Research at the New England School of Acupuncture

Harvard Medical School 's Osher Institute and the New England School of Acupuncture jointly conducted a pilot RCT to evaluate Tai Chi for heart failure (HF) as an adjunct to usual care. A total of 30 patients were recruited from the HF clinics at Beth Israel Deaconness Medical Center and Brigham and Women's Hospital. Patients were randomized to one of two groups: usual care plus 12 weeks of Tai Chi training vs. usual care without a supervised exercise regimen. A simple, tailored intervention of traditional warm-up exercises and 5 Tai Chi forms adapted from Master Cheng Man-Ch'ing's Yang-style Tai Chi was developed. Group classes with experienced Tai Chi instructors were held for one hour twice weekly. Classes followed a standard protocol, but patients were allowed to progress at their own pace. A videotape was provided for home practice. Outcome measures included exercise capacity, quality of life, and biochemical markers of cardiovascular health.

Current Status: Subject recruitment, TC intervention, follow-up measurements, and data analysis are completed.

Results: At 12 weeks, the patients in the Tai Chi group demonstrated improved quality-of-life scores, six-minute walk distance, and serum B-type natriuretic peptide (BNP) level compared to controls (p<0.001, p<0.001, and p=0.03, respectively). Trends toward improvement were seen in increased peak VO2. In addition, on heart rate variability analyses, the intervention group showed significant increases in pNN30 and pNN40 values that were not seen in the control group during the 6 hours of sleep. pNNx values are important time domain variables representing the percentage of differences between adjacent normal sinus to normal sinus (NN) intervals greater than 10-50 milliseconds. These pNNx increases suggest a decrease in sympathetic activation and increase in vagal tone with Tai Chi. These results are summarized in the publications listed below.

Principal Investigators (PI) - Gloria Yeh, MD (2); Russell Phillips, MD (2)

Co-Investigators: Peter Wayne , PhD (NESA); David Eisenberg, MD (1, 2); Malissa Wood, MD (3); Beverly Lorell, MD (2); Lynne Warner-Stevenson, MD (4); Ary Goldberger, MD (2); Roger Davis , ScD (2)

Collaborating Institutions: (1) Harvard Medical School 's Osher Institute; (2) Beth Israel Deaconess Medical Center ; (3) Massachussets General Hospital ; (4) Brigham and Women's Hospital

Yeh GY, Lorell BH, Stevenson LW, Wood MJ, Eisenberg DM, Wayne PM, Goldberger AL , Davis RB, Phillips RS. Benefit of Tai Chi as an Adjunct to Standard Care in Patients with Chronic Heart Failure. J Card Fail. 2003, 9(5):51.
Yeh GY, Wood MJ, Lorell BH, Stevenson LW, Eisenberg DM, Wayne PM, Goldberger AL , Davis RB, Phillips RS. Effect 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.