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Harvard Medical School: Tai Chi Shows Multiple Effects on Heart Failure Patients
May 18, 2014 -
The May 2014 issue of Journal of alternative and complementary medicine published a qualitative analysis by Harvard Medical School to explore patient experiences, perceived changes, and health benefits associated with a Tai Chi program in a clinical trial of patients with heart failure.

The researchers randomized 100 patients with chronic systolic heart failure to a 12-week group Tai Chi program or an education control. At 12 weeks, semi-structured interviews were conducted on a random subset (17 in Tai Chi group, 15 in control group), audio-recorded and transcribed verbatim. Two independent reviewers extracted information using grounded-theory methods for emergent themes. The researchers explored differences in themes/sub-themes between the groups, and examined qualitative association with changes from baseline to post-intervention in previously reported measures.

The researchers identified themes related to illness perspective, relationship to self, physical and psychosocial benefits, and relationship to others (e.g., spouse). Common themes emerged from both groups including: acceptance of illness, hope, motivation to improve health, and self-efficacy related to activity/exercise and diet. However, the groups differed in the source of patients' locus-of-control, with those in education more external (e.g., gain hope from family/friends) versus those in Tai Chi more internal (e.g., gain hope/optimism from within one's self).

Additional themes in Tai Chi included self-awareness, pride, calm, life appreciation, decreased stress reactivity. These themes mirrored improvements in quantitative measures (quality-of-life, self-efficacy, and mood) in Tai Chi compared to control. Patients in Tai Chi also reported physical benefits (e.g., improved balance, endurance).

The researchers concluded: positive themes emerged from both groups, although there were qualitative differences in concepts such as locus-of-control and self-efficacy. Those in Tai Chi reported additional gains such as self-awareness, stress reduction, and balance. Future studies of mind-body exercise might further examine locus-of-control and self-efficacy as potential mediators of effect.



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