Tai chi improves quality of life in patients with heart failure
MedWire News: Tai chi exercise may improve quality of life, mood, and ability to perform daily activities in heart failure (HF) patients, say US researchers.
Traditionally, HF patients have been advised to avoid physical activity, but more recently, gentle "mind-body" exercises such as tai chi have been receiving increasing scientific interest. A team led by Gloria Yeh (Beth Israel Deaconess Medical Center, Brookline, Massachusetts) investigated the impact of a 12-week tai chi program, as an adjunct to standard care, on functional capacity and quality of life in patients with chronic systolic HF.
The single-blind, multisite, parallel-group randomized controlled trial included 100 patients who were randomly assigned to a 12-week tai chi exercise program or heart health education program for the same duration (control).
Hourly tai chi classes led by one or two certified and experienced instructors were held twice a week for 12 weeks. The control group attended education sessions led by a nurse practitioner for the same duration and frequency. The mean age of the study participants was 67 years, their mean baseline left ventricular fraction was 29%, and median New York Heart Association class of HF was class II. The two groups were generally similar in terms of demographics, clinical classification of heart disease severity, and comorbidity rate.
Results of the study, which was reported in the journal Archives of Internal Medicine, showed that changes in peak oxygen uptake and 6-minute walking distance were similar in the two groups. However, quality of life, measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ), where a lower score indicates better quality of life, improved significantly more in the tai chi group, with an average reduction of 19 points compared with a 1-point increase in the education group (p=0.02). At 6-month follow up, the trend towards improved MLHFQ score in the tai chi patients remained, but was no longer significant.
The tai chi group also showed greater improvement in exercise self-efficacy, defined as the confidence to perform exercise-related activities, increased daily activity, and related feelings of well-being after 12 weeks than the control group.
The authors believe that the effects of tai chi could be mediated by favorable modulation of the autonomic nervous system, but acknowledge that the definitive physiological mechanism is yet to be identified.
They state that their study findings provide a foundation for future research into the effects of tai chi, and its mechanism.
"This may allow us to better tailor our interventions, target subpopulations with specific constellations of symptoms, and further support clinical findings," conclude Yeh et al.
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By Piriya Mahendra