Cystic Fibrosis
Conditions
Keywords
cystic fibrosis, tai chi
Brief summary
Cystic fibrosis (CF) is a progressive disease. Symptoms include coughing, poor lung ventilation, recurrent infections, poor weight gain, diarrhoea, malnutrition, stress, frustration, depression, irritability, worry, insomnia, behavioural issues and missed school/work. Tai chi, a Chinese form of exercise, uses slow choreographed movements, breathing exercises and mindfulness. Research suggests tai chi can improve physical and emotional wellbeing for various chronic conditions. This study compares methods of teaching tai chi to 70 people with CF, and evaluates the effect on symptoms and quality of life. Adults and children with CF will be recruited and randomly allocated to an intervention group or a control group. The former will receive 8 individual face to face sessions of tai chi over a 3 month period and a video and handouts to aid home practice. The latter will have routine care for the first 12 weeks, followed by 8 individual online sessions of tai chi over a 3 month period, and a video and handouts for home practice. Both groups will be encouraged to practice tai chi at home in the months following the taught sessions. Questionnaire data on how participants and their carers are coping with CF, any general improvements in wellbeing, and differences in other clinical outcomes (medication etc.)will be collected. Data will be collected at the beginning and end of the intervention, and at 6 and 9 months post intervention and differences between the 2 groups compared over time. Feedback from on line focus groups will ask about their experiences, feasibility of learning and practicing of tai chi, engagement with the process, perceived health impact, and experiences of participation. It is hoped that the study may show how Tai Chi can help people with CF to maintain their health through mindful exercise, and improve troublesome symptoms like sleep and anxiety.
Interventions
OTHERTai chi
Tai Chi, a Chinese form of mindful exercise, may help alleviate CF symptoms, encourage active self-management and provide a practical way to relieve and manage stress for patients and carers. It involves gentle physical exercises, combined with breathing techniques and mindful awareness. It will be taught by qualified instructors either face to face in the participant's home or over videoconferencing technology e.g. Skype. A DVD of the Tai Chi was developed in Phase 1 which was successful for teaching adults, and will be used here, along with a child-friendly DVD. This will be filmed with and aimed at children aged 6-18. Teaching support materials, incorporating child-specific guidance such as animal-based Tai Chi movements, will be prepared for use in conjunction with the DVD.
Sponsors
Royal Brompton & Harefield NHS Foundation Trust
London South Bank University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
6 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* diagnosis of CF * no previous experience in Tai Chi, but ability/potential to undertake these movements * able to commit to a 9 month study * living in or near London or Brighton (depending on teacher locations) * able to understand, read and write English * 6 years old and above * to have internet access for web based learning
Exclusion criteria
* participant in the feasibility phase * currently taking part in another interventional research study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cystic Fibrosis Questionnaire (CFQ-R ) | Change from baseline at 3 months | • Cystic Fibrosis Questionnaire-Revised (CFQ-R), a disease-specific instrument (Quittner et al 2005; Modi & Quittner 2003). The CFQ uses 5 point Likert scales in 9 quality of life domains (physical, role/school, vitality, emotion, social, body image, eating, treatment burden, health perceptions), 3 symptoms (weight, respiratory, and digestion) and health perception. CFQ-R was seen as acceptable, appropriate and easily completed in the feasibility study. There are four different versions of the CFQ-R which will be used as appropriate: Adult/adolescent version completed by the patient for those 14 and over; 12-13 year old version completed by the patient; parent CFQ for children aged 6 to 13; for children 6 to 11 child CFQ in interviewer format (parent/carer) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Five facets mindfulness scale | Change from baseline at 3 months | The five facets scale is a 39 item questionnaire about awareness of thoughts, anxieties, self-management |
Other
| Measure | Time frame | Description |
|---|---|---|
| Routine clinical data from hospital records | Change from baseline at 3 months | Changes in general health and respiratory function will be measured using routine clinical data from hospital records, to include: Body Mass Index (BMI), medications, antibiotic use, Forced Expiratory Volume (FEV1), Forced Vital Capacity (FVC), and oxygen saturation (amount of oxygen in red blood cells) |
| Child and Adolescent Mindfulness Measure (CAMM) | Change from baseline at 3 months | CAMM is a 10 item questionnaire about awareness of thoughts, anxieties, self-management. |
| Changes that week | Before and after each tai chi session | Details of any changes in medication, exacerbations, antibiotic use, clinical trial participation, or care provision (start of session only), asked verbally by the instructor |
| Modified Borg dyspnoea scale | Before and after each tai chi session | Modified Borg dyspnoea scale is a one item, 10 point scale that rates comfort of breathing (American Thoracic Society, 2002, Borg and Borg, 2002, Borg, 1970) |
| Pittsburgh Sleep Quality Index (PSQI) | Change from baseline at 3 months | Pittsburgh Sleep Quality Index (PSQI) (Buysse et al., 1989), a 10 item questionnaire about sleep quality and duration. This will be completed by the parent/carer for children under 12. |
Countries
United Kingdom
Outcome results
None listed