Exploring correlates of improved depression symptoms and quality of life following tai chi exercise for patients with heart failure

Author: Christina M Luberto1, Charles A Coey2, Roger B Davis3, Peter M Wayne2, Sydney Crute1, Gloria Y Yeh3
Author Information:
1 Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, 100 Cambridge St, 16th Floor, Boston, MA, 02114, USA.
2 Department of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA.
3 Department of Medicine, Division of General Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA.
Conference/Journal: ESC Heart Fail
Date published: 2020 Oct 9
Other: Special Notes: doi: 10.1002/ehf2.13046. , Word Count: 254


Aims:
Tai chi exercise has been shown in a prior randomized controlled trial to improve depression symptoms and quality of life (QoL) in patients with heart failure (HF), but correlates of these improvements are not well known. The purpose of this secondary analysis was to explore whether tai chi is associated with improvements in biopsychosocial and behavioural measures and whether such improvements are correlated with improved depression and QoL.

Methods and results:
Participants were n = 100 adults with chronic systolic HF (mean age = 67.4, SD = 12.0; 64% male; 96% White; New York Heart Association class = 1-3) randomized to a 12 week tai chi exercise intervention or health education control. Constructs of interest included social support, exercise self-efficacy, activity engagement, sense of coherence, and inflammatory biomarkers. Tai chi was associated with increased everyday activity engagement compared with the health education group (P < 0.05), but there were no group differences in social support or sense of coherence. Among tai chi participants, improved self-efficacy was correlated with QoL (r = 31, P = 0.05), and there was a trend toward improved depression symptoms and social support (r = -0.22, P = 0.13). Among all participants, controlling for intervention group, improved sense of coherence, and inflammation (C-reactive protein) were associated with improved depression symptoms, and improved self-efficacy, sense of coherence, and frequency of activity engagement were associated with improved QoL.

Conclusions:
Tai chi exercise promotes inter-related psychosocial improvements for patients with HF. A range of biopsychosocial and behavioural variables are relevant to mood management in patients with HF.

Keywords: Activity; Depression; Heart failure; Self-efficacy; Social support; Tai chi.

PMID: 33034157 DOI: 10.1002/ehf2.13046

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