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The Effects of Tai Chi vs. Cycling on Patients with Congestive Heart Failure

The Effects of Tai Chi vs. Cycling on Patients with Congestive Heart Failure. Laura Stigler, Lauren Rouse, Megan Kaiser, Adam Fischer. Background. Endurance training has many aerobic benefits in individuals with CHF Tai Chi improves exercise tolerance and promotes hemodynamic stability

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The Effects of Tai Chi vs. Cycling on Patients with Congestive Heart Failure

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  1. The Effects of Tai Chi vs. Cycling on Patients with Congestive Heart Failure Laura Stigler, Lauren Rouse, Megan Kaiser, Adam Fischer

  2. Background • Endurance training has many aerobic benefits in individuals with CHF • Tai Chi improves exercise tolerance and promotes hemodynamic stability • Kentucky Tai Chi and Qigong Center

  3. Clinical Significance • Physical therapists must be able to effectively treat these patients • Physical therapy is needed to prevent additional cardiopulmonary complications • CHF is a chronic condition

  4. PICO Question • Patient : Patients with CHF • Intervention : Tai Chi training • Comparison : Cycling • Outcome : VO2 Max 6MWT distance QOL http://www.wpclipart.com/recreation/cycling/bicycle_parts/bike_wheel.png.html http://www.easternhealingcenter.com/En/essence_tai_chi.htm

  5. Yeh et al, 2009METHODS • Usual Care group (n=15) • Pharmacologic therapy • Dietary and exercise counseling • Tai Chi group (n=15) • 12 weeks of Tai Chi + usual care • 1 hr class 2x/week

  6. Yeh et al, 2009RESULTS • QOL (Minnesota Living with HF Questionnaire) significantly improved (p=0.001) • Exercise capacity (6MWT) significantly improved (p=0.001)

  7. Caminiti et al, 2003METHODS • Exercise training: 30 min of cycling or walking at 60-70% VO2max • Combined training: • Tai Chi for 30 min 2x/week • Cycling or walking for 30 min 2x/week 4 sessions/week for 12 weeks

  8. Caminiti et al, 2003RESULTS • QOL (MacNewQLML) significantly improved (esp social and emotional) (p=0.026) • 6MWT distance increased from 214+32 m to 291+46 m (p=0.001) • SBP significantly decreased (p=0.025)

  9. Giannuzzi et al, 2003METHODS • Functional eval at baseline and 6 mo FU • Exercise group: • 30 min cycle ergometer > 3x/wk at 60% of peak VO2 • > 30 min daily walk and calisthenics • Control group: • Educational support

  10. Giannuzzi et al, 2003RESULTS • Ejection fraction increased in exercise group by 16% • SBP and rate-pressure product at rest decreased slightly in exercise group • O2uptake increased at ventilatorythreshold and at peak exercise • 6MWT distance increased by 20%

  11. Conclusion • Research has not yet compared effects of cycling versus Tai Chi on patients with CHF • Both resulted in improved QOL, 6MWT distance and VO2max • Consider incorporating both interventions into POC for patients

  12. References • Barrow DE, Bedford A. Ives G, OToole L, Channer KS. An evaluation of the effects of Tai Chi Chuan and Chi Kung training in patients with symptomatic heart failure: a randomised controlled pilot study. Postgrad Med J. 2007;83(985):717-721. • Belardinelli R, Georgiou D, Cianci G, Purcaro A. 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. • Caminiti G, Volterrani M, Marazzi G, Cerrito A, Massaro R, Arisi A, Franchini A, Sposato B, Rosano G. Tai Chi enhances the effects of endurance training in the rehabilitation of elderly patients with chronic heart failure. Rehab Research Prac. 2011;2011:1-6. • Giannuzzi P, Temporelli PL, Corrà U, Tavazzi L. Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure. Circulation. 2003;108:554-559.

  13. References • Pan L, Yan JH, Guo YZ, Yan JH. Effects of Tai Chi training on exercise capacity and quality of life in patients with chronic heart failure: a meta-analysis. Eur J Heart Fail. 2013;15(3): 316-323. • Smart N. A, Murison, R. Rate of change in physical fitness and quality of life and depression following exercise training in patients with congestive heart failure. Congestive Heart Failure. 2013; 19:1. • Wei L, Liu HY. The effect of simplified Tai Chi on cardiovascular function in patients with heart failure. Chin J Clin Rehahil. 2003;7:1460-1461. • Yeh GY, Wood MJ, Lorell BH, et al. Effects of Tai Chi mind-body movement therapy on functional status and exercise capacity in patients with chronic heart failure: a randomized controlled trial. Am J Med. 2004;117(8):541-548.

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