Mindful Movement Intervention for Post-MI Patients (HeartChi)
Myocardial Infarction
About this trial
This is an interventional supportive care trial for Myocardial Infarction focused on measuring Tai Chi
Eligibility Criteria
Inclusion Criteria:
- Suffered an MI (ST Elevation MI (STEMI) or Non-ST Elevation MI (NSTEMI) with creatine kinase MB fraction elevation 3 times the upper limits of normal and with ischemic ECG changes within 6 months of baseline testing;
- Clinically stable---defined as no active arrhythmia, no residual ischemia;
- Able to perform light to moderate exercise;
- Able to give informed consent, understand study procedures and to comply with them for the entire length of the study;
- A 30 day period since Percutaneous Coronary Intervention (PCI);
- Medical clearance by their cardiologist;
- "Treatment as usual" medications prescribed by their cardiologist (see allowed medications under 6.2. Description of Evaluations);
- Antidepressant treatment with SSRIs or SNRIs is allowed, but not required;
- > 35 years of age.
Exclusion Criteria:
- Unstable angina;
- Severe valvular disease;
- Severe COPD;
- Recent stroke or significant cerebral neurologic impairment;
- Moderate to severe suicidal risk (BDI-II #9 > 1 or from the SCID interview for MDD);
- Cancer;
- Currently in an exercise program;
- Current uses of mood stabilizers, or antipsychotics;
- Medications (steroids) and conditions affecting immune status
- Pregnant, lactating or intending to become pregnant;
- Meets criteria for bipolar disorder, schizophrenia, substance use disorder
- Currently taking benzodiazepines and mood stabilizers
- Inability to give written informed consent in English.
- Participation in another intervention study.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Tai Chi
Health Education
A manual consisting of 8 movements learned over a period of 12 weeks will be used to teach participants in the Tai Chi condition. Classes will include around 5-6 subjects, each class lasting one hour, including a 10-minute warm-up and cool-down, and meet twice per week. Patients will be told to practice Tai Chi three times/week at home. After 12 weeks of training patients will be told to practice at home five times/week for 8 more weeks, until the 8-week follow-up visit. Subjects will be asked to rate their perceived exertion/work intensity during each session using the Borg's perceived exertion scale and asked to increase the size of their movements to reach 12-13 (moderate difficulty), which consistently matches with 65-70% of HR max.
Participants in the Health Education condition will also meet for one hour, twice per week for 12 weeks for a total of 24 hours. Sessions will be highly structured and will emphasize key concepts in the presentations. Medical and allied health experts will provide twelve didactic videotaped presentations on a series of health-related themes and a group leader will be present to answer questions. Themes will include: Epidemiology of Cardiovascular Disease, Patient/Physician Communication, Medication Adherence, Nutrition and Exercise, The Nature and Structure of Sleep, and Navigating the Health Care System.