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A Randomized Study Examining the Effects of Mild-to-Moderate Group Exercises on Cardiovascular, Physical, and Psychological Well-being in Patients With Heart Failure

Redwine, Laura S. PhD; Wilson, Kathleen MS; Pung, Meredith A. PhD; Chinh, Kelly BS; Rutledge, Thomas PhD; Mills, Paul J. PhD; Smith, Barbara PhD, RN, FACSM, FAAN

Journal of Cardiopulmonary Rehabilitation and Prevention: November 2019 - Volume 39 - Issue 6 - p 403–408
doi: 10.1097/HCR.0000000000000430
Heart Failure

Purpose: To compare 2 mild-to-moderate group exercises and treatment as usual (TAU) for improvements in physical function and depressive symptoms.

Methods: Patients with heart failure (n = 70, mean age = 66 yr, range = 45-89 yr) were randomized to 16 wk of tai chi (TC), resistance band (RB) exercise, or TAU.

Results: Physical function differed by group from baseline to follow-up, measured by distance walked in the 6-min walk test (F = 3.19, P = .03). Tai chi participants demonstrated a nonsignificant decrease of 162 ft (95% confidence interval [CI], 21 to −345, P = .08) while distance walked by RB participants remained stable with a nonsignificant increase of 70 ft (95% CI, 267 to −127, P = .48). Treatment as usual group significantly decreased by 205 ft (95% CI, −35 to −374, P = .02) and no group differences occurred over time in end-systolic volume (P = .43) and left ventricular function (LVEF) (P = .67). However, groups differed over time in the Beck Depression Inventory (F = 9.2, P < .01). Both TC and RB groups improved (decreased) by 3.5 points (95% CI, 2-5, P < .01). Treatment as usual group decreased insignificantly 1 point (95% CI, −1 to 3, P = .27).

Conclusions: Tai chi and RB participants avoided a decrease in physical function decrements as seen with TAU. No groups changed in cardiac function. Both TC and RB groups saw reduced depression symptoms compared with TAU. Thus, both TC and RB groups avoided a decrease in physical function and improved their psychological function when compared with TAU.

Tai chi (TC), resistance band (RB) exercise, and treatment as usual (TAU) were compared in 70 heart failure patients. Tai chi and RB group's physical function remained stable, while TAU showed declines. Tai chi and RB groups had reduced depression symptoms compared with TAU. None of the groups changed in cardiac function.

Departments of Psychiatry (Drs Redwine, Rutledge, and Mills and Ms Chinh) and Family Medicine and Public Health (Ms Wilson and Drs Pung and Mills), University of California, San Diego; and College of Nursing, University of South Florida, Tampa (Drs Redwine and Smith).

Correspondence: Laura S. Redwine, PhD, College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd, MDC22, Tampa, FL 33612 (

This research was supported by R01HL096784.

The protocol for the parent study can be found at

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Clinical Trial number: NCT01625819. ORCID#: 0000-0001-7633-2034.

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