| Chronic heart failure is the terminal stage of most chronic cardiovascular diseases.Evidence-based medical evidence shows that exercise is effective for the rehabilitation of patients with chronic heart failure.At the present stage,under the premise of ensuring the effectiveness,we need to find sports rehabilitation projects with high safety,low loss rate of subjects,good mass foundation and easy to promote.Tai Chi,as a unique national traditional sport in China,is gentle and slow,with a deep mass base,which is in line with the physical characteristics of chronic heart failure patients with long illness and weak body and poor exercise endurance.How to give full play to the advantages of Tai Chi exercise rehabilitation and provide a more suitable and localized rehabilitation program for patients with chronic heart failure is the focus of the field of heart rehabilitation at home and abroad.This paper mainly includes five parts:The first part: a systematic review of the effective of Tai Chi on patients with chronic heart failure: a META-analysis of Tai Chi randomized controlled trialsObjective: To explore the effective of Tai Chi randomized controlled trials on the health intervention of patients with chronic heart failure.Methods: according to the established criteria,the randomized controlled study of Tai Chi health intervention in patients with chronic heart failure at home and abroad was searched and screened,and the included literature was evaluated,and the research data were processed and analyzed by statistical software.Results: Finally,17 articles were included.Compared with the conventional treatment group,the 6-minute walking distance(MD = 40.55;95% CI [37.57-43.52;P = 0.003),quality of life(MD =-8.32;95% CI [-8.79,-7.85];P < 0.00001),left ventricular ejection fraction(MD = 7.85;95% CI [4.57-11.13];P < 0.00001),B-type brain natpeptide(MD =-11.32;95% CI [37.57-43.52];P = 0.003),quality of life(MD =-8.32;95% CI [37.57-43.52];P = 0.003),quality of life(MD =-8.32;95% CI [-8.79,-7.85],P < 0.00001),left ventricular ejection fraction(MD 95% CI [1.01,2.19];Compared with the routine exercise group,the patients with 6-minute walking distance(MD = 14.43;95% CI [9.34-19.52];P = 0.02),quality of life(MD =-2.10;95% CI [-2.75,-1.45];P = 0.10),B-type brain natriupeptide(MD =-27.16;95% CI [-47.88,-6.43];P = 0.01)and systolic blood pressure(MD =-6.99;95% CI [-7.96,-6.01];P <0.00001)had better rehabilitation effect.Conclusion: Tai Chi has rehabilitation effect on patients with chronic heart failure.It is suggested that the research methods should be standardized in the future,the evaluation indexes should be expanded and the scope of research objects should be expanded.The second part: safety of Tai Chi: the systematic review of Tai Chi randomized controlled trialsObjective: To explore the safety of Tai Chi randomized controlled trial and the safety of Tai Chi training in patients with chronic heart failure.Methods: according to the established criteria,the randomized controlled study of Tai Chi health intervention was searched and screened,and the included literature was evaluated,the safety related data were extracted,and the research data were processed and analyzed by statistical software.Results: Finally,24 randomized controlled trials were included.In randomized controlled trials.The frequency and degree of serious adverse reactions of Tai Chi intervention has no difference with other exercise(RD = 0.00,95% CI: [-0.02,0.02];P = 0.84)or non exercise intervention(RD =-0.03,95% CI: [-0.06,0.00];P = 0.08);in randomized controlled trials,there is no difference in the frequency and degree of serious adverse reactions between Tai Chi intervention and other sports(RD = 0.01,95% CI: [-0.01,0.03];P = 0.45)or non exercise intervention(RD = 0.03,95% CI:(0.00,0.02,P = 0.84;P = 0.84)or non exercise intervention(RD =-0.03,95% CI: [-0.06,it's a good idea;There was no difference between the two groups(P = 0.07).Compared with non exercise intervention,Tai Chi could significantly reduce the number of serious adverse reactions in patients with chronic heart failure(RD =-0.11,95% CI: [-0.20,-0.03];P = 0.01).Conclusion: Tai Chi practice is safe,and Tai Chi is safe and reliable as an auxiliary treatment of chronic heart failure.Tai Chi practice should be encouraged for both healthy and chronic heart failure patients.It is hoped that the future literature of Tai Chi randomized controlled trials will include high-quality adverse reaction data reports as much as possible and more sample sizes.The third part: a randomized controlled trial of Tai Chi on exercise rehabilitation of patients with chronic heart failureObjective: to follow the international consort standard process of Tai Chi randomized controlled trial developed by this study,and carry out an empirical study on the effectiveness and safety of Tai Chi in the exercise rehabilitation of elderly patients with chronic heart failure.Methods: Taking the patients with chronic heart failure as the research object,Tai Chi was used in the intervention group,and low-intensity aerobic exercise was used in the control group for 12 weeks.The main outcome measures were 6-minute walking distance,quality of life scale,B-type natriuretic peptide and adverse reactions.Results: In this study,44 patients with chronic heart failure who met the inclusion and exclusion criteria were included in this study,and 42 patients were finally completed the experiment,including 22 cases in Tai Chi intervention group and 20 cases in aerobic training control group(2 cases dropped off).After the experiment,the data showed that the exercise endurance of patients before and after the intervention of Tai Chi and aerobic exercise was significantly improved,and there was no difference between the two groups(P = 0.88);the quality of life of patients before and after Tai Chi and aerobic exercise was significantly improved,and there was no difference between the two groups(P = 0.74);the level of B-type natriuretic peptide in patients before and after Tai Chi intervention was significantly improved,there was a difference between the two groups(P < 0.05).No serious adverse reactions were observed.Conclusion: Tai Chi health intervention is effective and safe for elderly patients with chronic heart failure.It is suggested that the future research can include more samples,multiple levels of heart function classification,direct cooperation with hospitals,and sufficient follow-up period of Tai Chi randomized controlled trials.The fourth part: a randomized controlled trial of different doses of Tai Chi on health intervention of patients with chronic heart failureObjective: To compare the difference of different doses of Tai Chi health intervention in patients with chronic heart failure.Methods: The subjects were randomly divided into 5-day group(5 times * 30 mins),3 days group(3 times * 50 mins)and 2 days group(2 times * 75 mins)for 12 weeks.Outcome measures included 6-minute walking distance,MLHF score scale,B-type natriuretic peptide,adverse reactions and compliance.T-test was used to analyze the difference between the three groups.Multiple regression analysis was used to analyze the dose effect among the three groups.Results: In this study,53 patients(3 cases dropped off)completed the study,including 16 cases in the 5-day group(3 cases of dropped off),22 cases in the 3-day group and 15 cases in the 2-day group.The results of 5-day and 3-day exercise tolerance groups were significantly improved(P < 0.05);the results of 5-day and 3-day groups of MLHF score were significantly improved(P < 0.05);the results of BNP 3-day and 2-day groups were significantly improved(P < 0.05).The main effect factor of exercise tolerance,quality of life and compliance was exercise frequency,and the main effect factor of blood index was intervention time per time.Conclusion: The health intervention dose of Tai Chi is suitable for patients with chronic heart failure.It is not recommended for this population to exercise with low frequency and long duration.The interval of each intervention should not exceed 3 days. |
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