Abstract
Background: Tai chi (TC) is a popular form of exercise among adults with chronic heart failure (CHF), yet services are greatly underutilized. The aim of the current study was to identify and summarize the existing evidence and to systematically determine the clinical effectiveness of Tai Chi in the management of CHF using a systematic overview.Methods: Both English and Chinese databases were searched for systematic reviews (SRs)/meta-analyses (MAs) on TC for CHF from their inception to June 2020. The methodological quality, reporting quality, and risk of bias of SRs/MAs were assessed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and Risk of Bias in Systematic reviews (ROBIS), respectively. The evidence quality of outcome measures was assessed by the Grades of Recommendations, Assessment, Development and Evaluation (GRADE).Results: Six SRs/MAs using a quantitative synthesis to assess various outcomes of TC in CHF were included in this overview. The methodological quality, reporting quality and risk of bias of the SRs/MAs and the evidence quality of the outcome measures are generally unsatisfactory. The limitations of the past SRs/MAs included the lack of either the protocol or registration, the list of excluded studies, and the computational details of meta-analysis were inadequately reported. The critical problems were that qualitative data synthesis relied on trials with small sample sizes and critical low quality.Conclusions: TC may be a promising complementary treatment for CHF. However, further rigorous and comprehensive SRs/MAs and RCTs are required to provide robust evidence for definitive conclusions.
Highlights
Heart failure (HF) is a serious clinical syndrome caused by a variety of structural and functional cardiac disorders that result in the inability of the heart to meet the body’s needs (1)
Six systematic review (SR)/MAs using a quantitative synthesis to assess various outcomes of Tai Chi (TC) in chronic heart failure (CHF) were included in this overview
Internationally recognized clinical guidelines; (b) intervention: TC combined with conventional medication (CM) vs. CM alone; (c) outcomes: 6-min walk distance (6MWD), quality of life (QoL), serum B-type natriuretic peptide or N-terminal pro brain natriuretic peptide (BNP or NT pro-Btype natriuretic peptide (BNP)), left ventricular ejection fraction (LVEF), peak oxygen uptake, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate(HR)
Summary
Heart failure (HF) is a serious clinical syndrome caused by a variety of structural and functional cardiac disorders that result in the inability of the heart to meet the body’s needs (1). Tai Chi for Chronic Heart Failure at $108 billion per annum (3). Dyspnea and fatigue are two of the most debilitating symptoms in patients with chronic heart failure (CHF) (4); these individuals frequently experience low exercise tolerance, poor quality of life (QoL), and recurrent hospitalizations and are at greater risk for morbidity and mortality (5, 6). Exercise-based cardiac rehabilitation is an effective means to improve the QoL of patients with CHF with improved exercise tolerance and fewer CHF-related hospitalizations reported (6, 7). As a low-intensity, low-impact physical activity that originated from China, Tai Chi (TC) is suitable for older adults to perform, including those with poor exercise tolerance or chronic health conditions (9). Tai chi (TC) is a popular form of exercise among adults with chronic heart failure (CHF), yet services are greatly underutilized. The aim of the current study was to identify and summarize the existing evidence and to systematically determine the clinical effectiveness of Tai Chi in the management of CHF using a systematic overview
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