Tai Chi: Well-Being and Heart Failure

描述(申请者提供)：太极是一种流行的运动，是治疗充血性心力衰竭的潜在补充疗法。它结合了一种以放松为基础的运动的冥想形式，建议改善生活质量和生理因素。也许与标准医疗最显著的区别是，练习太极采用了一种整体的医疗方法，对整个人、心理和身体都有好处。作为一种体育运动，它的冲击力很小，可以进行中等强度的运动，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)。与太极相关的生活质量改善包括：活力增强，执行日常任务的自我效能，跌倒和疲劳的减少。太极包含放松/冥想的成分，可能对生理因素和生活质量都有好处。它还促进心理上的好处，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，也被证明有一系列的生理和心理健康益处。然而，令人惊讶的是，人们对太极是否对充血性心力衰竭患者的健康有传统锻炼以外的好处知之甚少。考虑到太极的独特性质，它包含了身体和冥想的组成部分，我们建议来研究这个问题。这项研究的发现将有助于为心力衰竭患者确定更有效、更安全的锻炼方式。这项研究的目的之一是确定太极干预是否比步行锻炼或健康教育组更有效地降低CHF的严重程度。CHF的严重程度将通过以下方面的变化来评估：(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型利尿肽；(D)全球严重程度评估和呼吸困难评分。第二个目的是考察太极在改善幸福感方面是否有独特的好处：(A)用贝克抑郁量表(BDI)衡量的情绪；(B)用堪萨斯城心肌病问卷(KCCQ)衡量的与健康相关的生活质量，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.