***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Preliminary evidence suggests that meditative exercise may have benefits for patients with chronic systolic heart failure ( HF ) ; this has not been rigorously tested in a large clinical sample . We sought to investigate whether tai chi , as an adjunct to st and ard care , improves functional capacity and quality of life in patients with HF . METHODS A single-blind , multisite , parallel-group , r and omized controlled trial evaluated 100 out patients with systolic HF ( New York Heart Association class I-III , left ventricular ejection fraction ≤40 % ) who were recruited between May 1 , 2005 , and September 30 , 2008 . A group-based 12-week tai chi exercise program ( n = 50 ) or time-matched education ( n = 50 , control group ) was conducted . Outcome measures included exercise capacity ( 6- minute walk test and peak oxygen uptake ) and disease-specific quality of life ( Minnesota Living With Heart Failure Question naire ) . RESULTS Mean ( SD ) age of patients was 67 ( 11 ) years ; baseline values were left ventricular ejection fraction , 29 % ( 8 % ) and peak oxygen uptake , 13.5 mL/kg/min ; the median New York Heart Association class of HF was class II . At completion of the study , there were no significant differences in change in 6-minute walk distance and peak oxygen uptake ( median change [ first quartile , third quartile ] , 35 [ -2 , 51 ] vs 2 [ -7 , 54 ] meters , P = .95 ; and 1.1 [ -1.1 , 1.5 ] vs -0.5 [ -1.2 , 1.8 ] mL/kg/min , P = .81 ) when comparing tai chi and control groups ; however , patients in the tai chi group had greater improvements in quality of life ( Minnesota Living With Heart Failure Question naire , -19 [ -23 , -3 ] vs 1 [ -16 , 3 ] , P = .02 ) . Improvements with tai chi were also seen in exercise self-efficacy ( Cardiac Exercise Self-efficacy Instrument , 0.1 [ 0.1 , 0.6 ] vs -0.3 [ -0.5 , 0.2 ] , P < .001 ) and mood ( Profile of Mood States total mood disturbance , -6 [ -17 , 1 ] vs -1 [ -13 , 10 ] , P = .01 ) . CONCLUSION Tai chi exercise may improve quality of life , mood , and exercise self-efficacy in patients with HF . Trial Registration clinical trials.gov Identifier : NCT00110227 Background : Capacity to exercise may not be fully restored in patients with heart failure even in the long term after ventricular assist device ( VAD ) implantation . The benefits of exercise training in patients with VAD are unknown . Design and methods : Fifteen patients , aged 38.3 ± 15.9 years , bridged to heart transplantation with left ventricular assist device or biventricular assist device were r and omized at a ratio of 2 : 1 to a  training group  ( TG , n = 10 ) or a control group ( n = 5 ) , 6.3 ± 4 months after implantation . Both the groups were advised to walk 30–45 min/day . TG also underwent moderate-intensity aerobic exercise using a bike or treadmill for 45 min , three to five times a week , combined with high-intensity inspiratory muscle training using a computer- design ed software to respiratory exhaustion , two to three times a week for 10 weeks . The patients were tested using cardiopulmonary exercise testing , 6-min walk test , spirometry and electronic pressure manometer for inspiratory muscle strength ( Pimax ) and endurance ( sustained Pimax ) measurement . Quality of life was assessed with the Minnesota Living with Heart Failure question naire . Results : TG improved peak oxygen consumption ( 19.3 ± 4.5 vs. 16.8 ± 3.7 ml/kg per min , P = 0.008 ) and VO2 at ventilatory threshold ( 15.1 ± 4.2 vs. 12 ± 5.6 ml/kg per min , P = 0.01 ) , whereas the ventilation/carbon dioxide slope decreased ( 35.9 ± 5.6 vs. 40 ± 6.5 , P = 0.009 ) . The 6-min walk test distance increased ( 527 ± 76 vs. 462 ± 88 m , P = 0.005 ) and quality of life was improved ( 38.2 ± 11.6 vs. 48.9 ± 12.8 , P = 0.005 ) , as well as Pimax ( 131.8 ± 33 vs. 95.5 ± 28cmH2O , P = 0.005 ) , sustained Pimax ( 484 ± 195 vs. 340 ± 193cmH2O/s/10 3 , P = 0.005 ) , and inspiratoty lung capacity ( 2.4 ± 0.9 vs. 1.7 ± 0.7 L , P = 0.008 ) were improved . No significant changes were noted in the control group . Conclusion : Our findings indicate that exercise training may improve the functional status of VAD recipients  even at a later period after implantation and thus , may have additional importance in cases of destination therapy BACKGROUND We hypothesised that combined aerobic training ( AT ) with resistance training ( RT ) and inspiratory muscle training ( IMT ) could result in additional benefits over AT alone in patients with chronic heart failure ( CHF ) . METHODS Twenty-seven patients , age 58 ± 9 years , NYHA II/III and LVEF 29 ± 7 % were r and omly assigned to a 12-week AT ( n=14 ) or a combined AT/RT/IMT ( ARIS ) ( n=13 ) exercise program . AT consisted of bike exercise at 70 - 80 % of max heart rate . ARIS training consisted of AT with RT of the quadriceps at 50 % of 1 repetition maximum ( 1RM ) and upper limb exercises using dumbbells of 1 - 2 kg as well as IMT at 60 % of sustained maximal inspiratory pressure ( SPI(max ) ) . At baseline and after intervention patients underwent cardiopulmonary exercise testing , echocardiography , evaluation of dyspnea , muscle function and quality of life ( QoL ) scores . RESULTS The ARIS program as compared to AT alone , result ed in additional improvement in quadriceps muscle strength ( 1RM , p=0.005 ) and endurance ( 50%1 RM × number of max repetitions , p=0.01 ) , SPI(max ) ( p<0.001 ) , exercise time ( p=0.01 ) , circulatory power ( peak oxygen consumption × peak systolic blood pressure , p=0.05 ) , dyspnea ( p=0.03 ) and QoL ( p=0.03 ) . CONCLUSIONS ARIS training was safe and result ed in incremental benefits in both peripheral and respiratory muscle weakness , cardiopulmonary function and QoL compared to that of AT . The present findings may add a new prospect i ve to cardiac rehabilitation programs of heart failure patients whilst the clinical significance of these outcomes need to be addressed in larger r and omised studies BACKGROUND The effects of mind-body interventions ( MBIs ) ( eg , Tai Chi , yoga , meditation ) for individuals with heart failure ( HF ) have not been systematic ally evaluated . METHODS AND RESULTS We performed a systematic review of r and omized controlled trials ( RCTs ) examining the effects of MBIs in HF . We extracted participant characteristics , MBI procedure , outcomes assessed , and main results of English- language RCTs before October 2016 . We identified 24 RCTs ( n = 1314 participants ) of 9 MBI types : Tai Chi ( n = 7 ) , yoga ( n = 4 ) , relaxation ( n = 4 ) , meditation ( n = 2 ) , acupuncture ( n = 2 ) , biofeedback ( n = 2 ) , stress management ( n = 1 ) , Pilates ( n = 1 ) , and reflexology ( n = 1 ) . Most ( n = 22 , 95.8 % ) reported small-to-moderate improvements in quality of life ( 14/14 studies ) , exercise capacity ( 8/9 studies ) , depression ( 5/5 studies ) , anxiety and fatigue ( 4/4 studies ) , blood pressure ( 3/5 studies ) , heart rate ( 5/6 studies ) , heart rate variability ( 7/9 studies ) , and B-type natriuretic peptide ( 3/4 studies ) . Studies ranged from 4 minutes to 26 weeks and group sizes ranged from 8 to 65 patients per study arm . CONCLUSIONS Although wide variability exists in the types and delivery , RCTs of MBIs have demonstrated small-to-moderate positive effects on HF patients ' objective and subjective outcomes . Future research should examine the mechanisms by which different MBIs exert their effects Aims : The aims of this study were to determine whether yoga and hydrotherapy training had an equal effect on the health-related quality of life in patients with heart failure and to compare the effects on exercise capacity , clinical outcomes , and symptoms of anxiety and depression between and within the two groups . Methods : The design was a r and omized controlled non-inferiority study . A total of 40 patients , 30 % women ( mean±SD age 64.9±8.9 years ) with heart failure were r and omized to an intervention of 12 weeks , either performing yoga or training with hydrotherapy for 45–60 minutes twice a week . Evaluation at baseline and after 12 weeks included self-reported health-related quality of life , a six-minute walk test , a sit-to-st and test , clinical variables , and symptoms of anxiety and depression . Results : Yoga and hydrotherapy had an equal impact on quality of life , exercise capacity , clinical outcomes , and symptoms of anxiety and depression . Within both groups , exercise capacity significantly improved ( hydrotherapy p=0.02 ; yoga p=0.008 ) and symptoms of anxiety decreased ( hydrotherapy p=0.03 ; yoga p=0.01 ) . Patients in the yoga group significantly improved their health as rated by EQ-VAS ( p=0.004 ) and disease-specific quality of life in the domains symptom frequency ( p=0.03 ) , self-efficacy ( p=0.01 ) , clinical summary as a combined measure of symptoms and social factors ( p=0.05 ) , and overall summary score ( p=0.04 ) . Symptoms of depression were decreased in this group ( p=0.005 ) . In the hydrotherapy group , lower limb muscle strength improved significantly ( p=0.01 ) . Conclusions : Yoga may be an alternative or complementary option to established forms of exercise training such as hydrotherapy for improvement in health-related quality of life and may decrease depressive symptoms in patients with heart failure BACKGROUND Despite recent advances in pharmacologic and device therapy , morbidity and mortality from heart failure ( HF ) remain high . Yoga combines physical and breathing exercises that may benefit patients with HF . We hypothesized that an 8-week regimen of yoga in addition to st and ard medical therapy would improve exercise capacity , inflammatory markers , and quality of life ( QoL ) in patients with HF . METHODS AND RESULTS New York Heart Association Class I-III HF patients were r and omized to yoga treatment ( YT ) or st and ard medical therapy ( MT ) .  Measurements included a grade d exercise test ( GXT ) to V O(2Peak ) and the following serum biomarkers : interleukin-6 ( IL-6 ) , high-sensitivity C-reactive protein ( hsCRP ) , and extracellular superoxide dismutase ( EC-SOD ) . The Minnesota Living with Heart Failure Question naire ( MLHFQ ) was administered to assess changes in QoL. A total of 19 patients were enrolled after the initial screening . Of the 19 patients , 9 were r and omized to YT and 10 to MT . Patients had a mean EF of 25 % .  GXT time and V O(2Peak ) were significantly improved in the YT versus MT groups ( + 18 % in the YT and -7.5 % in MT ; P = .03 vs. control and + 17 in YT and -7.1 in MT ; P = .02 , respectively ) . There were statistically significant reductions in serum levels of IL-6 and hsCRP and an increase in EC-SOD in the YT group ( all P < .005 vs. MT ) . MLHFQ scores improved by 25.7 % in the YT group and by 2.9 % in the MT group . CONCLUSIONS Yoga improved exercise tolerance and positively affected levels of inflammatory markers in patients with HF , and there was also a trend toward improvements in Background Heart failure with preserved ejection fraction ( HFpEF ) is remarkably common in elderly people with highly prevalent comorbid conditions . Despite its increasing in prevalence , there is no evidence -based effective therapy for HFpEF . We sought to evaluate whether inspiratory muscle training ( IMT ) improves exercise capacity , as well as left ventricular diastolic function , biomarker profile and quality of life ( QoL ) in patients with advanced HFpEF and nonreduced maximal inspiratory pressure ( MIP ) . Design and methods A total of 26 patients with HFpEF ( median ( interquartile range ) 
    Output:
    
IMT_Ph had the highest effect sizes for VO2 peak and 6MWT , IMT_Pm highest for QoL , and Qi_Ex highest for heart rate .
Aerobics had the second highest for VO2 peak , Qi_Ex second highest for 6MWT , and IMT_Ph second highest for heart rate and QoL. CONCLUSION This study supports that high- and medium-intensity machine-assisted training improves exercise capacity and QoL in hospital-based heart failure patients .
After hospital discharge , non-machine-assisted training continuously improves cardiac function