Tai Chi: Well-Being and Heart Failure

描述（由申请人提供）：太极是一种流行的运动，是CHF的潜在补充治疗。它结合了一种以放松为基础的运动为中心的冥想形式，建议改善生活质量和生理因素。也许与标准医疗方法最显着的区别是，练习太极使用整体医疗方法，使整个人，心灵和身体受益。作为一种体育锻炼，它是低冲击的，可以在中等水平的努力，对血压和心肺功能的老年人有类似的影响，作为中等强度的有氧运动。太极拳还可以提高运动能力，降低B型利钠肽水平（CHF的可靠亚临床标志物）。与太极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，减少福尔斯和疲劳。太极包含放松/冥想成分，这可能有利于生理因素和生活质量。它还促进心理益处，如减少焦虑和抑郁症状。因此，太极拳可以改善CHF患者的生理和心理症状。传统的运动，如步行和阻力运动，也被证明具有一系列生理和心理健康的好处。然而，令人惊讶的是，关于太极拳是否对CHF患者的健康有益于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成分，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和更安全的运动。本研究的目的之一是确定太极拳干预是否比步行锻炼或健康教育团体更有效地降低CHF严重程度。通过检查以下指标的变化来评估CHF严重程度：（a）射血分数（EF）（B）6分钟步行试验，以评估身体功能的变化（c）B型利钠肽和（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有独特的好处，在改善福祉（a）情绪，测量与贝克抑郁量表（BDI）和（B）健康相关的生活质量测量与堪萨斯城心肌病问卷（KCCQ）相比，步行锻炼或健康教育。健康教育将被用作对照组，而不是通常的护理，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.