Clinical and Autonomic Effects of Mind-Body Exercise in COPD

描述（由申请人提供）：慢性阻塞性肺疾病（COPD）是一个主要的公共卫生问题，是美国第四大死亡原因。尽管进行了药物和手术治疗，COPD仍然导致相当高的发病率和死亡率，并且是前十名中患病率持续增加的唯一主要疾病。需要新型和廉价的干预措施，可以改善症状，健康相关的生活质量，功能能力，并可能改变疾病进展。 太极拳是一种流行的身心运动，它结合了温和的身体活动，自我意识和放松与缓慢的身心呼吸。它可能特别适合于患有COPD的去适应个体，他们患有运动耐量有限和运动时呼吸短促，并且它整合了与COPD管理相关的多个组件，包括低强度有氧运动，压力管理和缓慢的身心呼吸训练。 在本申请中，我们提出了一项3臂随机对照试验（N=102），以评估太极拳运动（包括身心呼吸）与坐姿身心呼吸（综合太极拳计划的一个孤立的关键组成部分）与教育对照的益处。这种设计将使我们能够检查每种身心干预对COPD临床结局的个体疗效，但也将允许两种干预之间的临床和生理比较，从而深入了解身心疗法的组成部分和机制。将从门诊初级保健和肺科诊所招募COPD患者（1-3期全球阻塞性肺疾病，伴有呼吸困难症状）。我们的主要目的是研究太极拳和身心呼吸对这一人群生活质量和运动能力的影响。次要目的将进一步探索对临床症状、心理社会指数、心肺功能、力量和灵活性、全身炎症生物标志物和自主活动的影响。我们提出的研究结果将有助于为COPD的临床治疗提供信息，并进一步加深我们对身心运动和缓慢身心呼吸作用的机械理解。 公共卫生相关性：慢性阻塞性肺疾病（COPD）是一个主要的公共卫生问题，并且是美国第四大死亡原因。这项拟议的研究探讨了太极拳，一种有前途的身心运动，及其关键组成部分之一，缓慢的身心呼吸，这可能是特别相关的，并有利于慢性阻塞性肺病患者。这项研究的结果将有助于为COPD的临床治疗提供信息，并进一步加深我们对身心疗法的机械理解以及缓慢身心呼吸的作用。

DESCRIPTION (provided by applicant): Chronic obstructive pulmonary disease (COPD) is a major public health problem and is the fourth leading cause of death in the United States. Despite pharmacologic and surgical therapy, COPD continues to cause considerable morbidity and mortality and is the only major disease among the top ten that continues to increase in prevalence. Novel and inexpensive interventions that can improve symptoms, health-related quality-of-life, functional capacity, and potentially modify disease progression are needed. Tai chi is a popular mind-body exercise that combines gentle physical activity, self awareness, and relaxation with slow mind-body breathing. It may be particularly suited to deconditioned individuals with COPD, who suffer from limited exercise tolerance and shortness of breath on exertion, and it integrates multiple components relevant to COPD management, including low-intensity aerobic exercise, stress management and slow mind-body breathing training. In this application, we propose a 3-arm randomized controlled trial (N=102) to evaluate the benefits of tai chi exercise (which includes mind-body breathing) versus seated mind-body breathing alone (an isolated, key component of the comprehensive tai chi program) versus education control. This design will allow us to examine the individual efficacy of each mind-body intervention on clinical outcomes in COPD, but will also allow clinical and physiological comparisons between the two interventions, providing insight into the components and mechanisms of mind-body therapies. Patients with COPD (Global Obstructive Lung Disease stages 1-3 with symptoms of dyspnea) will be recruited from outpatient primary care and pulmonary clinics. Our primary aim will be to examine the effects of tai chi and mind-body breathing on quality-of-life and exercise capacity in this population. Secondary aims will further explore the effects on clinical symptoms, psychosocial indices, cardiopulmonary function, strength and flexibility, biomarkers of systemic inflammation, and autonomic activity. The results of our proposed research will help inform clinical treatment of COPD, and further our mechanistic understanding of mind-body exercises and the role of slow, mind-body breathing. PUBLIC HEALTH RELEVANCE: Chronic obstructive pulmonary disease (COPD) is a major public health problem and is the fourth leading cause of death in the United States. This proposed study examines tai chi, a promising mind- body exercise, and one of its key components, slow mind-body breathing, that may be particularly relevant and beneficial to patients with COPD. The results of this study will help inform clinical treatment of COPD, and further our mechanistic understanding of mind-body therapies in general and the role of slow mind-body breathing.