Abstract 27: Group- Plus Home-based Tai Chi Program Improves Physical Function and Psychosocial Well-being Among Patients With Coronary Heart Disease

Abstract

Introduction: Substantial evidences demonstrate impaired physical health and decreased psychosocial well-being among patients with coronary heart disease (CHD). Tai Chi is an effective exercise option in cardiac rehabilitation to manage CHDs. There has been an increasing focus on home-based cardiac rehabilitation to improve participation rate, while none of studies emphasized the effect of home-based Tai Chi program. Hypothesis: A group- plus home-based Tai Chi program improves physical function (aerobic endurance, lower-body strength, lower-body flexibility, and agility and dynamic balance), and psychosocial well-being (perceived stress, social support, exercise self-efficacy) among CHD patients. Methods: In this randomized controlled trial, 98 community-dwelling patients with CHD (mean age: 69.2±4.68 years; 69 women; 29 men) were randomized to Tai Chi (n=49) or control group (n=49). Participants in Tai Chi group first attended 6 weeks supervised group-based Tai Chi classes that were scheduled as follows: 2 times/week for week 1 and 2, 3 times/week for weeks 3 and 4, and then 4 times/week for week 5 and 6, with 60 minutes/class. After that, participants in Tai Chi group practiced home-based Tai Chi 4 times/week, 60 minutes for each time, for another 6 weeks. Outcomes, namely, aerobic endurance, lower-body strength, lower-body flexibility, and agility and dynamic balance were tested by 2-Minute Step Test (steps), Chair Stand Test (times), Chair Sit-and-Reach Test (cm), and 8-Foot Up-and-Go Test (seconds), respectively. Other outcomes included perceived stress, social support, and exercise self-efficacy. Data were collected at baseline, post group-based Tai Chi training at 6-week, post Tai Chi intervention at 12-week, and at 24-week follow-up assessment. Generalized estimating equations models were used to compare changes in outcomes over time between groups. Results: Compared to changes in control group, Tai Chi showed significant improvements in aerobic endurance (+12 steps), lower-body strength (+3 times), agility and dynamic balance (log-transformed score: -0.058s), perceived stress, emotional support, belonging support, tangible support, and exercise self-efficacy at 24-week. Significant improvement in lower-body flexibility (4 cm) was only achieved at 12-week, compared to changes in control group. No significant changes in self-esteem support over time between groups were observed. Intervention adherence: Tai Chi=79.6% (39 of 49) (attending ≥75% of total Tai Chi sessions). Attrition rate: Tai Chi=20.4% (10 of 49), control=24.5% (12 of 49). Conclusions: This Tai Chi program significantly improve physical function and psychosocial well-being among CHD patients, indicating that Tai Chi could be taught in group sessions and then continued independently as a home exercise routine for health promotion in CHD patients.