Qui Gong Programme vs Short Form Sun Style Tai Chi in COPD Patients

Study Overview
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Brief Summary
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This was a Randomized control Trial. Purposive sampling was done to obtained Sample (n=78) which were randomly allocated to Group A (n=39) and Group B (n=39). Study was conducted from August 2019 to December 2019 in HBS Hospital Islamabad.To determine the effects of Qigong vs. Shot form Sun Style Tai Chi (SSTC) on Lung function, six min walk distance, dyspnea and quality of life in COPD patients.

Detailed Description
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Chronic obstructive pulmonary disease (COPD) is characterized by persistent respiratory symptoms and air-ﬂow limitation. Dyspnea is related with daily life activity. COPD patients often suffer from dyspnea and exacerbation, which leads to inactivity, deconditioning, and poor functional capacity and quality of life. Several interventions have been investigated with the aim of improving lung function, decreasing dyspnea symptoms and improving quality of life in this patient. Tai Chi, an exercise involving both upper and lower extremities, originated from China. Tai chi is characterized by posture alignment, weight shifting and circular movements that incorporate elements of muscle endurance and strengthening, balance, relaxation and breathing control. Among previous studies Tai Chi in pulmonary rehabilitation showed a modest complementary benefit in exercise capacity. The Tai Chi program is a safe, effective and feasible method to improve exercise capacity and health-related quality of life in people with COPD. Short form sun style Tai chi is one of the most common styles of t'ai chi. each form can be broken down into several movements which make it easy to learn and teach. Compared to some other styles of t'ai chi, SSTC involves less difficult movements, such as less deep-knee bending and single leg standing, which may make it more suitable for older people. Qi Gong is defined as a mind-body exercise that involves whole body movements, breathing techniques, postural control, and internal awareness. effects of Qi Gong on functional capacity and lung functions in COPD patients , and concluded that functional capacity, dyspnea scores and quality of life was significantly improved in mild to moderate COPD patients.

Official Title
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Comparison of Qui Gong Programme With Short Form Sun Style Tai Chi in COPD Patients

Conditions
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COPD

Intervention / Treatment
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* Other: Qi Gong Programme
* Other: Short Form Sun Style Tai Chi


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinically Diagnosed patient: Mild to moderate stage COPD according to GOLD criteria {i-e Global Initiative for Chronic Obstructive Lung Disease (GOLD) } Patients who can walk without any dependency were included in study. Exclusion Criteria: Patients with acute exacerbation within 4 weeks before starting the study Patient having significant, cognitive impairment Patient having Tuberculosis, asthma Patient having musculoskeletal Patient having psychological, cardiovascular and benign conditions (that prohibit exercise were excluded from the study)

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Qi Gong Programme<br>Qi Gong Programme | Other: Qi Gong Programme<br>* Warm-up: In warm up session joint activities were performed along with light stretching. Patients performed these activities with instructor's commands for 5 minutes. Liu Zi Jue exercise: patients performed intact Liu Zi Jue exercise (form of Qigong). This includes six healing sounds, Xu, He, Hu, Si, Chui, Xi and the Harmonized actions along with the instructor for 20 minutes. Cooling-down: After completion of Qigong, patient done gentle stretching to adjust back their breathing and this cool down session lasted for 5 minutes. Subjects received supervised training session for 30 min twice a week.<br>|
| Experimental: Short Form Sun Style Tai Chi<br>Short Form Sun Style Tai Chi | Other: Short Form Sun Style Tai Chi<br>* Commencing Movement, Opening and closing hand, Single whip, Waving hands in the cloud, Opening and closing hands, Brush knee, Playing lute, Perry and Punch, Block and close, Pushing the mountain, Closing movement. Participants attended two supervised 30min sessions twice a week. Participants learnt 3 to 4 forms per week and at the completion of study (which is the six week of training), they completed all 21 forms. In each training session, participants revised previous SSTC forms that they learnt earlier up to that session.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Forced Expiratory Volume in 1 second (FEV1) | Changes from the Baseline, the digital spirometer is used in clinical setting to analyze Forced Expiratory Volume in 1 second FEV1 in Liters | 6th week | 
| Forced vital Capacity (FVC) | Changes From the Baseline, the digital spirometer is used in clinical setting to analyze Forced vital Capacity in Liters. | 6th week | 
| Peak Expiratory Flow (PEF) | Changes from the Baseline, the digital spirometer is used in clinical setting to analyze peak expiratory flow PEF in Liter/second. | 6th week | 
| 6 min walk test: Distance (meters) | Changes from the baseline, 6 min walk test was used to measure Functional capacity. It is a sub maximal exercise test which can aid in assessing functional capacity of patients with cardiopulmonary diseases, in this test we find out the maximum distance in meters which an individual covers in 6 min without any support. | 6th week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Modified Medical Research Council Dyspnea Scale (mMRC) | Changes from the Baseline, It was used to measure Dyspnea score. This scale ranges from 0 to 4 in which 0 indicates that strenuous exercise leads to breathlessness and 4 means too breathless | 6 week | 
| Quality of life: St. George's Respiratory Questionnaire (SGRQ) | was used to access the quality of life; SGRQ is used for determining quality of life in COPD patients. This questionnaire is designed in 50 items to check the impact of COPD. 0 to 100 is the range of this score. Scores having higher values means more limitations. | 6 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pulmonary Disease, Qigong, Tai chi