WELL BEING IN HEART FAILURE PATIENTS PRACTICING TAI CHI

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 目的1.探讨太极拳干预、步行锻炼和健康教育对老年充血性心力衰竭患者干预后12周和24周幸福感的相对影响：(A)情绪、Beck抑郁量表(BDI)、(B)健康相关生活质量、堪萨斯城心肌病问卷(KCCQ)和(C)疲劳、疲劳严重程度量表。 假设1.a.与随机分为步行锻炼组或医学教育组的参与者相比，被随机分配到太极组的充血性心力衰竭患者在干预后12周和24周将显示出显著的幸福感增加，包括抑郁情绪和绝望的更大程度的减少，生活质量的提高和疲劳感的减少。 假设1.B.与随机分为医学教育组的参与者相比，被随机分配到运动组的充血性心力衰竭患者在干预后12周和24周将显示出显著的幸福感增加，包括抑郁情绪、绝望、生活质量的提高和疲劳的减少。 目的：观察太极拳训练、步行锻炼和健康教育对老年充血性心力衰竭患者干预后12周和24周细胞因子(肿瘤坏死因子、IL-6、干扰素、IL-10)和应激激素(去甲肾上腺素、肾上腺素和皮质醇)水平的影响。 假设2.a.与随机分为步行锻炼组和健康教育组的参与者相比，随机分为太极组的充血性心力衰竭患者在干预12周和24周后，促炎细胞因子、肿瘤坏死因子和白介素6显著降低，Th1/Th2比率(干扰素/白介素10)升高。 假设2.B：与随机分为健康教育组的参与者相比，随机分为步行运动组的充血性心力衰竭患者在干预12周和24周后，在促炎细胞因子、肿瘤坏死因子和IL-6的降低以及Th1/Th2比率(干扰素/IL-10)的升高上表现出更大的降低。 假设2.C.条件分配和生活质量之间的关系将通过减少 促炎症细胞因子、肿瘤坏死因子、白介素6和干扰素/白介素10比值升高。 目的：探讨太极拳练习、步行锻炼和健康教育对充血性心力衰竭患者干预后12周和24周的次级结局、脑钠素和6分钟步行试验的相对影响。 假设3：在干预后12周和24周，随机分为太极组的充血性心力衰竭患者在6分钟步行试验中BNP水平显著降低，步行距离显著增加。

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. AIM 1. To determine the relative effects of the Tai Chi intervention, walking exercise program and health- education in older adults with congestive heart failure at 12 and 24 weeks post-intervention on well-being: (a) mood, Beck Depression Inventory (BDI) (b) health related quality of life, Kansas City Cardiomyopathy Questionnaire (KCCQ) and (c) fatigue, Fatigue Severity Scale. Hypothesis 1.A. Participants with congestive heart failure randomized to the Tai Chi group will show significant increases in well-being, including greater reductions in depressed mood and hopelessness, increases in quality of life and decreases in fatigue 12 and 24 weeks post-intervention relative to participants randomized to walking exercise or medical education groups. Hypothesis 1.B. Participants with congestive heart failure randomized to the exercise group will show significant increases in well-being, including greater reductions in depressed mood, hopelessness, increases in quality of life and decreases in fatigue 12 and 24 weeks post-intervention relative to participants randomized into the medical education group. AIM 2. To determine the relative effects of Tai Chi training, walking exercise program and health-education on cytokines (TNF, IL-6, IFN, IL-10) and stress hormone (norepinephrine, epinephrine and cortisol) profiles in older adults with congestive heart failure, at 12 and 24 weeks post-intervention. Hypothesis 2.A. Participants with congestive heart failure randomized to the Tai Chi group will show significant reductions in proinflammatory cytokines, TNF and IL-6 and increases in the Th1/Th2 ratio (IFN /IL-10) 12 and 24 weeks after intervention relative to participants randomized to walking exercise and health-education groups. Hypothesis 2.B. Participants with congestive heart failure randomized to the walking exercise group will show significantly greater reductions in proinflammatory cytokines, TNF and IL-6 and increases in the Th1/Th2 ratio (IFN/IL-10) 12 and 24 weeks after intervention relative to the participants randomized to the health-education group. Hypothesis 2.C. The relationship between condition assignment and quality of life will be mediated by reductions in proinflammatory cytokines, TNF and IL-6 and increases in IFN /IL-10 ratios. AIM 3. To determine the relative effect of Tai Chi practice, walking exercise and health education on secondary outcomes, BNP, and six minute walk test 12 and 24 weeks post-intervention in patients with congestive heart failure. Hypothesis 3. Participants with congestive heart failure randomized to the Tai Chi group will show significant reductions in BNP levels and increases in distance walked in the six minute walk test at 12 and 24 weeks post-intervention.