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Adharenz in herzgruppen: ein prospektiver, randomisierter vergleich einer konventionell durchgefuhrten herzgruppe zu einer Tai-Chi-herzgruppe (Adherence to phase III cardiac rehabilitation programs: a prospective, randomized comparison between a conventionally conducted program and a Tai Chi-based program) [German]
Wieczorrek G, Weber U, Wienke A, Egner E, Schroder J, Vogt A, Muller-Werdan U, Weber A, Steighardt J, Girschick C, Schlitt A
Sportverletzung Sportschaden 2016 Jun;30(2):95-100
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: In patients with cardiac diseases, lifestyle changes such as an increase in physical activity are recommended to prevent further cardiac events. In Germany this is possible by attending outpatient heart groups. A problem inherent in these programs is the lack of adherence since more than two thirds of patients stop attending cardiac rehabilitation programs after six months. An alternative to the conventional implementation of heart groups is Tai Chi, which was found to improve adherence to cardiac rehabilitation programs in international studies. METHODS: Patients were randomly assigned to a conventional heart group or a heart group with Tai Chi exercises. At the beginning of the study, a medical history was taken and physical and instrumental tests were carried out, including an assessment of anxiety/depression (HADS questionnaire) and physical well-being (SD-12). Follow-up tests were performed every three months. RESULTS: Patients were 62.6 +/- 8.5 years old, the mean BMI was 28.6 +/- 62 kg/m2, and the proportion of women was 29.8%. The groups were different in terms of age (conventional heart group 65.0 +/- 7.5; Tai Chi group 59.9 +/- 8.9 years). Therefore, age-adjusted analyses were performed in addition to the planned analyses. Regarding the primary endpoint of the study, there was no difference between the groups. After twelve months, 50% of subjects were active in the Tai Chi group and 48% in the conventional heart group (odds ratio 0.92, p = 0.891). After adjustment for age by logistic regression, the odds ratio was 0.47 (p = 0.285). Furthermore, both the participation period in weeks (Tai Chi group 43.3 +/- 26.0; conventional group 45.5 +/- 24.2, p = 0.766) and the participation rate (Tai Chi group 66.8 +/- 19.2%; conventional group 76.3 +/- 16.5%, p = 0.074) did not differ between the two groups. A further analysis showed a non-significant trend for improvement of anxiety, depression and physical well-being in the Tai Chi group compared with the conventional group. CONCLUSION: The insight gained in international studies regarding a better adherence to Tai Chi-guided prevention programs was not transferable to heart group participants from Germany. However, there was a trend regarding a better mental condition in the Tai Chi group.

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