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Table 1 Characteristics of included studies on Tai Chi for CVD and/or risk factors

From: Does tai chi improve psychological well-being and quality of life in patients with cardiovascular disease and/or cardiovascular risk factors? A systematic review

Study ID

Disease/

condition

Sample size

Intervention

Duration (weeks)

Control

Lost to follow up (No. (%))

Outcome measures

Barrow DE 2007 [35]

Symptomatic heart failure

65

Wu Chian Chuan style Tai Chi, twice 55-min sessions weekly

+ Usual medical care

16

Usual medical care

13/65 (20%) in total; I: 7/32 (21.8%);

C: 6/33 (18.1%)

Safety; mood (SCL-R); QoL (MLHF)

Caminiti G 2011 [36]

Chronic heart failure

60

A modified 10-form Yang-style Tai Chi, three 50-min sessions weekly

+ Endurance Training

+ Usual medical care

12

Endurance Training: three 50-min sessions weekly

+ Usual medical care

3/60 (5.0%) in total; I: 0;

C: 3/30 (10.0%)

Safety; QoL (MacNewQLMI)

Chan AWK 2018 [37]

Hypertension

246

24 simplified Tai Chi, 60 min per session, 2 sessions weekly

12

Control 1: Aerobic exercise

Control 2: No treatment

28/246 (11.4%) in total; I: 13/82 (15.9%); C1: 19/82 (23.2%); C2: 20/82 (24.4%)

Stress (PSS-10), Exercise self-efficacy (TCSE&SEE), QoL (SF-12)

Cui H 2020 [38]

Chronic heart disease

44

Tai Chi

+ conventional pharmacologic therapy

12

Aerobic exercise

+ conventional pharmacologic therapy

2/44 (4.5%) in total; C: 2/22 (9.1%)

Safety; QoL (MLHF)

Ding FM 2013 [39]

Acute myocardial infarction after PCI

90

42-form Chen style Tai Chi, at least five 60-min sessions per week

+ Behaviour guidance

+ Usual medical care

+ Jogging

24

Control 1: Behaviour guidance + Usual medical care

Control 2: Jogging

NR

QoL (SF-36)

Fan QY 2020 [40]

Coronary heart disease

86

Tai Chi

+ usual treatment and care

NA

Usual treatment and care (medication, psychological, diet, walking)

NA

QoL (SF-36)

Gong ZY 2020 [41]

T2DM

20

Tai Chi (eight fundamental movements and five steps)

12

C1: usual medication treatment

C2: Tai Chi + sand table game

NA

Depression (SDS), anxiety (SAS)

Han QY 2010 [42]

Hypertension

60

24 simplified Yang-style Tai Chi, 45-60 min per session, 1-2 sessions daily

+ Usual medical care

240

Usual medical care

2/60 (3.3%) in total; I: 0;

C: 2/30 (6.6%)

Safety, QoL (SF-36)

Li Y 2019 [43]

Chronic heart failure

326

Five movements and 24-form Yang style Tai Chi, 1 h per session daily

+ conventional treatment and care (the treatment of CHD symptoms, appropriate diets, exercises, medicine, and psychological therapy)

24

Conventional treatment and care (the treatment of CHD symptoms, appropriate diets,

exercises, medicine, and psychological therapy)

77/326 (23.6%) in total: I: 35/163 (21.5%); C: 42/163 (25.8%)

QoL (SF-36), Depression (SDS), anxiety (SAS)

Liu J 2020 [44]

Chronic heart failure

70

24-form Tai Chi, 50-60 min per session, twice a day

+ same treatment as control

40

Routine treatment, examination, nursing, and health education. Antidepressant amitriptyline was administered at a dose of 50–200 mg/day according to the different severity degrees of depression

9/70 (12.9%) in total: I: 5/35 (14.3%); C: 4/35 (11.4%)

QoL (SF-36), Depression (SDS), anxiety (SAS)

Luberto CM 2020 [45]

Heart failure

100

5 simplified Yang-style Tai Chi, twice 60-min sessions weekly and home practice > 3 times weekly

+ Usual medical care

+ General exercise advice

12

Usual medical care

+ General exercise advice

+ Health education

4/100 (4.0%) in total; I: 1/50 (2.0%); C: 3/50 (6.0%)

Depression (EPOMS), QoL (MLFHQ), Social support (The Multidimensional Scale of Perceived Social Support), Cardiac exercise self-efficacy (a 16-item measure used to assess an individual’s self-efficacy for exercise-related activities)

Ma CH 2018 [46]

Hypertension

158

24 simplified Tai Chi, two 90-min sessions weekly & home practice in group

+ Usual medical care

29

Usual medical care

45/158 (28.5%) in total; I:24/79 (30.4%); C:21/79 (26.6%)

Social support (SSRS), Depression (CES-D), QoL (SF36)

Ma CJ 2020 [47]

Coronary heart disease

32

Tai Chi (24-form simplified Tai Chi)

+ usual medication treatment

12

Usual medication treatment

2/32 (6.25%) in total;

Safety; QoL (SF-36)

Meng E 2014 [48]

Type 2 diabetes

200

Tai Chi

+ Health education

+ Diet guidance

+ Usual medical care

12

Health education

+ Dietary guidance

+ Usual medical care

NR

QoL (SF-36)

Pan XF 2016 [49]

Chronic heart failure

61

24 simplified Yang-style Tai Chi, one 30-min session daily

+ Health education

+ Diet guidance

+ Usual medical care

24

Health education

+ Diet guidance

+ Usual medical care

NR

QoL (SF-36)

Redwine LS 2019 [50]

Heart failure

70

Yang-style Tai Chi Chuan-Short Form (first third), twice 60-min sessions weekly and practice at home for 10-20 min/day, on non-class days

+ usual care (including regular visits to their cardiologist, primary care physicians, and other health specialists

16

resistance band (RB) (based on the Center for Disease Control’s “Move” program), twice 60-min sessions weekly and practice at home for 10-20 min/day, on non-class days + usual care (including regular visits to their cardiologist, primary care physicians, and other health specialists / usual care (including regular visits to their cardiologist, primary care physicians, and other health specialists

11/70 (15.7%) in total; I: 4/25 (16.0%); C1: 3/22 (13.6%); C2: 4/23 (17.4%)

Depression (BDI)

Sang L 2015 [51]

Chronic heart failure

100

Specially designed Tai Chi program, one 15-min session daily

+ Usual medical care

12

Usual medical care

NR

QoL (MLHF)

Shen XY 2019 [52]

T2DM

108

Tai Chi

+ usual medication treatment

12

Usual medication treatment

+ walking

7/108 (6.5%) in total; I:2/54 (3.7%); C: 5/54 (9.3%)

QoL (DAQL), Depression (GDS)

Shou XL 2019 [53]

Hypertension

208

24-Style Simplified Tai Chi

+ same general daily lifestyle intervention as control

12

General daily lifestyle advice (hypertension knowledge propaganda, propaganda for blood pressure monitoring, and healthy lifestyle self-management, such as persuasion for smoking cessation, alcohol restriction, sodium restriction, dietary balance, weight control, and general daily exercise)

10/208 (4.8%) in total; I:6/104 (5.8%); C: 4/104 (3.8%)

QoL (SF-36)

Song R 2021 [54]

Stroke

34

Tai Chi-based stroke rehabilitation program

24

Stroke-specific symptom management program

5/34 (14.7%) in total; I:3/18 (16.7%); C: 4/104 (12.5%)

QoL (SS-QOL)

Sun F 2014 [55]

Hypertension

90

24 simplified Yang style Tai Chi, one 2-h session daily

8

Health education

10/90 (11.1%) in total; I: 7/45 (15.5%); C: 3/45 (6.6%)

Depression (SDS), anxiety (SAS)

Sun J 2015 [56]

Hypertension

300

Tai Chi in group 3 h & 2 h home practice weekly

48

Active controls: non-exercise-related activities such as reading

35/300 (11.6%) in total; I: 14/150 (9.3%); C: 20/150 (13.3%)

QoL (SF-12)

Tsang T 2007 [57]

Type 2 diabetes

38

Tai Chi for Diabetes (a 12-movement hybrid from Sun and Yang styles), twice 1-h sessions weekly

16

Sham exercise (e.g., seated calisthenics & gentle stretching)

1/38 (2.6%) in total; I: 1/18 (5.5%);

C: 0

Safety; QoL (SF-36)

Wang HP 2014 [58]

Type 2 diabetes

70

24 simplified Yang-style Tai Chi, five 40-min sessions weekly

+ Diet guidance

+ Usual medical care

8

Dietary guidance

+ Usual medical care

NR

Mood (SCL-90)

Wang P 2009 [59]

Type 2 diabetes

64

24 simplified Yang-style Tai Chi, 45-60 min per session, 5-7 sessions weekly

+ Health education

+ Usual medical care

24

Health education

+ Usual medical care

0

QoL (SF-36)

Wang XB 2019 [60]

Hypertension

100

Tai Chi (24-form simplified Tai Chi)

+ usual treatment and care

12

Usual treatment and care (medication, daily life behaviour, psychological, diet, exercise)

NA

QoL (WHO-BREF), anxiety (SAS)

Wang XK 2013 [61]

Acute myocardial infarction after PCI

60

42-form Chen style Tai Chi, five 60-min sessions weekly

+ Behaviour guidance

+ Usual medical care

24

Behaviour guidance

+ Usual medical care

NR

QoL (SF-36)

Wang YH 2019 [62]

Chronic heart failure

50

Tai Chi

+ usual medication treatment

8

C1: usual treatment (medication, health education, diet guidance)

C2: usual medication + Tai Chi + external counterpulsation

NA

QoL (SF-36)

Wu F 2010 [63]

Type 2 diabetes

40

24 simplified Yang-style Tai Chi, 60-min per session, > 3 sessions weekly

+ Usual medical care

24

Usual medical care

NR

QoL (SF-36)

Yao CD 2010 [64]

Chronic heart failure

150

42-form Chen style Tai Chi, 5-15 min per session (30 min per session after the first month), > 5 sessions weekly

+ Lifestyle guidance

+ Usual medical care

24

Lifestyle guidance

+ Usual medical care

NR

QoL (MLHF)

Yeh GY 2004 [66]

Chronic heart failure

30

5-form simplified Yang-style Tai Chi, twice 60-min sessions weekly & home practice > 3 times weekly

+ Usual medical care

+ Dietary guidance

+ General exercise advice

12

Usual medical care

+ Dietary guidance

+ General exercise advice

0

Safety; QoL (MLHF)

Yeh GY 2011 [65]

Chronic heart failure

100

5-form simplified Yang-style Tai Chi, twice 60-min sessions weekly & home practice > 3 times weekly

+ Usual medical care

+ General exercise advice

12

Usual medical care

+ General exercise advice

+ Health education

4/100 (4.0%) in total; I: 1/50 (2.0%);

C: 3/50 (6.0%)

Safety; mood (POMS), psychosocial functioning (CESI); QoL (MLHF)

Yeh GY 2013 [67]

Heart failure with a preserved ejection fraction

16

5-form simplified Yang-style Tai Chi, twice 60-min sessions weekly & home practice > 3 times weekly

+ Usual medical care

+ General exercise advice

12

Usual medical care

+ General exercise advice

+ Aerobic exercise, twice 1-h weekly

0

Safety; mood (POMS), self-efficacy (SEBES); QoL (MLHF)

Yin NN 2020 [68]

T2DM

68

Tai Chi (18-form Chen-style)

12

C1: Healthy Qi Gong; C2: Health education (knowledge about diabetes, management interventions, nursing for complications, and healthy lifestyle behaviours)

15/68 (22.1%) in total; I:9/33 (27.3%); C: 6/35 (17.1%)

Well-being (Index of Well-Being), depression (CES-D)

Zhang EM 2014 [69]

Type 2 diabetes with depression (SDS > 40)

40

24 simplified Yang-style Tai Chi, 60-min per session

+ Usual medical care

14

Usual medical care

+ Walking (80-100 steps/min)

NR

Depression (SDS)

Zhang GW 2020 [70]

Coronary heart disease

36

Tai Chi

+ Traditional Chinese medicine (including Danshen and Suxiao Jiuxin Pills)

+ health education lesson

12

Usual lifestyle

+ equal amount of physical activities

+ Traditional Chinese medicine (including Danshen and Suxiao Jiuxin Pills)

+ health education lesson

6/36 (16.7%) in total; I:1/19 (5.3%); C: 5/17 (29.4%)

QoL (CQQC)

Zhang SQ 2011 [71]

Acute myocardial infarction after PCI

132

42-form Chen style Tai Chi, 5-15 min per session (30-min session after the first month), >  5 sessions weekly

+ Behaviour guidance

+ Usual medical care

48

Behaviour guidance

+ Usual medical care

NR

QoL (MLHF)

Zhou B 2020 [72]

Heart failure

103

Tai Chi

+ Cardiac rehab

12

Cardiac rehab (heath education, usual medication, diet guidance, exercise)

NA

Depression (HAMD, SDS), QoL (MLHF)

  1. Abbreviations: PCI Percutaneous coronary intervention, QoL Quality of life, STAI State and anxiety inventory, PSS The Perceived Stress Scale, CES-D The Center for Epidemiological Studies-Depression, MOS Medical Outcomes Study, SSRS Social Supporting Rating Scale, SPS The revised Social Provision Scale, MAAS The Mindful Attention Awareness Scale, SCS-R The revised Self-Compassion Scale, SIBS-R The revised Spiritual Involvement and Beliefs Scale, MLHFQ The Minnesota Living with Heart Failure questionnaire, WHOQOL-100 The World Health Organization Quality of Life, SAS Zung Self-Rating Anxiety Scale, SCL-90 Symptom Checklist-90, SCL-R Symptom Checklist-90-Revised, POMS The Profile of Mood States, SEBES The Self-Efficacy-Barriers to Exercise Scale