Tai Chi: Well-Being and Heart Failure

描述（由申请人提供）：太极拳是一种流行的运动，是慢性心力衰竭的潜在补充治疗。它结合了一种以放松运动为中心的冥想形式，可以改善生活质量和生理因素。也许与标准医学治疗最显著的区别是，练习太极拳使用整体医疗方法，有利于整个人，身心。作为一种体育锻炼，它的影响很小，可以在中等强度的运动中进行，对老年人的血压和心肺功能的影响与中等强度的有氧运动相似。太极拳还能提高运动能力，降低b型利钠肽水平（可靠的慢性心力衰竭亚临床指标）。与太极拳相关的生活质量改善包括，增加活力，执行日常任务的自我效能，减少跌倒和疲劳。太极拳含有放松/冥想的成分，这可能有利于生理因素和生活质量。它还促进心理上的益处，如减少焦虑和抑郁症状。因此，太极拳可以改善慢性心力衰竭患者的生理和心理症状。传统的运动，如散步和阻力运动，也被证明对生理和心理健康有一系列的好处。然而，令人惊讶的是，人们对太极拳是否对心力衰竭患者有传统运动之外的健康益处知之甚少。鉴于太极拳的独特性质，它结合了身体和冥想的组成部分，我们建议研究这个问题。这项研究的结果将有助于为心力衰竭患者确定更有效、更安全的锻炼方式。本研究的目的之一是确定太极干预是否比步行运动或健康教育团体更有效地降低心力衰竭的严重程度。通过检查以下指标的变化来评估CHF的严重程度：(a)射血分数（EF）； (b)六分钟步行试验，以评估身体功能的变化；(c) b型天然肽；(d)严重程度和呼吸困难量表的总体评估。第二个目的是研究太极拳是否在改善健康方面具有独特的益处(A)用贝克抑郁量表（BDI）测量的情绪和(b)用堪萨斯城心肌病问卷（KCCQ）测量的健康相关生活质量，与步行锻炼或健康教育相比。健康教育将作为对照组，而不是常规护理，以控制其他两组的社会互动。

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.