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.

References 

  1. American Heart Association . Heart Disease and Stroke Statistics—2003 Update . Dallas, Texas: American Heart Association; 2002;
  2. Pina IL , Apstein CS , Balady GJ , et al.  Exercise and heart failure (a statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention) . Circulation . 2003;107:1210–1225
  3. Hunt SA , Baker DW , Chin MH , et al.  ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure) . http://www.acc.org/clinical/guidelines/failure/hf_index.htm Accessed June 23, 2004
  4. Coats AJ , Adamopolous S , Radaelli A , et al.  Controlled trial of physical training in chronic heart failure (exercise performance, hemodynamics, ventilation, and autonomic function) . Circulation . 1992;85:2119–2131
  5. Kiilavouri K , Toivonen L , Naveri H , Leinonen H . Reversal of autonomic derangements by physical training in chronic heart failure . Eur Heart J . 1996;16:490–495
  6. Belardinelli R , Georgiou D , Cianci G . Randomized controlled trial of long-term moderate exercise training in chronic heart failure (effects on functional capacity, quality of life, and clinical outcome) . Circulation . 1999;99:1173–1182
  7. Wolf SL , Huiman XB,  for the Atlanta FICSIT Group. . Reducing frailty and falls in older persons (an investigation of tai chi and computerized balance training) . J Am Geriatr Soc . 1996;44:489–497
  8. Wolfson L , Whipple R . Balance and strength training in older adults (intervention gains and tai chi maintenance) . J Am Geriatr Soc . 1996;44:498–506
  9. Wu G . Evaluation of the effectiveness of tai chi for improving balance and preventing falls in the older population—a review . J Am Geriatr Soc . 2002;50:746–754
  10. Lan C , Lai JS , Wong MK . 12-Month tai chi training in the elderly (its effect on health fitness) . Med Sci Sports Exerc . 1998;30:345–351
  11. Lan C , Lai JS , Wong MK . Cardiorespiratory function, flexibility, and body composition among geriatric tai chi chuan practitioners . Arch Phys Med Rehabil . 1996;77:612–616
  12. Wu G , Zhou X , Wei L , Zhao F . Improvement of isokinetic knee extensor strength and reduction of postural sway in the elderly from long-term tai chi exercise . Arch Phys Med Rehabil . 2002;83:1364–1369
  13. Kirsteins AE , Dietz F , Hwang SM . Evaluating the safety and potential use of a weight-bearing exercise, tai chi chuan for rheumatoid arthritis patients . Am J Phys Med Rehabil . 1991;70:136–141
  14. Jin P . Efficacy of tai chi, brisk walking, meditation, and reading in reducing mental and emotional stress . J Psychosom Res . 1992;36:161–170
  15. Brown DR , Wang Y , Ward A , Ebbeling CB . Chronic psychological effects of exercise and exercise plus cognitive strategies . Med Sci Sports Exerc . 1995;27:765–775
  16. Li F , Harmer P , McCauley E , Fisher KJ , Duncan TE , Duncan SC . Tai chi, self-efficacy, and physical function in the elderly . Prev Sci . 2001;2:229–239
  17. Lai JS , Lan C , Wong MK , Tenh SH . Two-year trends in cardiorespiratory function among older tai chi chuan practitioners and sedentary subjects . J Am Geriatr Soc . 1995;43:1222–1227
  18. Lan C , Chen SY . The effect of tai chi on cardiorespiratory function in patients with coronary artery bypass surgery . Med Sci Sports Exerc . 1999;31:634–638
  19. Channer KS , Barrow D , Barrow R . Changes in haemodynamic parameters following tai chi chuan and aerobic exercise in patients recovering from acute myocardial infarction . Postgrad Med . 1996;72:349–351
  20. Young DR , Appel LJ , Lee SH . The effects of aerobic exercise and t'ai chi on blood pressure in older people (results of a randomized trial) . J Am Geriatr Soc . 1999;47:277–284
  21. Fontana JA , Colella C . Tai chi chih as an intervention for heart failure . Nurs Clin North Am . 2000;35:1031–1461
  22. Fontana JA , Colella C . The energy costs of a modified tai chi exercise . Nurs Res . 2000;49:145
  23. Schneider D , Leung R . Metabolic and cardiorespiratory responses to the performance of wing chun and tai chi chuan exercise . Int J Sports Med . 1991;12:319–323
  24. Meyer K , Samek L , Schwaibold M . Physical response to different modes of interval exercise in patients with chronic heart failure—application to exercise training . Eur Heart J . 1996;17:1040–1047
  25. Cheng MC . T'ai Chi Ch'uan: A Simplified Method of Calisthenics for Health and Self Defense . Berkeley, California: North Atlantic Books; 1981;
  26. Wolf SL , Coogler C . Exploring the basis for tai chi chuan as a therapeutic exercise approach . Arch Phys Med Rehabil . 1997;78:886–892
  27. Rector TS , Cohn JN . Assessment of patient outcome with the Minnesota Living with Heart Failure questionnaire (reliability and validity during a randomized, double-blind, placebo-controlled trial of pimobendan) . Am Heart J . 1992;124:1017–1025
  28. Zugck C , Kruger C , Durr S . Is the 6 minute walk test a reliable substitute for peak oxygen uptake in patients with dilated cardiomyopathy . Eur Heart J . 2000;21:540–549
  29. Myers J , Gullestad L , Vagelos R , et al.  Cardiopulmonary exercise testing and prognosis in severe heart failure (14 ml/kg/min revisited) . Am Heart J . 2000;131:78–84
  30. Maisel AS , Krishnaswamy P , Nowak RM , et al.  Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure . N Engl J Med . 2002;347:161–167
  31. Hambrecht R , Niebauer J , Fiehn E . Physical training in patients with chronic stable heart failure (effects on cardiorespiratory fitness and ultrastructural abnormalities of leg muscles) . J Am Coll Cardiol . 1995;25:1239–1249
  32. Keteyian SJ , Brawner CA , Schairer JR , et al.  Effects of training on chronotropic incompetence in patients with heart failure . Am Heart J . 1999;138:233–240
  33. Belardinelli R , Georgiou D , Cianci G , Berman N , Ginzton L , Purcaro A . Exercise training improves left ventricular diastolic filling in patients with dilated cardiomyopathy (clinical and prognostic implications) . Circulation . 1995;91:2775–2784
  34. Keteyian SJ , Levine AB , Brawner CA , et al.  Exercise training in patients with heart failure (a randomized, controlled trial) . Ann Intern Med . 1996;124:1051–1057
  35. Gottlieb SS , Fisher ML , Freudenberger R , et al.  Effects of exercise training on peak performance and quality of life in congestive heart failure patients . J Card Fail . 1999;5:188–194
  36. Giannuzzi P , Temporelli PL , Corra U , Gattone M , Giordano A , Tavazzi L . Attenuation of unfavorable remodeling by exercise training in postinfarction patients with left ventricular dysfunction (results of the Exercise in Left Ventricular Dysfunction (ELVD) Trial) . Circulation . 1997;96:1790–1797
  37. Oka RK , Demarco T , Haskell WL , et al.  Impact of a home-based walking and resistance training program on quality of life in patients with heart failure . Am J Cardiol . 2000;85:365–369
  38. Kiilavuori K , Naveri H , Leinonen H , Harkonen M . The effects of physical training on hormonal status and exertional hormonal response in patients with chronic congestive heart failure . Eur Heart J . 1999;20:456–464
  39. McCullough PA , Nowak RM , McCord J , et al.  B-type natriuretic peptide and clinical judgement in emergency diagnosis of heart failure (analysis from Breathing Not Properly (BNP) multinational study) . Circulation . 2002;106:416–422
  40. Lan C , Lai JS , Chen SY . Tai chi chuan to improve muscular strength and endurance in elderly individuals (a pilot study) . Arch Phys Med Rehabil . 2000;81:604–607
  41. Young DR , Appel LA , Jee SH , Miller ER . The effects of aerobic exercise and t'ai chi on blood pressure in older people (results of a randomized trial) . J Am Geriatr Soc . 1999;47:277–284
  42. Vaananen J , Xusheng S , Wang S , et al.  Taichiquan acutely increases heart rate variability . Clin Physiol Funct Imaging . 2002;22:2–3
  43. Hartman CA , Manos TM , Winter C . Effects of t'ai chi training on function and quality of life indicators in older adults with osteoarthritis . J Am Geriatr Soc . 2000;48:1553–1559
  44. Kostis JB , Rosen RC . Nonpharmacologic therapy improves functional and emotional status in CHF . Chest . 1994;106:996–991001
  45. Moser DK , Dracup K , Woo MA , Stevenson LW . Voluntary control of vascular tone by using skin-temperature biofeedback-relaxation in patients with advanced heart failure . Altern Ther Health Med . 1997;3:51–59
  46. Luskin F , Newell K , Haskell WL . Stress management training of elderly patients with congestive heart failure (pilot study) . Prev Cardiol . 1999;2:101–104

 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

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