A mixed methods study of Tai Chi exercise for patients with chronic heart failure aged 70years and older.

Lena Hägglund,Margareta Brännström,Kurt Boman

doi:10.1002/nop2.127

Abstract

Aims and objectivesThis study aimed to evaluate Tai Chi group training among patients with chronic heart failure (CHF) aged 70 years and older.BackgroundPhysical activity is recommended for CHF treatment. Tai Chi is found to be beneficial to different patient groups, although few studies focus on older patients with CHF.DesignA mixed methods study. Participants were randomly assigned to Tai Chi training twice a week for 16 weeks (N = 25) or control (N = 20). Quantitative data were collected at baseline, at the end of the training period and 6 months after training, assessing self‐rated fatigue and quality of life, natriuretic peptides and physical performance. Individual qualitative interviews were conducted with participants (N = 10) in the Tai Chi training group.ResultsNo statistical differences between the Tai Chi training group and the control group in quality of life or natriuretic peptides was found. After 16 weeks, the training group tended to rate more reduced activity and the control group rated more mental fatigue. Participants in the training group rated increased general fatigue at follow‐up compared with baseline. Qualitative interviews showed that Tai Chi training was experienced as a new, feasible and meaningful activity. The importance of the leader and the group was emphasized. Improvements in balance were mentioned and there was no physical discomfort.ConclusionTai Chi was experienced as a feasible and meaningful form of physical exercise for patients with CHF aged over 70 years despite lack of achieved health improvement. Further investigations, using feasibility and meaningfulness as outcome variables seems to be useful.

Highlights

Chronic heart failure (CHF) is a common syndrome among older people, with a median prevalence rate of 11.8% for people 60 years or older
The attendance at the Tai Chi training sessions was as follows: 18 of 25 participants completed 75% or more of the sessions and seven participants completed less than 75%
Participants appreciated that the Tai Chi training was new for all the participants

Summary

Introduction

Chronic heart failure (CHF) is a common syndrome among older people, with a median prevalence rate of 11.8% for people 60 years or older (van Riet et al, 2016). Tai Chi (Tai Chi Chuan) is a Chinese traditional mind-body exercise that has met with increasing interest in Western countries It is a combination of physical activity and muscle relaxation through slow, graceful movements which focus on breath control and mental concentration. In the 2016 European Society of Cardiology guidelines regular physical activity and structured exercise training is a Class l recommended treatment for patients with stable CHF (Ponikowski et al, 2016). There is still a lack of evidence concerning exercise among older patients with CHF since the mean age in most studies are younger than 70 years (Taylor et al, 2014). A training programme combining endurance exercise and resistance training had positive effects on physical capacity in a group of CHF patients aged 76 years (Pihl, Cider, Strömberg, Fridlund, & Mårtensson, 2011)

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