢性阻塞性肺病患者肺康复后的太极拳：一项随机试验

• 批准号: 8540342
• 负责人: Marilyn L. Moy
• 金额: $ 60.26万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-29 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8540342
• 关键词: Activities of Daily Living; Address; Adherence; Aerobic; Aerobic Exercise; Breathing; Cardiopulmonary; Cause of Death; Chinese People; Chronic Obstructive Airway Disease; Clinical; Data; Dyspnea; Education; Elements; Exercise; Exercise Tolerance; Exhibits; Guidelines; Healed; Home environment; Home visitation; Hospitalization; House Call; Individual; Intervention; Investigation; Life; Lower Extremity; Lung; Martial Arts; Medical; Modality; Moods; Morbidity - disease rate; Operative Surgical Procedures; Patients; Persons; Physical activity; Physical therapy; Population; Public Health; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Recommendation; Rehabilitation therapy; Relaxation; Reporting; Risk Factors; Self Efficacy; Self Perception; Support Groups; Symptoms; Tai Ji; Techniques; Testing; Time; Training; United States; Upper Extremity; Walking; arm; base; body-mind; clinical care; cost; follow-up; healing; health related quality of life; improved; mortality; novel; programs; randomized trial; standard care; stress management

DESCRIPTION (provided by applicant): Chronic obstructive pulmonary disease (COPD) is a major public health problem and is the fourth leading cause of death in the United States. Despite pharmacologic and surgical therapy, COPD continues to cause considerable morbidity, and patients suffer from exercise intolerance and decreased physical activity, which are independent risk factors for exacerbations, hospitalizations, and mortality.Pulmonary rehabilitation (PR) has been shown to improve symptoms of dyspnea, health-related quality of life, and exercise capacity and national guidelines now recommend that all patients with COPD participate in such programs. Unfortunately, long-term exercise adherence after initial rehabilitation is very poor, and it is clear that benefits gained during PR diminish rapidly if patients do not continue to exercise. There remains a critical need for novel interventions that may sustain the benefits of regular exercise after PR, as well as promote long-term exercise adherence and exercise self-efficacy in the post-rehabilitation period in patients with COPD. Tai chi is a popular mind-body exercise that incorporates low-moderate intensity physical activity, self awareness, relaxation, and meditative slow breathing. It may be particularly suited to deconditioned individuals with COPD who suffer from limited exercise tolerance and dyspnea. Importantly, tai chi exercise comprehensively integrates several key elements of PR (aerobic exercise, upper and lower extremity training, breathing, and stress management) into one relatively low-cost and accessible activity. Studies in varied populations have suggested that tai chi can improve exercise capacity, quality of life, and promote exercise self-efficacy; and that adherence may be favorable when compared to conventional exercise modalities. In this application, we propose a three-arm randomized controlled trial in patients with COPD (N=126) to evaluate the benefits of six months of tai chi exercise, versus group walking, versus general recommendations for self-exercise (standard care) in maintaining clinical improvements after the completion of standard, supervised PR. Our primary aim will be to investigate whether tai chi can maintain gains in exercise capacity three and six months after PR. Secondary aims will examine quality of life, dyspnea, mood, activites of daily living, as well as exercise self-efficacy, intervention adherence and overall activity. Long-term follow-up assessment will be conducted at 1 year. The results of the proposed project have the potential to transform the clinical care of patients with COPD by providing a new strategy that may substantially extend the benefits of PR and promote continued physical activity in this population.

描述（由申请人提供）：慢性阻塞性肺疾病（COPD）是一个主要的公共卫生问题，是美国第四大死亡原因。尽管药理和手术疗法，COPD仍会引起相当大的发病率，并且患者患有运动不耐症和体育锻炼减少，这是导致病情，住院和死亡率的独立危险因素。肺部康复（PR）已被证明已被证明可以改善脾气痛的症状，适用于锻炼的人，并推荐了培养的症状，并推荐了该疗法，并推荐了该疗法，并推荐了全国性的指南。不幸的是，初步康复后的长期运动依从性非常差，很明显，如果患者不继续运动，则在PR期间获得的好处迅速减少。对于新的干预措施，仍有至关重要的需求，这些干预措施可能会在PR后维持定期运动的益处，并在COPD患者的康复后期促进长期运动遵守和行使自我效能感。 太极拳是一种流行的心身运动，它结合了低端强度的体育锻炼，自我意识，放松和冥想的缓慢呼吸。它可能特别适合于患有有限运动耐受性和呼吸困难的COPD的cop污染物。重要的是，Tai Chi练习全面整合了PR（有氧运动，上肢和下肢训练，呼吸和压力管理）的几个关键要素，并将其纳入一个相对较低的成本和可访问的活动中。对种群的研究表明，太极可以提高运动能力，生活质量并促进运动自我效能。与常规运动方式相比，这种依从性可能是有利的。 在此应用中，我们提出了一项针对COPD患者（n = 126）患者的三臂随机对照试验，以评估六个月的Tai Chi运动的好处，与集体步行相比，与一般的自我锻炼建议（标准护理）在保持临床改善后，在完成标准后的PR。我们的主要目的是调查TAI CHI是否可以在公关后三个月和六个月保持运动能力。次要目标将检查生活质量，呼吸困难，情绪，日常生活活动以及运动自我效能，干预依从性和整体活动。长期随访评估将在1年进行。拟议项目的结果有可能通过提供一种新策略来改变COPD患者的临床护理，该策略可能会大大扩展PR的益处并促进该人群的持续体育锻炼。