Tai Chi: Well-Being and Heart Failure

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DESCRIPTION (provided by applicant): Tai Chi is a popular exercise that is a potential complementary treatment for CHF. It incorporates a form of meditation centered on relaxation-based movements suggested to improve quality of life and physiological factors. Perhaps the most significant difference over standard medical treatments is that practicing Tai Chi uses a holistic medical approach, benefiting the entire person, mind and body. As a physical exercise, it is low-impact, and can be engaged at a moderate level of exertion, having similar effects on blood pressure and cardiorespiratory function in older adults as moderate-intensity aerobic exercise. Tai Chi also improves exercise capacity and reduces B-type natriuretic peptide levels (reliable subclinical marker of CHF). Quality of life improvements associated with Tai Chi include, increased vigor, self-efficacy for performing daily tasks, decreases in falls and fatigue. Tai Chi contains a relaxation/meditation component, which may benefit both physiological factors and quality of life. It also promotes psychological benefits such as reduced anxiety and depressive symptoms. Therefore, Tai Chi could lead to improvements in both physical and psychological symptoms of CHF patients. Traditional exercise such as walking and resistance exercise, are also demonstrated to have a range of physiological and psychological health benefits. However, surprisingly little is known about whether Tai Chi has health benefits beyond those of conventional exercise for CHF patients. Given the unique nature of Tai Chi that it has a combination of physical and meditation components we are proposing to examine this question. Findings from this study would help identify more effective and safer exercises for heart failure patients. One of the aims of this study is to determine if a Tai Chi intervention will be more effective than walking exercise, or health-education groups for reducing CHF severity. CHF severity would be assessed by examining changes in: (a) ejection fraction (EF) (b) six minute walk test, to assess changes in physical function (c) B-type naturetic peptide and (d) Global Assessment of Severity and Dyspnea scale. A second aim is designed to examine whether Tai Chi has unique benefits in improving well-being (a) mood, measured with the Beck Depression Inventory (BDI) and (b) health related quality of life measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ), compared to walking-exercises or health education. Health education would be used as a control group rather than usual care to control for social interactions in the other two groups.