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An evaluation of the effects of Tai Chi Chuan and Chi Kung training in patients with symptomatic heart failure: a randomised controlled pilot study

Department Cardiology, Royal Hallamshire Hospital, Sheffield, UK

Correspondence to:
Professor K S Channer, Department of Cardiology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK; kevin.channer{at}sth.nhs.uk

Objective: To study the effect of Tai Chi on exercise tolerance in patients with moderate heart failure.

Design: Randomised parallel group study balanced for baseline variables.

Setting: Cardiology Department, Royal Hallamshire Hospital.

Patients and methods: 52 patients (42 men, mean age (68.9 years), range (46–90 years), and 10 women, mean age (70.0 years), range (58–82)) with chronic heart failure (New York Heart Association symptom class II–III) were studied. Patients were randomised to Tai Chi Chuan twice a week for 16 weeks or to standard medical care without exercise rehabilitation.

Main outcome measures: The primary outcome measure was the change in the distance walked in the shuttle walk test. Secondary outcome measures were changes in symptom scores and quality of life indices.

Results: Objective measures of exercise tolerance did not improve significantly with Tai Chi, but patients having Tai Chi exercise had an improvement in symptom scores of heart failure measured by the Minnesota Living with Heart Failure Questionnaire (comparison of deltas, –2.4 control vs –14.9; p = 0.01), and depression scores measured by the SCL-90-R questionnaire (–2.9 vs –6.8; p = 0.12) compared with those patients in the control group.

Conclusion: In patients with chronic heart failure, 16 weeks of Tai Chi training was safe, with no adverse exercise related problems. It was enjoyed by all taking part and led to significant improvements in symptoms and quality of life.

Abbreviations: BNP, brain natriuretic peptide; DBP, diastolic blood pressure; ISWT, incremental shuttle walk test; MLHF, Minnesota Living with Heart Failure; NYHA, New York Heart Association; SBP, systolic blood pressure; O₂, oxygen consumption

Keywords: heart failure; exercise; shuttle walk test; Tai chi