Tai chi exercise appears to be associated with improved quality of life, mood and exercise self-efficacy in patients with chronic heart failure, according to a report in the April 25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

"Historically, patients with chronic systolic heart failure were considered too frail to exercise and, through the late 1980s, avoidance of physical activity was a standard recommendation," the authors write as background information in the study. "Preliminary evidence suggests that meditative exercise may have benefits for patients with chronic systolic heart failure; this has not been rigorously tested in a large clinical sample."

Gloria Y. Yeh, M.D., M.P.H., of the Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, and colleagues evaluated 100 outpatients with systolic heart failure who were recruited between May 1, 2005 and September 30, 2008. Fifty patients were randomized to a 12-week Tai chi-based exercise intervention group, and 50 were randomized to a time-matched education group.

The Tai chi intervention group consisted of one-hour group classes held twice weekly for 12 weeks. The education sessions were also held twice weekly for the same duration as the Tai chi lessons, and were led by a nurse practitioner. The two groups were generally similar in demographics, clinical classification of heart disease severity, and rates of comorbidities.

At completion of the study, there were no significant differences in change in six-minute walk distance and peak oxygen uptake when comparing the Tai chi and control groups; however, patients in the Tai chi group had greater improvements in quality of life. The Tai chi group also showed improvements in exercise self-efficacy (confidence to perform certain exercise-related activities), with increased daily activity, and related feelings of well-being compared with the education group.

"In conclusion, Tai chi exercise, a multi-component mind-body training modality that is safe and has good rates of adherence, may provide value in improving daily exercise, quality of life, self-efficacy and mood in frail, deconditioned patients with systolic heart failure," the authors write. "A more restricted focus on traditional measured exercise capacity may underestimate the potential benefits of integrated interventions such as Tai chi."

This study was supported by an award from the National Center for Complementary and Alternative Medicine and in part by a grant from the Beth Israel Deaconess Medical Center General Clinical Research Center from the National Institutes of Health.