Summary: In a small randomised trial in chronic coronary syndrome, a 12-week hybrid Tai Chi cardiac rehabilitation programme reduced perceived stress and oxidised LDL and raised antioxidant enzymes compared with conventional exercise rehabilitation, with perceived stress correlating with oxidative-stress markers.
PICO Summary
| Element | Detail |
|---|---|
| Population | 46 patients with chronic coronary syndrome on routine medication; China. |
| Intervention | 12-week hybrid Tai Chi cardiac rehabilitation programme (TCCRP), 3 sessions/week (n=23). |
| Comparison | 12-week conventional exercise cardiac rehabilitation (CECRP), 3 sessions/week (n=23). |
| Outcome | Perceived stress (CPSS) fell with Tai Chi but rose in the conventional group (between-group MD -7.71; 95% CI -10.75 to -4.68; p<0.001). Catalase and glutathione peroxidase rose markedly with Tai Chi (p<0.001). Perceived stress correlated positively with oxidised LDL (r=0.569) and negatively with glutathione peroxidase (r=-0.585). No adverse events. |
Tai Chi cardiac rehab vs conventional exercise
RCT · chronic coronary syndrome · 12 weeks
Tai Chi-based cardiac rehab lowered perceived stress and oxidised LDL and raised antioxidant enzymes versus conventional exercise. Small surrogate-marker trial; promising but not outcome-proven.
Expert Commentary
This is a thoughtful trial that targets a genuine gap, the psychological dimension of cardiac rehabilitation, which conventional treadmill-and-weights programmes often neglect. The mind-body rationale is coherent: chronic stress drives sympathetic and HPA-axis activation, oxidative stress, and endothelial injury, so a practice that lowers perceived stress could plausibly improve oxidative markers, and the correlation found here between perceived stress and oxidised LDL gives that pathway empirical support. The reduction in stress alongside rising antioxidant enzymes is encouraging, and the gentle, low-impact nature of Tai Chi makes it attractive for patients who are deconditioned, fearful of exercise, or burdened by comorbidities. My principal caveat is scale and endpoint: with only 46 participants and a 12-week window, this measures surrogate markers, not cardiovascular events or durability, and the comparator group’s stress actually worsening is a striking result that warrants replication. The population is chronic coronary syndrome rather than diabetes specifically, though the overlap is considerable. Can I use this with my patients? Yes, as a reasonable option. It supports offering Tai Chi-based rehabilitation to cardiac patients who will not engage with conventional programmes or who carry a high stress burden, while I treat the biomarker findings as promising rather than outcome-proven.
References
Cui M, Li C, Li Y, et al. Evaluating the effectiveness of a hybrid Tai Chi cardiac rehabilitation programme for psychological stress reduction and oxidative stress in patients with chronic coronary syndrome: a randomized controlled trial. Stress Health. 2025;41(5):e70088. doi:10.1002/smi.70088