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Cystic fibrosis—Children and adults Tai Chi study (CF CATS2): Can Tai Chi improve symptoms and quality of life for people with cystic fibrosis? Second phase study protocol

Abstract

Background

Cystic fibrosis (CF) is a genetic disorder affecting respiratory and digestive systems. People with CF experience physical symptoms; cough, poor lung ventilation, recurrent infections, poor weight gain, diarrhoea, and malnutrition, as well as lower quality of life. Tai Chi, a Chinese form of meditative movement, may help with the symptoms of CF and help people with CF to exercise. However, there is very little research in this area.

Objective

To evaluate the feasibility of studying Tai Chi for CF and to compare the effectiveness of Tai Chi to standard care and face-to-face Tai Chi with online Tai Chi for people with CF.

Methods

This is a comparative effectiveness trial with 72 people with CF over 6 years old and a patient at the Royal Brompton Hospital, London, UK. Participants receive 8 Tai Chi sessions, then home practice with a DVD. Sessions are one-on-one for group A, online for group B. Group B is a no treatment standard care control (first 3 months). At baseline, 3, 6 and 9 months, questionnaires will be used to measure quality of life, mindfulness and sleep, and medical data health and respiratory function. At Tai Chi sessions and at 4 follow-up points, the Borg Scale and healthcare use data will be collected. At 9 months online focus groups will assess participants’ experience, Tai Chi feasibility, perceived health impact, and study participation. Recruitment will use adverts in hospital clinics and website, and letter/phone for non-regularly attending patients. Block randomisation will use random number tables. The two groups will be compared for: weeks 1 to 12 (Tai Chi vs. standard care); before and after intervention (differences in delivery method); week 1 (of intervention) to month 9 (long-term impact). Qualitative data will use Framework analysis.

Discussion

We believe this is the first trial of Tai Chi for CF. Tai Chi may help with the physiological symptoms of CF and increase levels of exercise by providing a self-management technique and low stress activity. This study will provide data on the feasibility of a randomized controlled trial of Tai Chi for CF, including data for a sample size calculation and will inform future study design.

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References

  1. 1.

    Cystic Fibrosis Trust. Annual data report. 2011. Available at http://cysticfibrosis.org.uk/media/82506/CR_Annual_Data_Report_2011_Jan_13.pdf

    Google Scholar 

  2. 2.

    Pfeffer PE, Pfeffer JM, Hodson E. The psychosocial and psychiatric side of cystic fibrosis in adolescents and adults. J Cyst Fibros 2003;2:61–68.

    Article  CAS  PubMed  Google Scholar 

  3. 3.

    Sawyer MG, Reynolds KE, Couper JJ, French DJ, Kennedy D, Martin J, et al. Health-related quality of life of children and adolescents with chronic illness: a two year prospective study. Qual Life Res Springer Netherlands. 2004;13:1309–1319.

    Article  Google Scholar 

  4. 4.

    Goss CH, Edwards TC, Ramsey BW, Aitken ML, Patrick DL. Patient-reported respiratory symptoms in cystic fibrosis. J Cyst Fibros 2009;8:245–252.

    Article  CAS  PubMed  Google Scholar 

  5. 5.

    Tattersall R, Walshaw MJ. Posture and cystic fibrosis. J R Soc Med 2003;96:18–22.

    PubMed Central  PubMed  Google Scholar 

  6. 6.

    Ward C, Massie J, Glazner J, Sheehan J, Canterford L, Armstrong D, et al. Problem behaviours and parenting in preschool children with cystic fibrosis. Arch Dis Child 2009;94:341–347.

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Tanase A, Zanni R. The use of complementary and alternative medicine among pediatric cystic fibrosis patients. J Altern Complement Med 2008;14:1271–1273.

    Article  PubMed  Google Scholar 

  8. 8.

    Jahnke R, Larkey L, Rogers C, Etnier J, Lin F. A comprehensive review of health benefits of qigong and Tai Chi. Am J Health Promot 2010;24:e1–e25.

    Article  PubMed Central  PubMed  Google Scholar 

  9. 9.

    Philpott J, Houghton K, Luke A. Physical activity recommendations for children with specific chronic health conditions: Juvenile idiopathic arthritis, hemophilia, asthma and cystic fibrosis. Paediatr Child Health 2010;15:213–225.

    PubMed Central  CAS  PubMed  Google Scholar 

  10. 10.

    Wheatley CM, Wilkins BW, Snyder EM. Exercise is medicine in cystic fibrosis. Exerc Sport Sci Rev 2011;39:155–160.

    Article  PubMed  Google Scholar 

  11. 11.

    Lorenc A, Wang Y, Madge L, Hu X, Mian AM, Robinson N. Meditative movement for cystic fibrosis/respiratory function: a systematic review. J Respir Care 2013;59:427–440.

    Article  Google Scholar 

  12. 12.

    Lorenc A, Mian AM, Madge SL, Carr S, Robinson N. CFCATS: an uncontrolled feasibility study of using Tai Chi for adults with cystic fibrosis. Eur J Integr Med 2014;5:476–486.

    Article  Google Scholar 

  13. 13.

    Rosenstein BJ, Cutting GR. The diagnosis of cystic fibrosis: a consensus statement. Cystic Fibrosis Foundation Consensus Panel. J Pediatr 1998;132:589–595.

    CAS  Google Scholar 

  14. 14.

    Modi A C, Quittner AL. Validation of a disease-specific measure of health-related quality of life for children with cystic fibrosis. J Pediatr Psychol 2003;28:535–546.

    Article  PubMed  Google Scholar 

  15. 15.

    Quittner AL, Buu A, Messer MA, Modi AC, Watrous M. Development and validation of the cystic fibrosis questionnaire in the United States: a health-related quality-of-life measure for cystic fibrosis. Chest 2005;128:2347–2354.

    Article  PubMed  Google Scholar 

  16. 16.

    Baer R, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment 2006;13:27–45.

    Article  PubMed  Google Scholar 

  17. 17.

    Greco LA, Baer RA, Smith GT. Assessing mindfulness in children and adolescents: development and validation of the Child and Adolescent Mindfulness Measure (CAMM). Psychol Assess 2011;23:606–614.

    Article  PubMed  Google Scholar 

  18. 18.

    Buysse DJ, Reynolds CF, III, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193–213.

    Article  CAS  PubMed  Google Scholar 

  19. 19.

    Borg E, Borg G. A comparison of AME and CR100 for scaling perceived exertion. Acta Psychol (Amst) 2002;109:157–175.

    Article  Google Scholar 

  20. 20.

    Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 1970;2:92–98.

    CAS  PubMed  Google Scholar 

  21. 21.

    Ritchie J. The applications of qualitative reseach methods. London: Sage Publications Ltd; 2003:24–46.

    Google Scholar 

  22. 22.

    Lorenc A, Blair M, Robinson N. Parents’ and practitioners’ differing perspectives on traditional and complementary health approaches (TCAs) for children. Eur J Integr Med 2010;2:9–14.

    Article  Google Scholar 

  23. 23.

    Robinson N, Lorenc A. “No one wants to be the face of Herpes London”: a qualitative study of the challenges of engaging patients and the public in sexual and reproductive health and HIV/AIDS services. Health Expect 2012; doi: 10.1111/hex.12024 [Epub ahead of print]

    Google Scholar 

  24. 24.

    Chang YF, Yang YH, Chen CC, Chiang BL. Tai Chi Chuan training improves the pulmonary function of asthmatic children. J Microbiol Immunol Infect 2008;41:88–95.

    PubMed  Google Scholar 

  25. 25.

    Baron LJ, Fauber C. The role of Tai Chi Chuan in reducing state anxiety and enhancing mood of children with special needs. J Bodywork Movem Therap 2005;9:120–133.

    Article  Google Scholar 

  26. 26.

    Witt C, Becker M, Bandelin K, Soellner R, Willich SN. Qigong for schoolchildren: a pilot study. J Alternat Complement Med 2005;11:41–47.

    Article  Google Scholar 

  27. 27.

    Cystic Fibrosis Trust. Standards for the clinical care of children and adults with cystic fibrosis in the UK. 2011. Available at https://www.cysticfibrosis.org.uk/media/82070/CD_Standards_of_Care_Dec_11.pdf

    Google Scholar 

  28. 28.

    Ekeland AG, Bowes A, Flottorp S. Effectiveness of telemedicine: a systematic review of reviews. Int J Med Inform 2010;79:736–771.

    Article  PubMed  Google Scholar 

  29. 29.

    McLean S, Sheikh A, Cresswell K, Nurmatov U, Mukherjee M, Hemmi A, et al. The impact of telehealthcare on the quality and safety of care: a systematic overview. PLoS One 2013;8:e71238.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  30. 30.

    Wu G, Keyes LM. Group tele-exercise for improving balance in elders. Telemed J E Health 2006;12:561–570.

    Article  PubMed  Google Scholar 

  31. 31.

    Nield M, Hoo G. Real-time telehealth for COPD self-management using Skype. COPD 2012;9:611–619.

    Article  PubMed  Google Scholar 

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Correspondence to Patricia Ronan.

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Lorenc, A., Ronan, P., Mian, A. et al. Cystic fibrosis—Children and adults Tai Chi study (CF CATS2): Can Tai Chi improve symptoms and quality of life for people with cystic fibrosis? Second phase study protocol. Chin. J. Integr. Med. (2015). https://doi.org/10.1007/s11655-015-2150-1

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Keywords

  • cystic fibrosis
  • Tai Chi
  • study protocol
  • quality of life