Is Tai Chi Chuan effective in improving functional capacity among patients with recent myocardial infarction, as compared to full-body stretching exercises?
Date of publication of the randomized controlled trial: June 2015
Design
Randomized controlled trial (RCT).
Participants
61 patients with a recent myocardial infarction (age range: 40 to 85 years, mean age: 56 years in treatment group, 60 years in control group, male%: 90% in treatment group, 63% in control group).
Intervention
Three weekly 60-minute sessions of Tai Chi Chuan (TCC) exercise were provided for 12 consecutive weeks. Exercises were gentle to moderate in intensity and consisted of a series of slow, combined, sustained movements, weight shifting and upper-body and lower-body postures synchronized with respiratory rhyme. A standard protocol was used under the guidance of a master Tai Chi Chuan and physical education teachers.
Comparator
Comparison: TCC exercise versus attending 3 weekly sessions of full-body stretching exercises as control.
Major Outcomes
Outcome 1: Peak oxygen consumption (VO2 peak) after 12-week intervention (mL/kg per min).
Settings
This trial was performed in an outpatient setting.
Comparison    TCC exercise versus full-body stretching exercises
Main Results
Compared to full-body stretching exercises, TCC exercise showed significant increase in VO2 peak after the 12-week TCC-based intervention (mean difference (MD): 5.2, 95% CI: 2.8 to 7.7).
Comparison: TCC exercise versus full-body stretching exercises among patients with a recent myocardial infarction
Outcome (unit) No. of studies (Total no. of participants) Mean VO2 Peak (SD)/ No. of participants Heterogeneity test (I2) MD (95% CI) p value Overall quality of evidence*
Intervention 24.6(5.2)/31
1 (mL/kg per min) 1 (61) 24.6(5.2)/31 19.4(4.4)/30 Not applicable as there is only 1 study. 5.2 (2.8 to 7.7) <0.001 High
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Comparison    TCC exercise versus full-body stretching exercises
Main Results
Compared to full-body stretching exercises, TCC exercise showed significant increase in VO2 peak after the 12-week TCC-based intervention (mean difference (MD): 5.2, 95% CI: 2.8 to 7.7).
Comparison: TCC exercise versus full-body stretching exercises among patients with a recent myocardial infarction
Outcome (unit) 1 (mL/kg per min)
No. of studies (Total no. of participants) 1 (61)
Mean VO2 Peak (SD)/ No. of participants Intervention 24.6(5.2)/31
24.6(5.2)/31 19.4(4.4)/30
MD (95% CI) 5.2 (2.8 to 7.7)
p value <0.001
Overall quality of evidence* High
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Conclusion
Benefits
Compared to full-body stretching exercises, TCC exercise showed significant increase in VO2 peak after the 12-week TCC-based intervention. The overall quality of evidence is high. Further research is unlikely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events were reported in this trial.
Link to Original Article
http://www.ncbi.nlm.nih.gov/pubmed/26027624
The synopsis is based on the following article:
Nery RM, Zanini M, de Lima JB, Buhler RP, da Silveira AD, Stein R. Tai Chi Chuan improves functional capacity after myocardial infarction: A randomized clinical trial. American Heart Journal. 2015 Jun;169(6):854-60.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.