Preliminary application of “Three-in-one Taiji” in the integrated management of chronic kidney disease_West China Medical Journal

Authors：

YANG Yujie ¹ , YUAN Huaihong ¹ , LIU Jing ² , YU Shaobin ² ,  FU Ping ²

1. Department of Nephrology, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Nephrology / Kidney Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

FU Ping, Email: fupinghx@scu.edu.cn

Keywords：

Chronic kidney disease; Exercise rehabilitation; Three-in-one Taiji

DOI：

10.7507/1002-0179.202106173

Video：

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In 2020, chronic kidney disease has become one of the top 10 causes of death in the world. More and more evidence shows that proper exercise rehabilitation is beneficial to the health of patients with chronic kidney disease, which can improve the survival rate and slow down the decline of renal function. However, existing studies have significant differences in form, intensity, duration, and specific implementation methods of sports rehabilitation, which need to be further standardized and unified. This article introduces the impact of exercise rehabilitation on patients with chronic kidney disease and the clinical application of Chinese traditional exercises in patients with chronic kidney disease, and mainly discusses the application experience of exercise rehabilitation characterized by “Three-in-one Taiji” in the Department of Nephrology of West China Hospital of Sichuan University. It aims to provide a basis for the model innovation of integrated management of chronic kidney disease in China.

Citation： YANG Yujie, YUAN Huaihong, LIU Jing, YU Shaobin, FU Ping. Preliminary application of “Three-in-one Taiji” in the integrated management of chronic kidney disease. West China Medical Journal, 2021, 36(7): 841-845. doi: 10.7507/1002-0179.202106173 Copy

1.	Carney EF. The impact of chronic kidney disease on global health. Nat Rev Nephrol, 2020, 16(5): 251.
2.	GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2020, 395(10225): 709-733.
3.	Foreman KJ, Marquez N, Dolgert A, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories. Lancet, 2018, 392(10159): 2052-2090.
4.	Tonelli M, Muntner P, Lloyd A, et al. Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet, 2012, 380(9844): 807-814.
5.	Inker LA, Astor BC, Fox CH, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis, 2014, 63(5): 713-735.
6.	中国医师协会康复医师分会肾康复专业委员会, 马迎春. 我国成人慢性肾脏病患者运动康复的专家共识. 中华肾脏病杂志, 2019, 35(7): 537-543.
7.	Vanden Wyngaert K, Van Craenenbroeck AH, Van Biesen W, et al. The effects of aerobic exercise on eGFR, blood pressure and VO2peak in patients with chronic kidney disease stages 3-4:a systematic review and meta-analysis. PLoS One, 2018, 13(9): e0203662.
8.	Hellberg M, Höglund P, Svensson P, et al. Randomized controlled trial of exercise in CKD-the RENEXC study. Kidney Int Rep, 2019, 4(7): 963-976.
9.	Wu X, Yang L, Wang Y, et al. Effects of combined aerobic and resistance exercise on renal function in adult patients with chronic kidney disease: a systematic review and meta-analysis. Clin Rehabil, 2020, 34(7): 851-865.
10.	Pei G, Tang Y, Tan L, et al. Aerobic exercise in adults with chronic kidney disease (CKD): a meta-analysis. Int Urol Nephrol, 2019, 51(10): 1787-1795.
11.	Zhou J, Yu Y, Cao B, et al. Characteristic of clinical studies on baduanjin during 2000-2019: a comprehensive review. Evid Based Complement Alternat Med, 2020, 2020: 4783915.
12.	Wu S, Chen J, Wang S, et al. Effect of tai chi exercise on balance function of stroke patients: a meta-analysis. Med Sci Monit Basic Res, 2018, 24: 210-215.
13.	Shi ZM, Wen HP, Liu FR, et al. The effects of tai chi on the renal and cardiac functions of patients with chronic kidney and cardiovascular diseases. J Phys Ther Sci, 2014, 26(11): 1733-1736.
14.	Chang JH, Koo M, Wu SW, et al. Effects of a 12-week program of tai chi exercise on the kidney disease quality of life and physical functioning of patients with end-stage renal disease on hemodialysis. Complement Ther Med, 2017, 30: 79-83.
15.	Dziubek W, Bulińska K, Kusztal M, et al. Evaluation of exercise tolerance in dialysis patients performing tai chi training: preliminary study. Evid Based Complement Alternat Med, 2016, 2016: 5672580.
16.	Zou L, Yeung A, Quan X, et al. A systematic review and meta-analysis of mindfulness-based (baduanjin) exercise for alleviating musculoskeletal pain and improving sleep quality in people with chronic diseases. Int J Environ Res Public Health, 2018, 15(2): 206.
17.	Xiong X, Wang P, Li S, et al. Effect of baduanjin exercise for hypertension: a systematic review and meta-analysis of randomized controlled trials. Maturitas, 2015, 80(4): 370-378.
18.	Wen J, Lin T, Jiang C, et al. Effect of baduanjin exercises on elevated blood lipid levels of middle-aged and elderly individuals: protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ Open, 2017, 7(9): e017213.
19.	Tong H, Liu Y, Zhu Y, et al. The therapeutic effects of qigong in patients with chronic obstructive pulmonary disease in the stable stage: a meta-analysis. BMC Complement Altern Med, 2019, 19(1): 239.
20.	Xiao X, Wang J, Gu Y, et al. Effect of community based practice of baduanjin on self-efficacy of adults with cardiovascular diseases. PLoS One, 2018, 13(7): e0200246.
21.	Bennett PN, Ngo T, Kalife C, et al. Improving wellbeing in patients undergoing dialysis: can meditation help?. Semin Dial, 2018, 31(1): 59-64.
22.	Bantornwan S, Watanapa WB, Hussarin P, et al. Role of meditation in reducing sympathetic hyperactivity and improving quality of life in lupus nephritis patients with chronic kidney disease. J Med Assoc Thai, 2014, 97(Suppl 3): S101-S107.
23.	Vareesangthip J, Malai T, Otsu B, et al. The effect of buddhist meditation on the quality of life using Short Form 36 in continuous ambulatory peritoneal dialysis patients. Nephrol Dial Transplant, 2017, 32(suppl 3): iii632.
24.	Chatrung C, Sorajjakool S, Amnatsatsue K. Wellness and religious coping among thai individuals living with chronic kidney disease in southern California. J Relig Health, 2015, 54(6): 2198-2211.
25.	MacKinnon HJ, Wilkinson TJ, Clarke AL, et al. The association of physical function and physical activity with all-cause mortality and adverse clinical outcomes in nondialysis chronic kidney disease: a systematic review. Ther Adv Chronic Dis, 2018, 9(11): 209-226.
26.	Chen IR, Wang SM, Liang CC, et al. Association of walking with survival and RRT among patients with CKD stages 3-5. Clin J Am Soc Nephrol, 2014, 9(7): 1183-1189.
27.	Clarke AL, Zaccardi F, Gould DW, et al. Association of self-reported physical function with survival in patients with chronic kidney disease. Clin Kidney J, 2019, 12(1): 122-128.
28.	Warburton DE, Bredin SS. Reflections on physical activity and health: what should we recommend?. Can J Cardiol, 2016, 32(4): 495-504.
29.	Clyne N, Anding-Rost K. Exercise training in chronic kidney disease-effects, expectations and adherence. Clin Kidney J, 2021, 14(Suppl 2): ii3-ii14.
30.	Ortega-Pérez de Villar L, Martínez-Olmos FJ, Pérez-Domínguez FB, et al. Comparison of intradialytic versus home-based exercise programs on physical functioning, physical activity level, adherence, and health-related quality of life: pilot study. Sci Rep, 2020, 10(1): 8302.
31.	Moorman D, Suri R, Hiremath S, et al. Benefits and barriers to and desired outcomes with exercise in patients with ESKD. Clin J Am Soc Nephrol, 2019, 14(2): 268-276.
32.	Parsons TL, Bohm C, Poser K. “A Learned Soul to Guide Me”: the voices of those living with kidney disease inform physical activity programming. Physiother Can, 2018, 70(3): 289-295.
33.	Hornik B, Duława J. Frailty, quality of life, anxiety, and other factors affecting adherence to physical activity recommendations by hemodialysis patients. Int J Environ Res Public Health, 2019, 16(10): 1827.
34.	Bogataj Š, Pajek M, Buturović Ponikvar J, et al. Outcome expectations for exercise and decisional balance questionnaires predict adherence and efficacy of exercise programs in dialysis patients. Int J Environ Res Public Health, 2020, 17(9): 3175.
35.	Kendrick J, Ritchie M, Andrews E. Exercise in individuals with CKD: a focus group study exploring patient attitudes, motivations, and barriers to exercise. Kidney Med, 2019, 1(3): 131-138.
36.	Thompson S, Tonelli M, Klarenbach S, et al. A Qualitative study to explore patient and staff perceptions of intradialytic exercise. Clin J Am Soc Nephrol, 2016, 11(6): 1024-1033.
37.	Bennett PN, Wang W, Moore M, et al. Care partner: a concept analysis. Nurs Outlook, 2017, 65(2): 184-194.
38.	Huston P, McFarlane B. Health benefits of tai chi: what is the evidence?. Can Fam Physician, 2016, 62(11): 881-890.

1. Carney EF. The impact of chronic kidney disease on global health. Nat Rev Nephrol, 2020, 16(5): 251.
2. GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2020, 395(10225): 709-733.
3. Foreman KJ, Marquez N, Dolgert A, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories. Lancet, 2018, 392(10159): 2052-2090.
4. Tonelli M, Muntner P, Lloyd A, et al. Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet, 2012, 380(9844): 807-814.
5. Inker LA, Astor BC, Fox CH, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis, 2014, 63(5): 713-735.
6. 中国医师协会康复医师分会肾康复专业委员会, 马迎春. 我国成人慢性肾脏病患者运动康复的专家共识. 中华肾脏病杂志, 2019, 35(7): 537-543.
7. Vanden Wyngaert K, Van Craenenbroeck AH, Van Biesen W, et al. The effects of aerobic exercise on eGFR, blood pressure and VO2peak in patients with chronic kidney disease stages 3-4:a systematic review and meta-analysis. PLoS One, 2018, 13(9): e0203662.
8. Hellberg M, Höglund P, Svensson P, et al. Randomized controlled trial of exercise in CKD-the RENEXC study. Kidney Int Rep, 2019, 4(7): 963-976.
9. Wu X, Yang L, Wang Y, et al. Effects of combined aerobic and resistance exercise on renal function in adult patients with chronic kidney disease: a systematic review and meta-analysis. Clin Rehabil, 2020, 34(7): 851-865.
10. Pei G, Tang Y, Tan L, et al. Aerobic exercise in adults with chronic kidney disease (CKD): a meta-analysis. Int Urol Nephrol, 2019, 51(10): 1787-1795.
11. Zhou J, Yu Y, Cao B, et al. Characteristic of clinical studies on baduanjin during 2000-2019: a comprehensive review. Evid Based Complement Alternat Med, 2020, 2020: 4783915.
12. Wu S, Chen J, Wang S, et al. Effect of tai chi exercise on balance function of stroke patients: a meta-analysis. Med Sci Monit Basic Res, 2018, 24: 210-215.
13. Shi ZM, Wen HP, Liu FR, et al. The effects of tai chi on the renal and cardiac functions of patients with chronic kidney and cardiovascular diseases. J Phys Ther Sci, 2014, 26(11): 1733-1736.
14. Chang JH, Koo M, Wu SW, et al. Effects of a 12-week program of tai chi exercise on the kidney disease quality of life and physical functioning of patients with end-stage renal disease on hemodialysis. Complement Ther Med, 2017, 30: 79-83.
15. Dziubek W, Bulińska K, Kusztal M, et al. Evaluation of exercise tolerance in dialysis patients performing tai chi training: preliminary study. Evid Based Complement Alternat Med, 2016, 2016: 5672580.
16. Zou L, Yeung A, Quan X, et al. A systematic review and meta-analysis of mindfulness-based (baduanjin) exercise for alleviating musculoskeletal pain and improving sleep quality in people with chronic diseases. Int J Environ Res Public Health, 2018, 15(2): 206.
17. Xiong X, Wang P, Li S, et al. Effect of baduanjin exercise for hypertension: a systematic review and meta-analysis of randomized controlled trials. Maturitas, 2015, 80(4): 370-378.
18. Wen J, Lin T, Jiang C, et al. Effect of baduanjin exercises on elevated blood lipid levels of middle-aged and elderly individuals: protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ Open, 2017, 7(9): e017213.
19. Tong H, Liu Y, Zhu Y, et al. The therapeutic effects of qigong in patients with chronic obstructive pulmonary disease in the stable stage: a meta-analysis. BMC Complement Altern Med, 2019, 19(1): 239.
20. Xiao X, Wang J, Gu Y, et al. Effect of community based practice of baduanjin on self-efficacy of adults with cardiovascular diseases. PLoS One, 2018, 13(7): e0200246.
21. Bennett PN, Ngo T, Kalife C, et al. Improving wellbeing in patients undergoing dialysis: can meditation help?. Semin Dial, 2018, 31(1): 59-64.
22. Bantornwan S, Watanapa WB, Hussarin P, et al. Role of meditation in reducing sympathetic hyperactivity and improving quality of life in lupus nephritis patients with chronic kidney disease. J Med Assoc Thai, 2014, 97(Suppl 3): S101-S107.
23. Vareesangthip J, Malai T, Otsu B, et al. The effect of buddhist meditation on the quality of life using Short Form 36 in continuous ambulatory peritoneal dialysis patients. Nephrol Dial Transplant, 2017, 32(suppl 3): iii632.
24. Chatrung C, Sorajjakool S, Amnatsatsue K. Wellness and religious coping among thai individuals living with chronic kidney disease in southern California. J Relig Health, 2015, 54(6): 2198-2211.
25. MacKinnon HJ, Wilkinson TJ, Clarke AL, et al. The association of physical function and physical activity with all-cause mortality and adverse clinical outcomes in nondialysis chronic kidney disease: a systematic review. Ther Adv Chronic Dis, 2018, 9(11): 209-226.
26. Chen IR, Wang SM, Liang CC, et al. Association of walking with survival and RRT among patients with CKD stages 3-5. Clin J Am Soc Nephrol, 2014, 9(7): 1183-1189.
27. Clarke AL, Zaccardi F, Gould DW, et al. Association of self-reported physical function with survival in patients with chronic kidney disease. Clin Kidney J, 2019, 12(1): 122-128.
28. Warburton DE, Bredin SS. Reflections on physical activity and health: what should we recommend?. Can J Cardiol, 2016, 32(4): 495-504.
29. Clyne N, Anding-Rost K. Exercise training in chronic kidney disease-effects, expectations and adherence. Clin Kidney J, 2021, 14(Suppl 2): ii3-ii14.
30. Ortega-Pérez de Villar L, Martínez-Olmos FJ, Pérez-Domínguez FB, et al. Comparison of intradialytic versus home-based exercise programs on physical functioning, physical activity level, adherence, and health-related quality of life: pilot study. Sci Rep, 2020, 10(1): 8302.
31. Moorman D, Suri R, Hiremath S, et al. Benefits and barriers to and desired outcomes with exercise in patients with ESKD. Clin J Am Soc Nephrol, 2019, 14(2): 268-276.
32. Parsons TL, Bohm C, Poser K. “A Learned Soul to Guide Me”: the voices of those living with kidney disease inform physical activity programming. Physiother Can, 2018, 70(3): 289-295.
33. Hornik B, Duława J. Frailty, quality of life, anxiety, and other factors affecting adherence to physical activity recommendations by hemodialysis patients. Int J Environ Res Public Health, 2019, 16(10): 1827.
34. Bogataj Š, Pajek M, Buturović Ponikvar J, et al. Outcome expectations for exercise and decisional balance questionnaires predict adherence and efficacy of exercise programs in dialysis patients. Int J Environ Res Public Health, 2020, 17(9): 3175.
35. Kendrick J, Ritchie M, Andrews E. Exercise in individuals with CKD: a focus group study exploring patient attitudes, motivations, and barriers to exercise. Kidney Med, 2019, 1(3): 131-138.
36. Thompson S, Tonelli M, Klarenbach S, et al. A Qualitative study to explore patient and staff perceptions of intradialytic exercise. Clin J Am Soc Nephrol, 2016, 11(6): 1024-1033.
37. Bennett PN, Wang W, Moore M, et al. Care partner: a concept analysis. Nurs Outlook, 2017, 65(2): 184-194.
38. Huston P, McFarlane B. Health benefits of tai chi: what is the evidence?. Can Fam Physician, 2016, 62(11): 881-890.

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