tai chi: a possible way to reduce cardiac risk factors in...

Tai Chi: a possible way to reduce cardiac risk factors in firefighters

Jane Christianson, RN, MSN, PIDissertation Committee: L. Sue Davis, RN, PhDAmit Bhattacharya, PhDKermit Davis, PhDTracey Yap, RN, PhDJohn C. Schafer, PhD

Background

• According to the United States Fire Association 2009 report, “Firefighting is the Nation’s most dangerous and hazardous job, with heart attacks, high stress levels, sprains and strains all too common” (p. iv.).

• In the US, 1 in 4 die from coronary heart disease (CHD)

• In firefighters, CHD accounts for 39% of the occupational fatalities (Drew-Nord, Hong, & Froelicher, 2009; Geibe, Holder, Peeples, Kinney, Burgess, & Kales, 2008; Lund, Taylor, & Herbold, 2001).

Background (cont.)• Physical fitness is the ability to carry out

daily tasks with vigor and alertness, with ample energy to enjoy leisure-time pursuits and respond to emergencies (Drew-Norton, et al.,2010,).

• Increasing the physical fitness of individuals can result in many health benefits such as: reducing the risk of coronary heart disease and obesity, while improving physical strength, and delaying the onset of chronic health problems.

Tai Chi • Tai Chi is a low-impact martial art that has

been used to promote health in various populations such as children and adults. Tai Chi movements are modeled from animal and bird movements and are used to improve health, breathing, strength, and endurance without adverse physical effects (Horowitz, 2009).

• Studies have provided strong evidence of how Tai Chi has greatly improved cardiac risk factors in individuals who are healthy and at high risk for cardiac disorders.

Study Aims

• To determine if Tai Chi was beneficial in reducing cardiac risk factors within the firefighter’s population of Cincinnati.

• To determine if Tai Chi was beneficial in improving physiological endurance in lower body strength and balance.

Tai Chi Video

Subjects• PI received permission to recruit

firefighters from both the district management and local union associated with the fire stations operated by the City of Cincinnati.

• 60 firefighters were recruited from the 6 of the larger stations (58 men 2 women)

• Ages: 21-64 • Stations included: Stations 14, 17, 21, 23,

29, and 32

Method

• Repeated measure, quasi-experimental intervention study was conducted.

• All subjects were given the opportunity to receive Tai Chi lessons by a Master Instructor, once a week over a 10 week period at their worksite.

• Each the participating fire stations received a DVD and an illustrated book of Tai Chi movements to be used as resource and facilitate group practice. Participants were given a booklet for practice away from work.

Data Collected

• Demographic information • Occupational Fatigue Exhaustion

Recovery (OFER) was compiled at the beginning and end of study.

• Blood pressure, pulse, lower body strength, and percentage of body fat was collected at the beginning of the study, at midpoint, and the completion of the study.

• Balance was measured at the beginning and after completion of the study.

• The Holmes-Rahe Life Stress Inventory was collect with final measurements.

Obstacles

• Because of “brown-outs” “Kelly days” and transfers 27 participants were not able to participate in the Tai Chi study. They remained in the study as the control group.

• 32 firefighter’s were in the intervention group.

• Balance data has not been included in the preliminary analysis – Ashu Mani performed the balance testing

Force Plate Testing

Preliminary Data Results - ControlPaired Samples Test

Paired Differences

t df Sig. (2-tailed)Mean Std. Deviation

Std. Error

Mean

95% Confidence Interval of the

Difference

Lower Upper

Pair 1 Heart rate 1 - Heart rate 2 1.800 7.300 2.308 -3.422 7.022 .780 9 .456

Pair 2 Heart rate 1 - Heart rate 3 1.591 8.296 1.769 -2.087 5.269 .899 21 .379

Pair 3 Heart rate 2 - Heart rate 3 .200 6.941 2.195 -4.765 5.165 .091 9 .929

Pair 4 Systolic BP 3 - Systolic BP

2

2.600 10.803 3.416 -5.128 10.328 .761 9 .466


3

-4.409 21.771 4.642 -14.062 5.244 -.950 21 .353


3

.400 10.648 3.367 -7.217 8.017 .119 9 .908

Pair 7 Diastolic BP 1 - Diastolic

BP 2

-1.600 9.652 3.052 -8.504 5.304 -.524 9 .613


BP 3

2.455 10.400 2.217 -2.157 7.066 1.107 21 .281


BP 3

1.800 11.134 3.521 -6.164 9.764 .511 9 .621

Pair 10 Wall squat 1 - Wall squat 2 -.067444 .760321 .253440 -.651879 .516990 -.266 8 .797

Pair 11 Wall squat 1 - Wall squat 3 -.201700 .626505 .140091 -.494913 .091513 -1.440 19 .166

Pair 12 Wall squat 2 - Wall squat 3 -.336300 .802628 .253813 -.910466 .237866 -1.325 9 .218

Pair 13 Body fat 1 - Body fat 2 1.88750 2.58702 .91465 -.27530 4.05030 2.064 7 .078

Pair 14 Body fat 1 - Body fat 3 -.87143 1.39197 .37202 -1.67513 -.06773 -2.342 13 .036

Pair 15 Body fat 2 - Body fat 3 -4.38000 2.72342 1.21795 -7.76157 -.99843 -3.596 4 .023

Pair 16 CF 1 - CF 2 1.86364 7.68608 1.63868 -1.54418 5.27145 1.137 21 .268

Pair 17 AF 1 - AF 2 .13636 3.52265 .75103 -1.42549 1.69822 .182 21 .858

Paired Samples Test

Paired Differences

t df Sig. (2-tailed)Mean Std. Deviation

Std. Error

Mean

95% Confidence Interval of

the Difference

Lower Upper

Pair 1 Heart rate 1 - Heart rate

2

4.462 8.696 1.705 .949 7.974 2.616 25 .015


3

3.267 8.940 1.632 -.072 6.605 2.001 29 .055


3

-.462 5.464 1.072 -2.669 1.746 -.431 25 .670

Pair 4 Systolic BP 3 - Systolic

BP 2

13.885 15.436 3.027 7.650 20.119 4.587 25 .000


BP 3

9.300 15.419 2.815 3.543 15.057 3.304 29 .003


BP 3

-4.000 12.621 2.475 -9.098 1.098 -1.616 25 .119


BP 2

10.769 10.882 2.134 6.374 15.165 5.046 25 .000


BP 3

4.667 9.415 1.719 1.151 8.182 2.715 29 .011


BP 3

-5.692 9.858 1.933 -9.674 -1.711 -2.944 25 .007

Pair 10 Wall squat 1 - Wall

squat 2

-.429920 .874732 .174946 -.790992 -.068848 -2.457 24 .022


squat 3

-1.021393 1.789371 .338159 -1.715239 -.327547 -3.020 27 .005


squat 3

-.576320 1.280369 .256074 -1.104830 -.047810 -2.251 24 .034

Pair 13 Body fat 1 - Body fat 2 -8.25440 40.99501 8.19900 -25.17631 8.66751 -1.007 24 .324

Pair 14 Body fat 1 - Body fat 3 -.98174 1.72744 .36020 -1.72874 -.23474 -2.726 22 .012

Pair 15 Body fat 2 - Body fat 3 -.64444 2.23692 .52725 -1.75684 .46795 -1.222 17 .238

Culture

R2P and Discussion• Prestigious medical establishments such

as Harvard Medical School and the Mayo Clinic have endorsed Tai Chi as an effective, low cost way to reduce stress related disorders, reduce absenteeism and boost creativity in the work place

• Locally The Christ Hospital, Cincinnati Reds and NIOSH – offer Tai Chi to their employee

• Publishing the results of the study could result in Tai Chi offerings at the worksite

Acknowledgement• “This research study was (partially)

supported by the National Institute for Occupational Safety and Health Pilot Research Project Training Program of the University of Cincinnati Education and Research Center Grant #T42/OH008432-05.”

tai chi: a possible way to reduce cardiac risk factors in...

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