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      Evaluation of the Effectiveness of Tai Chi versus Brisk Walking in Reducing Cardiovascular Risk Factors: Protocol for a Randomized Controlled Trial

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          Abstract

          Physical inactivity is one of the major modifiable lifestyle risk factors for cardiovascular disease (CVD). This protocol aims to evaluate the effectiveness of Tai Chi versus brisk walking in reducing CVD risk factors. This is a randomized controlled trial with three arms, namely, Tai Chi group, walking group, and control group. The Tai Chi group will receive Tai Chi training, which consists of two 60-min sessions each week for three months, and self-practice for 30 min every day. The walking group will perform brisk walking for 30 min every day. The control group will receive their usual care. 246 subjects with CVD risk factors will be recruited from two outpatient clinics. The primary outcome is blood pressure. Secondary outcomes include fasting blood for lipid profile, sugar and glycated haemoglobin (HbA1c); body mass index, waist circumference, body fat percentage; perceived stress level and quality of life. Data collections will be conducted at baseline, 3-month, 6-month and 9-month. Generalized estimating equations model will be used to compare the changes in outcomes across time between groups. It is expected that both the Tai Chi and walking groups could maintain better health and have improved quality of life, and that Tai Chi will be more effective than brisk walking in reducing CVD risk factors.

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          Three versions of Perceived Stress Scale: validation in a sample of Chinese cardiac patients who smoke

          Doris YP Leung, Tai Lam, Sophia Chan (2010)
          Background Smoking causes heart disease, the major cause of death in China and Hong Kong. Stress is one major trigger of smoking and relapse, and understanding stress among smoking cardiac patients can therefore help in designing effective interventions to motivate them to quit. The objective of this study was to examine the psychometric properties of the Perceived Stress Scale (PSS), and to compare the appropriateness of the three versions of the scale (PSS-14, PSS-10, and PSS-4) among Chinese cardiac patients who were also smokers. Methods From March 2002 to December 2004, 1860 cardiac patients who smoked were recruited at the cardiac outpatient clinics of ten acute hospitals in Hong Kong, and 1800 questionnaires were analysed. Participants completed a questionnaire including the PSS, nicotine dependence and certain demographic variables. The psychometric properties of the PSS were investigated: construct validity using confirmatory factor analysis, reliability using Cronbach's alpha and concurrent validity by examining the relationship with smoking- and health-related variables. Results For all the three versions of the PSS, confirmatory factor analyses corroborated the 2-factor structure of the scale, with the positive and negative factors correlating significantly and negatively to a moderate extent (r 0.5). All the correlations of the two subscales and the smoking- and health-related variables were statistically significant and in the expected directions although of small magnitudes, except daily cigarette consumption. Conclusions The findings confirmed the satisfactory psychometric properties of all three Chinese versions of PSS. We recommend the use of PSS-10 for research which focuses on the two components of perceived stress, as it shows a higher reliability; and the use of PSS-4 if such partition is not essential and space for multiple measures is limited.
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            Physical activity and health: a report of the Surgeon General

            National Center for Chronic Disease Prevention and Health Promotion (1996)
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              A comprehensive review of health benefits of qigong and tai chi.

              Roger Jahnke, Linda Larkey, Carol E. Rogers … (2015)
              Research examining psychological and physiological benefits of Qigong and Tai Chi is growing rapidly. The many practices described as Qigong or Tai Chi have similar theoretical roots, proposed mechanisms of action, and expected benefits. Research trials and reviews, however, treat them as separate targets of examination. This review examines the evidence for achieving outcomes from randomized controlled trials (RCTs) of both. The key words Tai Chi, Taiji, Tai Chi Chuan, and Qigong were entered into electronic search engines for the Cumulative Index for Allied Health and Nursing (CINAHL), psychological literature (PsycINFO), PubMed, Cochrane database, and Google Scholar. STUDY INCLUSION CRITERIA: RCTs reporting on the results of Qigong or Tai Chi interventions and published in peer-reviewed journals from 1993 to 2007. Country, type and duration of activity, number/type of subjects, control conditions, and reported outcomes were recorded for each study. Outcomes related to Qigong and Tai Chi practice were identified and evaluated. Seventy-seven articles met the inclusion criteria. The nine outcome category groupings that emerged were bone density (n = 4), cardiopulmonary effects (n = 19), physical function (n = 16), falls and related risk factors (n = 23), quality of life (n = 17), self-efficacy (n = 8), patient-reported outcomes (n = 13), psychological symptoms (n = 27), and immune function (n = 6). Research has demonstrated consistent, significant results for a number of health benefits in RCTs, evidencing progress toward recognizing the similarity and equivalence of Qigong and Tai Chi.
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                Author and article information

                Contributors
                Paul B. Tchounwou: Role: Academic Editor
                Journal
                Journal ID (nlm-ta): Int J Environ Res Public Health
                Journal ID (iso-abbrev): Int J Environ Res Public Health
                Journal ID (publisher-id): ijerph
                Title: International Journal of Environmental Research and Public Health
                Publisher: MDPI
                ISSN (Print): 1661-7827
                ISSN (Electronic): 1660-4601
                Publication date (Electronic): 05 July 2016
                Publication date (Print): July 2016
                Volume: 13
                Issue: 7
                Electronic Location Identifier: 682
                Affiliations
                [1 ]The Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China; janet.sit@ 123456cuhk.edu.hk (J.W.H.S.); sychair@ 123456cuhk.edu.hk (S.Y.C.); dorisleung@ 123456cuhk.edu.hk (D.Y.P.L.); tzefanlee@ 123456cuhk.edu.hk (D.T.F.L.); elizawong@ 123456cuhk.edu.hk (E.M.L.W.)
                [2 ]Physiotherapy Department, Kwong Wah Hospital, 25 Waterloo Road, Yaumatei, Kowloon, Hong Kong, China; lcwfung@ 123456ha.org.hk
                Author notes
                [* ]Correspondence: aileenchan@ 123456cuhk.edu.hk ; Tel.: +852-3943-4290; Fax: +852-2603-5269
                Article
                Publisher ID: ijerph-13-00682
                DOI: 10.3390/ijerph13070682
                PMC ID: 4962223
                PubMed ID: 27399735
                SO-VID: 82770354-9523-4534-9462-b99a4c24d92a
                Copyright © © 2016 by the authors; licensee MDPI, Basel, Switzerland.
                License:

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 23 May 2016
                Date accepted : 30 June 2016
                Categories
                Subject: Article

                ScienceOpen disciplines: Public health
                Keywords: brisk walking,cardiovascular risk factors,tai chi
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: brisk walking, cardiovascular risk factors, tai chi

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