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. 2018 Dec 14;4(4):00042-2018.
doi: 10.1183/23120541.00042-2018. eCollection 2018 Oct.

Children and Adults Tai Chi Study (CF-CATS2): a randomised controlled feasibility study comparing internet-delivered with face-to-face Tai Chi lessons in cystic fibrosis

Siobhán B Carr  1   2 , Patricia Ronan  3   2 , Ava Lorenc  3   4 , Awais Mian  3 , Susan L Madge  5   2 , Nicola Robinson  3   2
Affiliations

Children and Adults Tai Chi Study (CF-CATS2): a randomised controlled feasibility study comparing internet-delivered with face-to-face Tai Chi lessons in cystic fibrosis

Siobhán B Carr et al. ERJ Open Res. .

Abstract

Virtual healthcare is fast entering medical practice. Research into the feasibility of using it to teach treatment regimens such as exercise has not been explored. Maintaining an exercise regime can be difficult in cystic fibrosis: group classes risk potential infection, yet motivation is hard to maintain when alone. Tai Chi is a low-impact exercise and involves gentle, demanding movements. This study aimed to assess the feasibility, safety and acceptability of learning Tai Chi via an internet-based approach and compared patient-reported outcomes. Children and adults with cystic fibrosis were recruited to a randomised, comparative effectiveness trial. Participants learnt eight Tai Chi movements; teaching was delivered in eight lessons over 3 months: delivered either via the internet or face-to-face. Assessments were at 3-monthly intervals over 9 months. Outcomes included health status, quality of life, sleep, mindfulness and instructor-led questions. 40 adults and children completed the eight sets of Tai Chi lessons. The median age was 22.8 years (range 6.1-51.5 years); 27 patients were female. The cohort comprised 26 adults (aged >16 years), six teenagers and eight children (aged <12 years). The groups were well matched. Feasibility and safety were demonstrated. Participants showed significant improvements in self-reported sleep, cough (both daytime and night-time), stomach ache and breathing. No differences in lung function, health status, quality of life, sleep or mindfulness was shown before or after completing the lessons. Tai Chi was safe and well tolerated; it was feasible to deliver individual lessons via the internet, reducing concerns regarding cross-infection, and appeared to improve self-reported symptoms.

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Conflict of interest statement

Conflict of interest: S.B. Carr reports receiving personal fees and nonfinancial support for service on an advisory board, and accommodation and travel expenses to the advisory board and scientific committees from Vertex Pharmaceuticals, advisory board fees from Chiesi Pharmaceuticals and lecture fees from Teva Pharmaceuticals, outside the submitted work. Conflict of interest: P. Ronan has no conflicts of interest to declare. Conflict of interest: A. Lorenc has nothing to disclose. Conflict of interest: A. Mian has nothing to disclose. Conflict of interest: S.L. Madge has nothing to disclose. Conflict of interest: N. Robinson has no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
CONSORT 2010 flow diagram.
FIGURE 2
FIGURE 2
Cystic Fibrosis Questionnaire – Revised (CFQ-R) respiratory domain results at 3-monthly intervals during the study. Each line represents an individual subject.
FIGURE 3
FIGURE 3
Self-reported symptom scores immediately prior to each of the eight individual Tai Chi lessons for all participants. a) Trouble sleeping; b) waking due to cough; c) daytime cough; d) trouble breathing; e) stomach hurting (scale 0=never, 1=sometimes, 3=often, 4=always); f) visual analogue scores for general health and wellbeing.
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