Tai Chi Chuan improves functional capacity after myocardial infarction: A randomized clinical trial.

BACKGROUND: Patients with a recent myocardial infarction (MI) present a reduction in functional capacity expressed as a decrease in peak oxygen consumption (Vo2 peak). The impact of a Tai Chi Chuan (TCC) cardiac rehabilitation program for patients recovering from recent MI has yet to be assessed. Our goal is to evaluate functional capacity after a TCC-based cardiac rehabilitation program in patients with recent MI. METHODS: A single-blind randomized clinical trial was conducted. The researchers who performed the tests were blinded to group allocation. Between the 14th and 21st days after hospital discharge, all patients performed a cardiopulmonary exercise testing and a laboratory blood workup. Mean age was similar (56±9 years in the TCC group and 60±9 years in the control group). Patients allocated to the intervention group performed 3 weekly sessions of TCC Beijin style for 12 weeks (n=31). The control group participated in 3 weekly sessions of full-body stretching exercises (n=30). RESULTS: After the 12-week study period, participants in the TCC group experienced a significant 14% increase in Vo2 peak from baseline (21.6 ± 5.2 to 24.6 ± 5.2 mL/kg per minute), whereas control participants had a nonsignificant 5% decline in Vo2 peak (20.4 ± 5.1 to 19.4 ± 4.4 mL/kg per minute). There was a significant difference between the 2 groups (P<.0001). CONCLUSIONS: Tai Chi Chuan practice was associated with an increase in Vo2 peak in patients with a recent MI and may constitute an effective form of cardiac rehabilitation in this patient population.

Effects of Different Rehabilitation Protocols in Inpatient Cardiac Rehabilitation After Coronary Artery Bypass Graft Surgery: A RANDOMIZED CLINICAL TRIAL.

PURPOSE: Patients undergoing coronary artery bypass graft (CABG) surgery typically experience loss of cardiopulmonary capacity in the post-operative period. The purpose of this study was to evaluate the effects of different rehabilitation protocols used in inpatient cardiac rehabilitation on functional capacity and pulmonary function in patient status post-CABG surgery. METHODS: This was a single-blind randomized controlled trial. The primary endpoint of functional capacity and secondary endpoints of lung capacity and respiratory muscle function were assessed in patients scheduled to undergo CABG. After surgery, 40 patients were randomly assigned across 1 of 4 inpatient cardiac rehabilitation groups: G1, inspiratory muscle training, active upper limb and lower limb exercise training, and early ambulation; G2, same protocol as G1 without inspiratory muscle training; G3, inspiratory muscle training alone; and G4, control. All groups received chest physical therapy and expiratory positive airway pressure. Patients were reassessed on post-operative day 6 and post-discharge day 30 (including cardiopulmonary exercise testing). RESULTS: The 6-min walk distance on post-operative day 6 was significantly higher in groups that included exercise training (G1 and G2), remaining higher at 30 d post-discharge (P < .001 between groups). Peak oxygen uptake on day 30 was also higher in G1 and G2 (P = .005). All groups achieved similar recovery of lung function. CONCLUSION: Protocols G1 and G2, which included a systematic plan for early ambulation and upper and lower limb exercise, attenuated fitness losses while in the hospital and significantly enhanced recovery 1 mo after CABG.

Preoperative maximal expiratory pressure is associated with duration of invasive mechanical ventilation after cardiac surgery: An observational study.

OBJECTIVE: To evaluate the association of maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), and peak expiratory flow (PEF) with total duration of invasive mechanical ventilation (IMV) in subjects undergoing cardiac surgery. BACKGROUND: Prolonged IMV is associated with respiratory infections, prolonged hospitalization, and increased mortality. Pulmonary function tests can help predict postoperative outcomes after cardiac surgery. METHODS: We recruited subjects admitted for cardiac surgery. All MIP, MEP, and PEF measurements were performed before surgery. Multivariable analysis was performed using a multiple linear regression model to control for possible confounders and test for association of MIP, MEP, and PEF with IMV duration. RESULTS: Overall, 125 subjects were included in the study. Higher MEP was associated with reduced duration of IMV after adjustment for confounders (P = 0.015), but no such association was observed between MIP or PEF and IMV. CONCLUSIONS: In subjects undergoing elective cardiac surgery, preoperative MEP is associated with IMV duration.