Introduction
Chronic heart failure (CHF) remains a major global health burden, characterized by reduced exercise tolerance, impaired quality of life (QoL), and high healthcare utilization. Alongside conventional pharmacological and device-based therapies, non-pharmacological interventions such as cardiac rehabilitation play a crucial role in CHF management. Tai Chi (TC), a traditional mind–body exercise combining slow movements, controlled breathing, and mental focus, has gained attention as a potentially safe and accessible rehabilitation strategy for CHF patients. However, its clinical efficacy remains debated, necessitating evidence-based evaluation.
Rationale for Tai Chi in Cardiac Rehabilitation
Tai Chi is considered a low-to-moderate intensity aerobic exercise, making it suitable for older adults and patients with limited physical capacity, such as those with CHF. Its emphasis on balance, relaxation, and gentle movement may reduce sympathetic activation and improve psychosocial well-being. From a research perspective, TC offers a holistic intervention that may complement standard cardiac rehabilitation, particularly for patients unable or unwilling to engage in conventional exercise programs.
Methodological Approach of the Meta-Analysis
The meta-analysis synthesized evidence from randomized controlled trials (RCTs) evaluating TC in CHF patients with reduced left ventricular ejection fraction (≤45%). Comprehensive searches of PubMed and EMBASE databases ensured systematic identification of eligible studies. By calculating weighted mean differences (WMDs) and assessing heterogeneity using the I² statistic, the analysis aimed to quantitatively determine the impact of TC on functional capacity, biomarkers, hemodynamic parameters, and QoL outcomes.
Effects of Tai Chi on Quality of Life
One of the most consistent findings of the meta-analysis was the significant improvement in QoL among CHF patients practicing Tai Chi. The observed reduction in QoL scores suggests meaningful psychosocial and functional benefits, potentially mediated through reduced stress, enhanced self-efficacy, and improved emotional well-being. These findings highlight QoL as a sensitive outcome measure for mind–body interventions and underscore TC’s value beyond purely physiological endpoints.
Impact on Exercise Capacity and Clinical Outcomes
Despite favorable effects on QoL, Tai Chi did not demonstrate statistically significant improvements in objective clinical parameters such as N-terminal pro-brain natriuretic peptide levels, blood pressure, peak oxygen uptake, or six-minute walking distance. While trends toward improved exercise capacity were observed, the lack of significance may reflect limited sample sizes, short intervention durations, or variability in TC protocols across studies.
Research Gaps and Future Directions
The current evidence base is constrained by small-scale RCTs and methodological heterogeneity, limiting definitive conclusions regarding Tai Chi’s role in CHF management. Future research should prioritize larger, well-designed trials with standardized TC interventions, longer follow-up periods, and integration of both clinical and patient-reported outcomes. Such studies are essential to clarify whether Tai Chi can influence disease progression, functional capacity, and long-term prognosis in CHF patients.
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