{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T17:23:42Z","timestamp":1778088222312,"version":"3.51.4"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T00:00:00Z","timestamp":1627344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Aims:<\/jats:bold> The <jats:italic>Baduanjin<\/jats:italic> Eight-Silken-Movements wIth Self-Efficacy building for Heart Failure (BESMILE-HF) program is a contextually adapted cardiac rehabilitation program. It uses a traditional Chinese exercise, <jats:italic>Baduanjin<\/jats:italic>, to solve the unmet demand of exercise-based cardiac rehabilitation programs due to their scarcity and unaffordability in China. This pilot study assesses BESMILE-HF's feasibility and preliminary effects.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Eighteen patients with chronic heart failure were included: 8 in a BESMILE-HF group (age: 67 \u00b1 5 years, EF: 40.4 \u00b1 13.6%) and 10 in a control group (age: 70 \u00b1 13 years, EF: 42.9 \u00b1 12.5%). Both received the usual medications, with the intervention group receiving additionally the BESMILE-HF program for 6 weeks. Feasibility was explored by participants' involvement in the intended intervention. Clinical outcome assessments were conducted at baseline and post-intervention, while adverse events were captured throughout the study period.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The BESMILE-HF program was well-received by patients, and adherence to the intervention was good. The intervention group completed all required home exercises and total home-practice time was correlated with baseline self-efficacy (<jats:italic>r<\/jats:italic> = 0.831, <jats:italic>p<\/jats:italic> = 0.011). Moreover, after 6 weeks, self-efficacy increased in the BESMILE-HF group (<jats:italic>p<\/jats:italic> = 0.028) and the change was higher than in the control [mean difference (MD): 3.2; 95% confidence interval (CI) 0.6\u20135.9, <jats:italic>p<\/jats:italic> = 0.004]. For the exercise capacity, the control group demonstrated a significant decline in peak oxygen consumption (<jats:italic>p<\/jats:italic> =0.018) whereas, the BESMILE-HF group maintained their exercise capacity (<jats:italic>p<\/jats:italic> = 0.063). Although the between-group difference was not statistically significance, there was clear clinical improvement in the BESMILE-HF group (1.5 mL\/kg\/min, 95% CI, \u22120.3 to 3.2 vs. minimal clinically important difference of 1 mL\/kg\/min). Throughout the study period, no adverse events related to the intervention were captured.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> BESMILE-HF is feasible for patients with chronic heart failure in Chinese settings. A larger sample size and a longer follow-up period is needed to confirm its benefit on clinical outcomes.<\/jats:p><jats:p><jats:bold>Clinical Trial Registration:<\/jats:bold><jats:ext-link>ClinicalTrials.gov<\/jats:ext-link>: NCT03180320.<\/jats:p>","DOI":"10.3389\/fcvm.2021.715207","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T05:05:12Z","timestamp":1627362312000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Feasibility and Preliminary Effects of the BESMILE-HF Program on Chronic Heart Failure Patients: A Pilot Randomized Controlled Trial"],"prefix":"10.3389","volume":"8","author":[{"given":"Xiankun","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas P.","family":"Olson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia St\u00e5lsby","family":"Lundborg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zehuai","family":"Wen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weihui","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Marrone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,7,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1161\/CIRCHEARTFAILURE.113.001420","article-title":"Exercise training as therapy for heart failure: current status and future directions","volume":"8","author":"Fleg","year":"2015","journal-title":"Circ Heart Fail."},{"key":"B2","doi-asserted-by":"publisher","first-page":"CD003331","DOI":"10.1002\/14651858.CD003331.pub4","article-title":"Exercise-based rehabilitation for heart failure","volume":"2014","author":"Taylor","year":"2014","journal-title":"Cochrane Database Syst Rev."},{"key":"B3","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1038\/nrcardio.2014.98","article-title":"Global availability of cardiac rehabilitation","volume":"11","author":"Turk-Adawi","year":"2014","journal-title":"Nat Rev Cardiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.hfc.2014.09.001","article-title":"Rehabilitation practice patterns for patients with heart failure: the Asian perspective","volume":"11","author":"Sun","year":"2015","journal-title":"Heart Fail Clin."},{"key":"B5","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1136\/heartasia-2016-010758","article-title":"Availability and characteristics of cardiac rehabilitation programmes in China","volume":"8","author":"Zhang","year":"2016","journal-title":"Heart Asia."},{"key":"B6","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1016\/j.ijcard.2016.06.207","article-title":"Home-based cardiac rehabilitation for people with heart failure: a systematic review and meta-analysis","volume":"221","author":"Zwisler","year":"2016","journal-title":"Int J Cardiol."},{"key":"B7","article-title":"Thompson, Yu C-M. 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