Effects of Tai Chi training on exercise capacity and quality of life in patients with chronic heart failure: a meta-analysis

Abstract

Aim: Whether Tai Chi (TC) is effective in the cardiac rehabilitation of patients with chronic heart failure (CHF) remains controversial. We performed a meta-analysis to examine the effects of TC on exercise capacity and quality of life (QoL) in CHF patients.

Methods and results: PubMed and EMBASE databases were searched (up to May 2012) for relevant studies. Studies including participants with reduced left ventricular systolic function (ejection fraction ≤ 45%) were selected. Interventions considered were TC with or without comparisons (education or usual care). Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I(2) test. Four randomized controlled trials (RCTs) (n = 242) met the inclusion criteria. TC significantly improved QoL (WMD -14.54 points; 95% CI -23.45 to -5.63). TC was not associated with a significant reduction in N-terminal pro brain natriuretic peptide (WMD -61.16 pg/mL; 95% CI -179.27 to 56.95), systolic blood pressure (WMD -1.06 mmHg; 95% CI -13.76 to 11.63), diastolic blood pressure (WMD -0.08 mmHg; 95% CI -3.88 to 3.73), improved 6 min walking distance (WMD 46.73 m; 95% CI -1.62 to 95.09), or peak oxygen uptake (WMD 0.19 mL/kg/min; 95% CI -0.74 to 1.13).

Conclusions: TC may improve QoL in patients with CHF and could be considered for inclusion in cardiac rehabilitation programmes. However, there is currently a lack of evidence to support TC altering other important clinical outcomes. Further larger RCTs are urgently needed to investigate the effects of TC.