***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 AIMS The purpose of this study was to evaluate whether yoga training in addition to st and ard medical therapy can improve cardiac function and reduce N terminal pro B-type natriuretic peptide ( NT pro BNP ) in heart failure ( HF ) . METHODS 130 patients were recruited and r and omized into two groups : Control Group ( CG ) ( n = 65 ) , Yoga Group ( YG ) . In YG , 44 patients and in CG , 48 patients completed the study . Cardiac function using left ventricular ejection fraction ( LVEF ) , myocardial performance index ( Tei index ) , and NT pro BNP , a biomarker of HF , was assessed at baseline and after 12 weeks . RESULT Improvement in LVEF , Tei index , and NT pro BNP were statistically significant in both the groups . Furthermore , when the changes in before and after 12 weeks were in percentage , LVEF increased 36.88 % in the YG and 16.9 % in the CG , Tei index was reduced 27.87 % in the YG and 2.79 % in the CG , NT pro BNP was reduced 63.75 % in the YG and 10.77 % in the CG . The between group comparisons from pre to post 12 weeks were significant for YG improvements ( LVEF , P < 0.01 , Tei index , P < 0.01 , NT pro BNP , P < 0.01 ) . CONCLUSION These results indicate that the addition of yoga therapy to st and ard medical therapy for HF patients has a markedly better effect on cardiac function and reduced myocardial stress measured using NT pro BNP in patients with stable HF 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 Conventional cardiac rehabilitation program consist of 15 min of warm-up , 30 min of aerobic exercise and followed by 15 min calisthenics exercise . The Pilates method has been increasingly applied for its therapeutic benefits , however little scientific evidence supports or rebukes its use as a treatment in patients with heart failure ( HF ) . PURPOSE Investigate the effects of Pilates on exercise capacity variables in HF . METHODS Sixteen pts with HF , left ventricular ejection fraction 27 ± 14 % , NYHA class I-II were r and omly assigned to conventional cardiac rehabilitation program  ( n = 8) or mat Pilates training ( n = 8) for 16 weeks of 30 min of aerobic exercise followed by 20 min of the specific program . RESULTS At 16 weeks , pts in the mat Pilates group and conventional group showed significantly increase on exercise time 11.9 ± 2.5 to 17.8 ± 4 and 11.7 ± 3.9 to 14.2 ± 4 min , respectively . However , only the Pilates group increased significantly the ventilation ( from 56 ± 20 to 69 ± 17 L/min , P = 0.02 ) , peak VO(2 ) ( from 20.9 ± 6 to 24.8 ± 6 mL/kg/min , P = 0.01 ) , and O(2 ) pulse ( from 11.9 ± 2 to 13.8 ± 3 mL/bpm , P = 0.003 ) . The Pilates group showed significantly increase in peak VO(2 ) when compared with conventional group ( 24.8 ± 6 vs. 18.3 ± 4 , P = 0.02 ) . CONCLUSIONS The result suggests that the Pilates method may be a beneficial adjunctive treatment that enhances functional capacity in patients with HF who are already receiving st and ard medical therapy Background Congestive heart failure ( CHF ) is a complex clinical syndrome with autonomic dysbalance and increased plasma levels of inflammatory cytokines , which further worsen the syndrome . Experimental data have shown that stimulation of certain acupoints decreases autonomic dysbalance . Objective To test the therapeutic potential of acupuncture for life-threatening diseases such as CHF . Methods 17 stable patients with CHF ( New York Heart Association class II – III , ejection fraction < 40 % ) receiving optimised heart failure medication were r and omised into a verum acupuncture ( VA ) and placebo acupuncture ( PA ) group . Cardiopulmonary function , heart rate variability and quality of life were explored . Results No improvements of the cardiac ejection fraction or peak oxygen uptake were observed , but the ambulated 6 min walk distance was remarkably increased in the VA group ( + 32±7 m ) but not the PA group ( −1±11 m ; p<0.01 ) . Accordingly , post-exercise recovery after maximal exercise and the VE/VCO2 slope , a marker of ventilatory efficiency , were improved after VA but not PA . Furthermore , heart rate variability increased after VA , but decreased after PA . The ‘ general health ’ score and ‘ body pain ’ score of the quality -of-life question naire SF-36 tended to be improved after VA . Conclusion Acupuncture may become an additional therapeutic strategy to improve the exercise tolerance of patients with CHF , potentially by improving skeletal muscle function The purpose of this study was to evaluate the effect of stress management training on quality of life , functional capacity , and heart rate variability in elderly patients with New York Heart Association class I-III congestive heart failure ( CHF ) . While substantial research exists on stress management training for patients with coronary heart disease , there are few data on the value of psychosocial training on patients with CHF . Thirty-three multiethnic patients ( mean age , 66+/-9 years ) were assigned through incomplete r and omization to one of two treatment groups or a wait-listed control group . The 14 participants who completed the treatment attended eight training sessions during a 10-week period . The training consisted of 75-minute sessions adapted from the Freeze-Frame stress management program developed by the Institute of HeartMath . Subjects were assessed at baseline and again at the completion of the training . Depression , stress management , optimism , anxiety , emotional distress , and functional capacity were evaluated , as well as heart rate variability . Significant improvements ( p<0.05 ) were noted in perceived stress , emotional distress , 6-minute walk , and depression , and positive trends were noted in each of the other psychosocial measures . The 24-hour heart rate variability showed no significant changes in autonomic tone . The authors noted that CHF patients were willing study participants and their emotional coping and functional capacity were enhanced . This program offers a simple and cost-effective way to augment medical management of CHF . Given the incompleteness of CHF medical management and the exploding interest in complementary medical intervention , it seems imperative that further work in psychosocial treatment be undertaken BACKGROUND The number of African American ( AA ) patients living with heart failure ( HF ) has been increasing , especially among the economically disadvantaged . Yoga therapy has been found to improve physical and psychological parameters among healthy individuals , but its effect in patients with HF remains unknown . The purpose of this study was to examine the effects of yoga therapy on cardiovascular endurance ( VO2peak ) , flexibility , quality of life ( QoL ) , and inflammatory markers on medically stable HF patients . METHODS Forty patients ( 38 AA , 1 Asian , and 1 Caucasian ) with systolic or diastolic HF were r and omized to the yoga group ( YG , n = 21 ) or the control group ( CG , n = 19 ) . All patients were asked to follow a home walk program . Premeasurement and postmeasurement included a treadmill stress test to peak exertion , flexibility , interleukin-6 ( IL-6 ) , C-reactive protein ( CRP ) , and extracellular superoxide dismutase ( EC-SOD ) . QoL was assessed by the Minnesota Living with Heart Failure Question naire ( MLwHFQ ) . RESULTS The statistical analyses ( assessed by ANOVA and t-tests ) were significant for favorable changes in the YG , compared with those in the CG , for flexibility ( P = 0.012 ) , treadmill time ( P = 0.002 ) , VO2peak ( P = 0.003 ) , and the biomarkers ( IL-6 , P = 0.004 ; CRP , P = 0.016 ; and EC-SOD , P = 0.012 ) . Within the YG , pretest to posttest scores for the total ( P = 0.02 ) and physical subscales ( P < 0.001 ) of the MLwHFQ were improved . CONCLUSIONS Yoga therapy offered additional benefits to the st and ard medical care of predominantly AA HF patients by improving cardiovascular endurance , QoL , inflammatory markers , and flexibility PURPOSE Patients with various medical conditions benefit from eliciting the relaxation response ( RR ) , using a variety of techniques , but few studies have focused on chronic heart failure ( CHF ) . We evaluated the efficacy of an RR intervention program on the quality of life ( QOL ) and exercise capacity of CHF patients by conducting a single-blind , 3-arm , r and omized , controlled trial . METHODS Between April 2000 and June 200 
    Output:
    
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 .