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

Preliminary evidence suggests that Tai Chi may effectively relieve pain symptoms, increase quality of life, and reduce cardiovascular risk in patients with chronic coronary syndrome (CCS). However, few randomized controlled trials have specifically investigated the potential benefits of Tai Chi in patients with CCS, particularly regarding its effects on psychological stress and cellular stress levels. To evaluate the effectiveness of a hybrid Tai Chi cardiac rehabilitation programme in reducing perceived stress and oxidative stress in diagnosed patients. Forty-six patients with CCS were randomly assigned to 12 weeks of either a Tai Chi cardiac rehabilitation programme (TCCRP, n = 23) or a conventional exercise cardiac rehabilitation programme (CECRP, n = 23) (3 sessions per week). All participants continued their routine drug treatments daily. The main outcome measure was the Chinese Perceived Stress Scale (CPSS). The secondary outcome measures included the antioxidant enzymes catalase (CAT) and glutathione peroxidase (GSH-Px) and the stress marker oxidised low-density lipoprotein (ox-LDL). The data were analysed by 2-way mixed analysis of variance with post hoc Bonferroni adjustment and paired t tests. The group-by-time interaction effect on CPSS was significantly different (MD = -7.71, 95% CI [-10.750, -4.678], p < 0.001). Within the TCCRP group, the CPSS score significantly decreased (p < 0.05) from baseline to the end of the intervention. Notably, in the CECRP group, the CPSS score increased (p < 0.05) at the end of the intervention. The CAT and GSH-Px levels increased markedly in the TCCRP group after the intervention (p < 0.001). Spearman's correlation analysis revealed that CPSS was positively correlated with ox-LDL (r = 0.569, p < 0.05) and negatively correlated with GSH-Px (r = -0.585, p < 0.05). The correlation in the control group was not statistically significant (r = -0.148, p > 0.05). A 12-week hybrid Tai Chi cardiac rehabilitation programme can effectively regulate psychological stress perception and reduce physiological stress levels in patients with coronary heart disease.