Traditional Chinese exercises for pulmonary rehabilitation: evidence from a systematic review

Qigong (QG) and tai chi (TC), alternative forms of exercise based on traditional Chinese medicine, are reported to be beneficial to patients with chronic obstructive pulmonary disease (COPD). This systematic review analyzed the evidence and made recommendations for clinical applications and future research.

Key words "qigong," "tai chi," "COPD," and "randomized controlled trial" or corresponding terms in Chinese were searched using MEDLINE, EMBASE, and 3 Chinese databases. Randomized controlled trials (RCTs) on QG and/or TC for patients with COPD were included. The quality of each RCT was appraised using the Physiotherapy Evidence Database (PEDro) scale. Outcome variables that were reported by greater than one-third of the RCTs were pooled for analysis.

A total of 37 RCTs were identified, with 12 matching the inclusion criteria. The average PEDro score was 5.25, indicating that limitations were noted in the methodology. Only forced expiratory volume in the first second of expiration/forced vital capacity ratio and the 6-Minute Walk Test (6MWT) distance were common outcome measures in greater than one-third of the RCTs. The weighted mean differences and the 95% CI estimation for mean gains in forced expiratory volume in the first second of expiration/forced vital capacity ratio and mean gains in 6MWT distance between QG/TC and conventional exercise groups were 0.62 (95% CI, 0.30-0.93) and 12.18 (95% CI, 10.32-14.05) m, respectively. The corresponding values between QG/TC and no exercise groups were 2.90 (95% CI, 2.37-3.43) and 37.77 (95% CI, 35.42-40.12) m, respectively.

This systematic review supports the therapeutic value of QG/TC in patients with COPD and highlights areas for future research.