Dr Xin Liu
University of Queensland
$347,078 with beyondblue – Total funding $694,155
Cardiovascular Disease and Depression Strategic Research Program
Project completion year
Tai Chi has been used for chronic disease management in traditional Chinese medicine for more than 2,000 years and it is also claimed as a mind-body movement therapy. Tai Chi, as a gentle exercise, may provide an alternative form of physical activity for depressed mid-aged and older people, as well as people who are overweight or obese and at risk of cardiovascular disease (CVD), whose chronic health problems are perceived as a barrier to participation in more conventional physical activity such as gym-based training. Moreover, Tai Chi has been shown to have both physiological and psychological benefits. This indicates that Tai Chi may be beneficial in reducing depression and helping to improve the sustainability of beneficial effects on indicators of depression and metabolic syndrome, which is important for CVD prevention and management.
However, to date, no studies have focused specifically on the effects of Tai Chi on depressed adults with metabolic syndrome. The aim of this study is to evaluate the efficacy of Tai Chi mind-body movement therapy in improving depression and metabolic syndrome in depressed adults at risk of developing CVD.
There is now evidence from the researcher’s preliminary studies to suggest that Tai Chi may improve indicators of metabolic syndrome and glycaemic control in people with elevated blood glucose levels. A 12-week one group pilot study and a 12-week randomized controlled trial (RCT) were conducted to evaluate the feasibility and acceptability of the program and its effects on indicators of metabolic syndrome and glycaemic control in adults with elevated blood glucose levels. Both of the preliminary studies were conducted at the University of Queensland by Dr Liu et al (Dr Liu is the responsible investigator of the project).
Based on the promising findings from the preliminary pilot studies, this project is a phase II, 12 month, two group randomised controlled trial. Potential participants will attend a screening test two months prior to intervention (stage 1). Participants with depression and metabolic syndrome will then be randomly allocated to the Tai Chi, or the usual medical care alone control group using a computer-generated randomisation schedule. In addition to usual care, participants in the intervention groups will have three supervised instructor-led group training sessions per week during the first six months of intervention (stage 2); followed by self-led training during the remaining six months (stage 3).
During stage 2, Tai Chi group participants will receive DVD/video demonstrating the Tai Chi program and will be encouraged to practice at home on days when they do not attend group sessions. Each Tai Chi session will last approximately one hour with 10 minutes warm up, 40 minutes practice and 10 minutes cool down.
During stage 3, Tai Chi group participants will have ‘free choice’ (self-led training) and are encouraged to organise their own group training or practice at home. Monthly phone contact will be conducted to encourage intervention participants to continue with their ‘self led’ training and provide instructions/advice on their training.
Participants in the usual care alone control group will continue to receive medical usual care from their GPs throughout the study. Metabolic/biochemical, physical, psychological, general health and wellbeing, and behavioural measures will be assessed at screening, baseline, and at three, six, nine and 12 months.
The aim of the proposed study is to further evaluate and confirm the efficacy of the Tai Chi mind-body movement therapy in improving depression and metabolic syndrome control in depressed adults at risk of developing CVD.
1. To determine the recruitment effects of a Tai Chi program on the following variables associated with psychological health, metabolic syndrome, glycaemic control, general health and wellbeing, and behavioural change:
- indicators of psychological health including stress, depression, self-efficacy and social support
- indicators of the metabolic syndrome and glycemic control including body mass index, waist circumference, blood pressure, fasting blood glucose/insulin, HbA1c, insulin resistance, total cholesterol, triglycerides, HDLcholesterol, and LDL-cholesterol
- indicators of general health and well-being including leg strength and health-related quality of life (SF36)
- indicators of behavioral change including physical activity.
2. To determine the effects of a six-month 'instructor-led' group Tai Chi intervention program on the variables listed above, relative to the medical 'usual care' control group.
3. To assess the maintenance of any favourable effects of a six-month instructor-led group Tai Chi intervention, after a further six months of ‘self-led’ Tai Chi, relative to the medical 'usual care' control group.
4. To assess the determinants of changes in indicators of depression, metabolic syndrome and glycaemic control significantly improved by the intervention.