The American Journal of Medicine
Volume 117, Issue 8 , Pages 541-548, 15 October 2004

Effects of tai chi mind-body movement therapy on functional status and exercise capacity in patients with chronic heart failure: A randomized controlled trial

  • Gloria Y. Yeh, MD, MPH

      Affiliations

    • Division for Research and Education in Complementary and Integrative Medical Therapies (GYY, DME, RSP)
    • Harvard Medical School, Boston, Massachusetts; Division of General Medicine and Primary Care (GYY, RBD, RSP)
  • ,
  • Malissa J. Wood, MD

      Affiliations

    • Division of Cardiology (MJW), Massachusetts General Hospital, Boston, Massachusetts
  • ,
  • Beverly H. Lorell, MD

      Affiliations

    • Department of Medicine, and Cardiovascular Division (BHL, ALG), Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • ,
  • Lynne W. Stevenson, MD

      Affiliations

    • Division of Cardiology (LWS), Brigham and Women's Hospital, Program for Heart Failure, Boston, Massachusetts
  • ,
  • David M. Eisenberg, MD

      Affiliations

    • Division for Research and Education in Complementary and Integrative Medical Therapies (GYY, DME, RSP)
  • ,
  • Peter M. Wayne, PhD

      Affiliations

    • New England School of Acupuncture (PMW), Division for Research, Watertown, Massachusetts
  • ,
  • Ary L. Goldberger, MD

      Affiliations

    • Department of Medicine, and Cardiovascular Division (BHL, ALG), Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • ,
  • Roger B. Davis

      Affiliations

    • Harvard Medical School, Boston, Massachusetts; Division of General Medicine and Primary Care (GYY, RBD, RSP)
  • ,
  • ScD., Russell S. Phillips, MD

      Affiliations

    • Division for Research and Education in Complementary and Integrative Medical Therapies (GYY, DME, RSP)
    • Harvard Medical School, Boston, Massachusetts; Division of General Medicine and Primary Care (GYY, RBD, RSP)
    • Corresponding Author InformationRequests for reprints should be addressed to Gloria Y. Yeh, MD, MPH, Harvard Medical School Osher Institute, 401 Park Drive, Suite 22A, Boston, Massachusetts 02215

Received 6 November 2003; accepted 15 April 2004.

Purpose

To examine the effects of a 12-week tai chi program on quality of life and exercise capacity in patients with heart failure.

Methods

Thirty patients with chronic stable heart failure and left ventricular ejection fraction ≤40% (mean [± SD] age, 64 ± 13 years; mean baseline ejection fraction, 23% ± 7%; median New York Heart Association class, 2 [range, 1 to 4]) were randomly assigned to receive usual care (n = 15), which included pharmacologic therapy and dietary and exercise counseling, or 12 weeks of tai chi training (n = 15) in addition to usual care. Tai chi training consisted of a 1-hour class held twice weekly. Primary outcomes included quality of life and exercise capacity. Secondary outcomes included serum B-type natriuretic peptide and plasma catecholamine levels. For 3 control patients with missing data items at 12 weeks, previous values were carried forward.

Results

At 12 weeks, patients in the tai chi group showed improved quality-of-life scores (mean between-group difference in change, –25 points, P = 0.001), increased distance walked in 6 minutes (135 meters, P = 0.001), and decreased serum B-type natriuretic peptide levels (–138 pg/mL, P = 0.03) compared with patients in the control group. A trend towards improvement was seen in peak oxygen uptake. No differences were detected in catecholamine levels.

Conclusion

Tai chi may be a beneficial adjunctive treatment that enhances quality of life and functional capacity in patients with chronic heart failure who are already receiving standard medical therapy.

 

 This study was supported by unrestricted educational grants from the Bernard Osher Foundation and in part by the Beth Israel Deaconess Medical Center General Clinical Research Center grant (RR 01032) from the National Institutes of Health (NIH). Dr. Yeh was supported by an NIH Institutional National Research Service Award for Training in Alternative Medicine Research (AT00051). Dr. Phillips was supported by a Mid-career Investigator Award from the NIH National Center for Complementary and Alternative Medicine (AT00589). Dr. Goldberger was supported by the NIH National Center for Research Resources (RR13622), the National Institute on Aging (AG08812), and the G. Harold and Leila Y. Mathers Charitable Foundation. Dr. Stevenson was supported by the W. T. Young Foundation.

PII: S0002-9343(04)00424-3

doi:10.1016/j.amjmed.2004.04.016

The American Journal of Medicine
Volume 117, Issue 8 , Pages 541-548, 15 October 2004