BENEFIT OF TAI CHI AS AN ADJUNCT TO STANDARD CARE FOR PATIENTS WITH CHRONIC STA

太极拳作为慢性 STA 患者标准护理辅助手段的益处

• 批准号: 7366547
• 负责人: GLORIA Y YEH
• 金额: $ 0.81万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-01 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7366547
• 关键词: BENEFIT; TAI; CHI; ADJUNCT; STANDARD

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Heart Failure (HF) is a major public health problem in the United States, affecting approximately 5 million adults. Despite recent advances in pharmacological therapy and technological devices, HF is the most common reason for hospitalization among Medicare patients and is reaching epidemic proportions as the population ages. New and inexpensive interventions that can improve functional capacity, quality of life, as well as affect disease progression, are needed. Tai Chi is a popular mind-body exercise form that is a potential therapeutic adjunct for heart disease. Tai Chi incorporates both gentle physical activity and meditation. It may be particularly suited to frail and de-conditioned patients with HF, but has never been rigorously studied in this population. We conducted a feasibility study of Tai Chi in patients with HF (n=30) and found that those randomized to a Tai Chi program significantly improved their exercise capacity (six-minute walk distance), quality-of-life (Minnesota Living with Heart Failure score), and neurohormonal status (serum B-type natriuretic peptide levels) compared to patients who did not participate in Tai Chi. As part of a funded NCCAM study, we are now conducting a randomized controlled trial (n=150) over three years that compares a 12-week Tai Chi program with usual conventional care (both groups receiving HF educational materials). Patients with chronic stable HF (systolic dysfunction, left ventricular ejection fraction ?40%, New York Heart Association Class I-IV) will be recruited from outpatient primary care and cardiology clinics. Our primary aim will be to examine Tai Chi's effects on functional capacity and quality-of-life. Secondary aims are designed to further elucidate the mechanism of Tai Chi's effects, including examination of cognitive-behavioral or psychosocial influences (e.g., mood, psychosocial functioning, self-efficacy, beliefs and expectations of mind-body medicine) and HF-specific physiologic/metabolic processes in response to meditative exercise (e.g., neurohormonal status, heart rate variability and markers of autonomic tone, myocardial structure and function). The results of our proposed research will help define the role of Tai Chi in current HF management, further our understanding of the mechanism of action, and provide preliminary analyses of the costs and benefit of treatment.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子弹和调查员（PI）可能已经从其他NIH来源获得了主要资金，因此可以在其他清晰的条目中代表。列出的机构适用于该中心，这不一定是调查员的机构。心力衰竭（HF）是美国的主要公共卫生问题，影响了约500万成年人。尽管药理疗法和技术设备的最新进展，但HF是医疗保险患者住院的最常见原因，并且随着人口年龄的增长而达到流行病。需要提高功能能力，生活质量以及影响疾病进展的新型干预措施。太极拳是一种流行的身心运动形式，是心脏病的潜在治疗辅助手段。太极拳既包含轻柔的体育锻炼和冥想。它可能特别适合于脆弱的HF患者，但从未在该人群中进行严格研究。我们对TAI CHI进行了HF患者（n = 30）的可行性研究，发现那些随机到Tai Chi计划的患者显着提高了其运动能力（步行六分钟的步行距离），生活质量（明尼苏达州的心力衰竭得分）和神经瘤状态（血清B-Type Natriuretic chi与患者相比）与CHI相比，作为一项资助的NCCAM研究的一部分，我们现在在三年内进行了一项随机对照试验（n = 150），将12周的Tai Chi计划与通常的常规护理（两组都接受HF教育材料）进行了比较。慢性稳定HF（收缩功能障碍，左心室射血分数？40％，纽约心脏协会I-IV）的患者将从门诊初级保健和心脏病学诊所招募。我们的主要目的是检查太极对功能能力和生活质量的影响。次要目的旨在进一步阐明太极拳效应的机制，包括检查认知行为或心理社会影响（例如情绪，心情，心理社会功能，自我效能，思想医学的信念和期望）以及对HF特异性的生理/代谢过程（对Medity sectional andity Neurohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohohe时候无力，音调，心肌结构和功能）。我们提出的研究的结果将有助于定义太极拳在当前HF管理中的作用，进一步我们对行动机理的理解，并对治疗的成本和收益进行初步分析。