TAI CHI HELPS HEART FAILURE PATIENTS. IS IT MOTIVATION AND SELF BELIEF?

Dr Gloria Yeh from Beth Israel Deaconess Hospital Boston, presented an interesting paper at the recent Annual Scientific meeting of the Heart Failure Society of America 2010, entitled " Tai chi exercise improves quality of life in patients with chronic heart failure in a randomized controlled trial. "
This group from Boston studied 100 patients with class 1-3 heart failure and documented LVEF of <40%. They were divided into two groups, 50 doing Tai Chi, twice weekly for 12 weeks and the other group were given education and tutorial classes on heart failure rehab., and reading materials, twice weekly for 12 weeks. At the end of the 12 weeks period, there was no difference in the measured heart unction indices like 6 minute walk time, peak O2 utilisation on a bicycle ergometer, or BNP levels. But those patients on Tai Chi had a much better quality of life. They were able to do more activities, and had a more positive outlook. Granted, all these are very soft end points, but they were obviously better off.
Interesting, but I must say that the study design could be better. Perhaps, a larger patient cohort may have helped. 50 in each arm is a small number. I am sure that you could get more than 100 heart failure patients in Boston area. It may have been reasonable to measure improvements over followup of 1 - 5 years ( if funds allow ), how many were re-admitted for heart failure ( an index used in many heart failure treatment clinical trials ).
Nonetheless, we can say a few things. Obviously Tai Chi, is not contraindicated in heart failure patients once they are treated and controlled. Secondly, motivation and a positive frame of mind is very important. Acceptance of one's condition and motivation to move forward in life makes all the difference. Drugs and medical therapy is obviously important, to improve survival, but living life to the fullest, is what it is all about. What is quantity without quality?