12-month Tai Chi training in the elderly: its effect on health fitness

Impact of physical exercise on substance use disorders: a meta-analysis

OBJECTIVE

The goal of this meta-analysis was to examine whether long-term physical exercise could be a potential effective treatment for substance use disorders (SUD).

METHODS

The PubMed, Web of Science, Elsevier, CNKI and China Info were searched for randomized controlled trials (RCT) studies in regards to the effects of physical exercise on SUD between the years 1990 and 2013. Four main outcome measures including abstinence rate, withdrawal symptoms, anxiety, and depression were evaluated.

RESULTS

Twenty-two studies were integrated in the meta-analysis. The results indicated that physical exercise can effectively increase the abstinence rate (OR = 1.69 (95% CI: 1.44, 1.99), z = 6.33, p < 0.001), ease withdrawal symptoms (SMD = -1.24 (95% CI: -2.46, -0.02), z = -2, p<0.05), and reduce anxiety (SMD = -0.31 (95% CI: -0.45, -0.16), z  =  -4.12, p < 0.001) and depression (SMD  =  -0.47 (95% CI: -0.80, -0.14), z = -2.76, p<0.01). The physical exercise can more ease the depression symptoms on alcohol and illicit drug abusers than nicotine abusers, and more improve the abstinence rate on illicit drug abusers than the others. Similar treatment effects were found in three categories: exercise intensity, types of exercise, and follow-up periods.

CONCLUSIONS

The moderate and high-intensity aerobic exercises, designed according to the Guidelines of American College of Sports Medicine, and the mind-body exercises can be an effective and persistent treatment for those with SUD.

The Effect of an 8-Week Tai Chi Exercise Program on Physical Functional Performance in Middle-Aged Women

The purpose of this study was to determine the effectiveness of an 8-week Tai Chi Chih exercise program on physical functional performance (PFP) among women aged 45 to 65 years. A quasi-experimental design with a nonequivalent comparison group was used. Forty-one healthy inactive women were assigned to either an intervention group (n = 19) or a comparison group (n = 19). A 60-min Tai Chi Chih exercise class was conducted twice a week for 8 weeks. PFP was measured at baseline and postintervention using the Continuous Scale Physical Functional Performance-10 (CS-PFP 10). Between-group differences were analyzed using one-way analysis of covariance (ANCOVA). After participating in the 8-week program, intervention group participants showed greater improvement in the CS-PFP measures (p < .05, η(2) > .06). However, the comparison group had little changes. The findings from this study suggest that participation in an 8-week Tai Chi Chih exercise program can improve PFP in healthy, community-dwelling middle-aged women.

Breathing frequency-independent effect of Tai Chi Chuan on autonomic modulation

OBJECTIVE

This study investigates the breathing frequency (BF)-independent effect of Tai Chi Chuan (TCC) on autonomic nervous modulation in TCC practitioners.

METHODS

Twenty-five TCC practitioners and 25 sedentary normal controls were recruited. The stationary heart rate variability (HRV) measures of TCC practitioners and controls were compared. The same HRV measures in TCC practitioners and among the controls, TCC practitioners before TCC and TCC practitioners 30 min after TCC were compared.

RESULTS

In TCC practitioners, the BF, normalized high-frequency power (nHFP), and normalized very low-frequency power were significantly increased, while the normalized low-frequency power (nLFP) was significantly decreased 30 min after TCC. The BF correlated significantly and negatively with heart rate (HR), nHFP and nLFP, and correlated significantly and positively with mean RR interval (MnRR) before TCC in TCC practitioners. A slower BF is associated with a higher HR, a greater vagal modulation, and a greater combined sympatho-vagal modulation before TCC. To remove the effect of BF on HRV measures, new indices such as HR*BF, nHFP*BF, nLFP*BF, and MnRR/BF were introduced for comparison among the controls, TCC practitioners before TCC, and TCC practitioners 30 min after TCC. Thirty minutes after TCC, the MnRR/BF of TCC practitioner was smaller whereas HR*BF and nHFP*BF were greater than those before TCC.

INTERPRETATION

The BF-independent effects of TCC on the autonomic nervous modulation of TCC practitioners are an increase in vagal modulation and HR, and a decrease in mean RR interval. The mechanism underlying the parallel increase in HR and vagal modulation in TCC practitioners is not understood yet at present.

Effects of Tai Chi Chuan on the elderly balance: a semi-experimental study

Aging impairs the functional capacity, possibly compromising the balance over the years. However, Tai Chi Chuan is a martial art that can provide balance improvements in elderly people. This study aimed to evaluate balance in elderly after three and six months of Tai Chi Chuan practicing. Participants were 27 individuals (62±4.4 years) who underwent Tai Chi Chuan training (one hour each) twice a week, for six months. Balance was assessed by the Timed Up and Go (TUG) test, Berg Balance Scale (BBS) and Romberg test, all evaluated before and after three and six months of practicing. MANOVA for repeated measures was used to compare times in TUG and BBS tests. The Cochrane Q test was used to compare moments and frequencies in the Romberg test (α=0.05). Results showed significant improvement in TUG performance (p≤0.01), BBS score (p≤0.01) and in the Romberg test (p≤0.01) after three and six months, compared with pre-training. These results suggest that Tai Chi Chuan practice can improve the balance in elderly people.

Bikram yoga training and physical fitness in healthy young adults

There has been relatively little longitudinal controlled investigation of the effects of yoga on general physical fitness, despite the widespread participation in this form of exercise. The purpose of this exploratory study was to examine the effect of short-term Bikram yoga training on general physical fitness. Young healthy adults were randomized to yoga training (N = 10, 29 ± 6 years, 24 sessions in 8 weeks) or a control group (N = 11, 26 ± 7 years). Each yoga training session consisted of 90-minute standardized supervised postures performed in a heated and humidified studio. Isometric deadlift strength, handgrip strength, lower back/hamstring and shoulder flexibility, resting heart rate and blood pressure, maximal oxygen consumption (treadmill), and lean and fat mass (dual-energy x-ray absorptiometry) were measured before and after training. Yoga subjects exhibited increased deadlift strength, substantially increased lower back/hamstring flexibility, increased shoulder flexibility, and modestly decreased body fat compared with control group. There were no changes in handgrip strength, cardiovascular measures, or maximal aerobic fitness. In summary, this short-term yoga training protocol produced beneficial changes in musculoskeletal fitness that were specific to the training stimulus.

Tai chi chuan exercise for patients with cardiovascular disease

Exercise training is the cornerstone of rehabilitation for patients with cardiovascular disease (CVD). Although high-intensity exercise has significant cardiovascular benefits, light-to-moderate intensity aerobic exercise also offers health benefits. With lower-intensity workouts, patients may be able to exercise for longer periods of time and increase the acceptance of exercise, particularly in unfit and elderly patients. Tai Chi Chuan (Tai Chi) is a traditional Chinese mind-body exercise. The exercise intensity of Tai Chi is light to moderate, depending on its training style, posture, and duration. Previous research has shown that Tai Chi enhances aerobic capacity, muscular strength, balance, and psychological well-being. Additionally, Tai Chi training has significant benefits for common cardiovascular risk factors, such as hypertension, diabetes mellitus, dyslipidemia, poor exercise capacity, endothelial dysfunction, and depression. Tai Chi is safe and effective in patients with acute myocardial infarction (AMI), coronary artery bypass grafting (CABG) surgery, congestive heart failure (HF), and stroke. In conclusion, Tai Chi has significant benefits to patients with cardiovascular disease, and it may be prescribed as an alternative exercise program for selected patients with CVD.

Tai chi chuan in medicine and health promotion

Tai Chi Chuan (Tai Chi) is a Chinese traditional mind-body exercise and recently, it becomes popular worldwide. During the practice of Tai Chi, deep diaphragmatic breathing is integrated into body motions to achieve a harmonious balance between body and mind and to facilitate the flow of internal energy (Qi). Participants can choose to perform a complete set of Tai Chi or selected movements according to their needs. Previous research substantiates that Tai Chi has significant benefits to health promotion, and regularly practicing Tai Chi improves aerobic capacity, muscular strength, balance, health-related quality of life, and psychological well-being. Recent studies also prove that Tai Chi is safe and effective for patients with neurological diseases (e.g., stroke, Parkinson's disease, traumatic brain injury, multiple sclerosis, cognitive dysfunction), rheumatological disease (e.g., rheumatoid arthritis, ankylosing spondylitis, and fibromyalgia), orthopedic diseases (e.g., osteoarthritis, osteoporosis, low-back pain, and musculoskeletal disorder), cardiovascular diseases (e.g., acute myocardial infarction, coronary artery bypass grafting surgery, and heart failure), chronic obstructive pulmonary diseases, and breast cancers. Tai Chi is an aerobic exercise with mild-to-moderate intensity and is appropriate for implementation in the community. This paper reviews the existing literature on Tai Chi and introduces its health-promotion effect and the potential clinical applications.

Falls and fractures in participants and excluded non-participants of a fall prevention exercise program for elderly women with a history of falls: 1-year follow-up study

AIM

To evaluate the effectiveness of a strength and balance enhancing exercise intervention as a means of preventing falls in community-dwelling elderly Japanese women with a history of falls, while comparing functional fitness, fall and fracture rate in excluded subjects.

METHODS

A 1-year follow-up trial was carried out on 105 participants over the age of 70 years, who were randomly assigned to the exercise or education group, and also on 91 women excluded based on the exclusion criteria. The exercise group attended a 60-min exercise class twice a week for 3 months. Falls, injuries, fractures, and functional fitness assessments were measured at baseline, post-intervention and 1-year follow up.

RESULTS

During the follow up, fall rates were 19.6% in the exercise group, 40.4% in the education group and 40.8% in excluded subjects (χ(2)  = 7.069, P = 0.029). Compared with the exercise group, the odds ratio (OR) for falls was greater in the education group (OR 2.78, 95% confidence interval (CI) 1.17-6.96) and excluded participants (OR 2.83, 95%CI 1.25-6.80). The OR for fractures was over fourfold greater in excluded participants (OR 4.30, 95% CI 1.02-9.70) than the exercise group.

CONCLUSIONS

The exercise intervention for participants with fall history effectively decreased incidences of falls and fractures. However, fall and fracture rates in excluded people were high. Further research focusing on feasible countermeasures for falls in excluded people who are at high risk of fractures is required.

Changes in brain volume and cognition in a randomized trial of exercise and social interaction in a community-based sample of non-demented Chinese elders

Physical exercise has been shown to increase brain volume and improve cognition in randomized trials of non-demented elderly. Although greater social engagement was found to reduce dementia risk in observational studies, randomized trials of social interventions have not been reported. A representative sample of 120 elderly from Shanghai, China was randomized to four groups (Tai Chi, Walking, Social Interaction, No Intervention) for 40 weeks. Two MRIs were obtained, one before the intervention period, the other after. A neuropsychological battery was administered at baseline, 20 weeks, and 40 weeks. Comparison of changes in brain volumes in intervention groups with the No Intervention group were assessed by t-tests. Time-intervention group interactions for neuropsychological measures were evaluated with repeated-measures mixed models. Compared to the No Intervention group, significant increases in brain volume were seen in the Tai Chi and Social Intervention groups (p < 0.05). Improvements also were observed in several neuropsychological measures in the Tai Chi group, including the Mattis Dementia Rating Scale score (p = 0.004), the Trailmaking Test A (p = 0.002) and B (p = 0.0002), the Auditory Verbal Learning Test (p = 0.009), and verbal fluency for animals (p = 0.01). The Social Interaction group showed improvement on some, but fewer neuropsychological indices. No differences were observed between the Walking and No Intervention groups. The findings differ from previous clinical trials in showing increases in brain volume and improvements in cognition with a largely non-aerobic exercise (Tai Chi). In addition, intellectual stimulation through social interaction was associated with increases in brain volume as well as with some cognitive improvements.

Complexity-based measures inform Tai Chi's impact on standing postural control in older adults with peripheral neuropathy

BACKGROUND

Tai Chi training enhances physical function and may reduce falls in older adults with and without balance disorders, yet its effect on postural control as quantified by the magnitude or speed of center-of-pressure (COP) excursions beneath the feet is less clear. We hypothesized that COP metrics derived from complex systems theory may better capture the multi-component stimulus that Tai Chi has on the postural control system, as compared with traditional COP measures.

METHODS

We performed a secondary analysis of a pilot, non-controlled intervention study that examined the effects of Tai Chi on standing COP dynamics, plantar sensation, and physical function in 25 older adults with peripheral neuropathy. Tai Chi training was based on the Yang style and consisted of three, one-hour group sessions per week for 24 weeks. Standing postural control was assessed with a force platform at baseline, 6, 12, 18, and 24 weeks. The degree of COP complexity, as defined by the presence of fluctuations existing over multiple timescales, was calculated using multiscale entropy analysis. Traditional measures of COP speed and area were also calculated. Foot sole sensation, six-minute walk (6MW) and timed up-and-go (TUG) were also measured at each assessment.

RESULTS

Traditional measures of postural control did not change from baseline. The COP complexity index (mean ± SD) increased from baseline (4.1 ± 0.5) to week 6 (4.5 ± 0.4), and from week 6 to week 24 (4.7 ± 0.4) (p=0.02). Increases in COP complexity-from baseline to week 24-correlated with improvements in foot sole sensation (p=0.01), the 6MW (p=0.001) and TUG (p=0.01).

CONCLUSIONS

Subjects of the Tai Chi program exhibited increased complexity of standing COP dynamics. These increases were associated with improved plantar sensation and physical function. Although more research is needed, results of this non-controlled pilot study suggest that complexity-based COP measures may inform the study of complex mind-body interventions, like Tai Chi, on postural control in those with peripheral neuropathy or other age-related balance disorders.

Can Taichi reshape the brain? A brain morphometry study

Although research has provided abundant evidence for Taichi-induced improvements in psychological and physiological well-being, little is known about possible links to brain structure of Taichi practice. Using high-resolution MRI of 22 Tai Chi Chuan (TCC) practitioners and 18 controls matched for age, sex and education, we set out to examine the underlying anatomical correlates of long-term Taichi practice at two different levels of regional specificity. For this purpose, parcel-wise and vertex-wise analyses were employed to quantify the difference between TCC practitioners and the controls based on cortical surface reconstruction. We also adopted the Attention Network Test (ANT) to explore the effect of TCC on executive control. TCC practitioners, compared with controls, showed significantly thicker cortex in precentral gyrus, insula sulcus and middle frontal sulcus in the right hemisphere and superior temporal gyrus and medial occipito-temporal sulcus and lingual sulcus in the left hemisphere. Moreover, we found that thicker cortex in left medial occipito-temporal sulcus and lingual sulcus was associated with greater intensity of TCC practice. These findings indicate that long-term TCC practice could induce regional structural change and also suggest TCC might share similar patterns of neural correlates with meditation and aerobic exercise.

A systems biology approach to studying Tai Chi, physiological complexity and healthy aging: design and rationale of a pragmatic randomized controlled trial

INTRODUCTION

Aging is typically associated with progressive multi-system impairment that leads to decreased physical and cognitive function and reduced adaptability to stress. Due to its capacity to characterize complex dynamics within and between physiological systems, the emerging field of complex systems biology and its array of quantitative tools show great promise for improving our understanding of aging, monitoring senescence, and providing biomarkers for evaluating novel interventions, including promising mind-body exercises, that treat age-related disease and promote healthy aging.

MATERIAL AND METHODS

An ongoing, two-arm randomized clinical trial is evaluating the potential of Tai Chi mind-body exercise to attenuate age-related loss of complexity. A total of 60 Tai Chi-naïve healthy older adults (aged 50-79) are being randomized to either six months of Tai Chi training (n=30), or to a waitlist control receiving unaltered usual medical care (n=30). Our primary outcomes are complexity-based measures of heart rate, standing postural sway and gait stride interval dynamics assessed at 3 and 6months. Multiscale entropy and detrended fluctuation analysis are used as entropy- and fractal-based measures of complexity, respectively. Secondary outcomes include measures of physical and psychological function and tests of physiological adaptability also assessed at 3 and 6months.

DISCUSSION

Results of this study may lead to novel biomarkers that help us monitor and understand the physiological processes of aging and explore the potential benefits of Tai Chi and related mind-body exercises for healthy aging.

Effects of Tai Chi versus Proprioception Exercise Program on Neuromuscular Function of the Ankle in Elderly People: A Randomized Controlled Trial

Background. Tai Chi is a traditional Chinese medicine exercise used for improving neuromuscular function. This study aimed to investigate the effects of Tai Chi versus proprioception exercise program on neuromuscular function of the ankle in elderly people. Methods. Sixty elderly subjects were randomly allocated into three groups of 20 subjects per group. For 16 consecutive weeks, subjects participated in Tai Chi, proprioception exercise, or no structured exercise. Primary outcome measures included joint position sense and muscle strength of ankle. Subjects completed a satisfaction questionnaire upon study completion in Tai Chi and proprioception groups. Results. (1) Both Tai Chi group and proprioception exercise group were significantly better than control group in joint position sense of ankle, and there were no significant differences in joint position sense of ankle between TC group and PE group. (2) There were no significant differences in muscle strength of ankle among groups. (3) Subjects expressed more satisfaction with Tai Chi than with proprioception exercise program. Conclusions. None of the outcome measures on neuromuscular function at the ankle showed significant change posttraining in the two structured exercise groups. However, the subjects expressed more interest in and satisfaction with Tai Chi than proprioception exercise.

The autonomic and rate pressure product responses of tai chi practitioners

Background:

Spectral analysis of autonomic nervous system activity can provide insight into cardiovascular function. Rate pressure product is the parameter often targeted pharmacologically to decrease the incidence of myocardial events.

Aim:

The purpose of this study was to investigate whether or not Tai Chi Chuan practitioners would demonstrate autonomic responses that would be more cardioprotective when compared to non-trained controls.

Materials and Methods:

This was a cross-sectional study that measured the autonomic responses and rate pressure product of 2 groups of subjects; a Tai Chi Chuan trained (n = 13) and non-trained sedentary controls (n = 13) at rest and during 2 stressor phases that simulated functional activities of daily living.

Results:

The Tai Chi group maintained a greater parasympathetic outflow at rest and during the isometric grip stressor phase (P<0.05). Sympathetic outflow, systolic blood pressure and rate pressure product were significantly lower in the Tai Chi group at rest, during the isometric grip and standing stressor phases (P<0.05).

Conclusion:

Although a cause-and-effect relationship cannot be concluded in this study, the Tai Chi group was able to demonstrate efficiency of the myocardium with suppressed rate pressure product values and autonomic responses that favored parasympathetic outflow. This type of training may complement non-pharmacological anti-hypertensive therapy.

Mitigating cellular inflammation in older adults: a randomized controlled trial of Tai Chi Chih

OBJECTIVES

To evaluate the effects of a behavioral intervention, Tai Chi Chih (TCC) on circulating markers of inflammation in older adults.

DESIGN

A prospective, randomized, controlled trial with allocation to two arms, TCC and health education (HE), 16 weeks of intervention administration, and 9 weeks follow-up.

PARTICIPANTS

A total of 83 healthy older adults, aged 59 to 86 years.

MEASUREMENTS

The primary endpoint was circulating levels of interleukin 6 (IL-6). Secondary outcomes were circulating levels of C-reactive protein, soluble IL-1 receptor antagonist, soluble IL-6 receptor, soluble intercellular adhesion molecule, and IL-18. Severity of depressive symptoms, sleep quality, and physical activity was also assessed over the treatment trial.

RESULTS

Among those older adults with high levels of IL-6 at entry, a trend for a treatment group by time interaction was found (F[1,70] = 3.48, p = 0.07), in which TCC produced a drop of IL-6 levels comparable to those found in TCC and HE subgroups who had low levels of IL-6 at entry (t72's = 0.80, 1.63, p's >0.10), whereas IL-6 in HE remained higher than the TCC and HE subgroups with low entry IL-6 (t72 = 2.47, p = 0.02; t72 = 1.71, p = 0.09). Decreases in depressive symptoms in the two treatment groups correlated with decreases of IL-6 (r = 0.28, p <0.05). None of the other cellular markers of inflammation changed in TCC versus HE.

CONCLUSION

TCC can be considered a useful behavioral intervention to reduce circulating levels of IL-6 in older adults who show elevated levels of this inflammatory marker and are at risk for inflammation-related morbidity.

A randomized controlled trial of Tai chi for balance, sleep quality and cognitive performance in elderly Vietnamese

OBJECTIVE

To evaluate the effects of Tai chi exercise on balance, sleep quality, and cognitive performance in community-dwelling elderly in Vinh city, Vietnam.

DESIGN

A randomized controlled trial.

PARTICIPANTS

One hundred two subjects were recruited.

INTERVENTION

Subjects were divided randomly into two groups. The Tai chi group was assigned 6 months' Tai chi training. The control group was instructed to maintain their routine daily activities.

OUTCOME MEASURES

The Falls Efficacy Scale (FES), Pittsburgh Sleep Quality Index (PSQI), and Trail Making Test (TMT) were used as primary outcome measures.

RESULTS

Participants in the Tai chi group reported significant improvement in TMT (part A) (F [1, 71] = 78.37, P < 0.001) and in TMT (part B), (F [1, 71] = 175.00, P < 0.001) in comparison with the control group. Tai chi participants also reported better scores in FES (F [1, 71] = 96.90, P < 0.001) and in PSQI (F [1,71] = 43.69, P = 0.001) than the control group.

CONCLUSION

Tai chi is beneficial to improve balance, sleep quality, and cognitive performance of the elderly.

MULTIJOINT COORDINATION OF LOWER EXTREMITY IN TAI CHI EXERCISE

The goal of this study was to investigate the movement coordination among the hip, knee, and ankle joints during solo performance of the Tai Chi (TC) basic movements in order to understand its dynamic postural control. Nine male community-dwelling adults with experienced TC pushing hands participated in this cross-sectional study. The Eagle®motion analysis system with eight cameras was used to collect the trajectories of all reflective markers at sampling rate 100 Hz while the subject performed the ward-off, rollback, press, and push movements. Motion among the hip, knee, and ankle joints was highly coupled. Coupled joint motion, hip flexion-knee flexion-ankle dorsiflexion or reverse, existed in ward-off, rollback, and press phases for the front leg. However, in the push phase, the hip joint angle was kept almost constant with coupled knee and ankle motions. For the rear leg, coupled motion existed between the hip and the knee joints only. The ankle joint motion differed between the front and the rear legs during the basic movements of TC (p < 0.05). Basic characteristics were documented such as the forward knee never extending further than forward toe and both legs maintaining flexion during the full exercise cycle with hip and knee of front and rear legs having synchronized movements in opposite directions. The forward and backward shifts of TC basic movements have considerable contributions to the posture control in terms of the fine coordination of three lower extremity joints. This information could improve training protocol design for TC Chuan teaching and help beginners make an efficient and less damaging movement.

Effects of 14-Week Tai Ji Quan Exercise on Metabolic Control in Women with Type 2 Diabetes

The present study investigated the effects of 14 weeks of practicing Tai Ji Quan (TJQ) on metabolic control and lipid metabolism in women with type 2 diabetes. Twenty Beijing female residents (57.4 ± 6.2 years) were recruited and were randomly assigned to either the TJQ training or the control group. In the TJQ group, the exercise duration was 1 hour per day and 5 days a week for 14 weeks. FPG, GSP, FPI, TC, HDL-C, LDL-C, TG, resting blood pressures and heart rate were measured before and after the 14 weeks in the 2 groups. It was found that after 14 weeks, the TJQ group had significantly lower FPG, GSP, TG and higher FPI concentration, whereas there were no significant differences in TC, HDL-C and LDL-C. It was concluded that TJQ exercise could be used as an intervention tool to improve glycaemic control and serum TG level in the elderly people. Future research with TJQ of different styles and exercise of different intensities were recommended.

The Aerobic Capacity and Ventilatory Efficiency During Exercise in Qigong and Tai Chi Chuan Practitioners

The objective of this study was to compare cardiorespiratory responses to exercise among older Qigong participants, Tai Chi Chuan (TCC) practitioners and normal sedentary controls during cycle ergometry. Thirty-six community-dwelling men with a mean age of 59.1±6.6 years participated in this study. Each group (Qigong, TCC and control) included 12 subjects with matched age and body size. The Qigong group practiced Qigong regularly for 2.3±1.5 years; the TCC group practiced Yang TCC for 4.7±2.3 years. Heart rate (HR) responses were measured during the practice of Qigong and TCC. Additionally, breath-by-breath measurement of cardiorespiratory function was performed during the incremental exercise of leg cycling. The mean HR during Qigong and TCC practice was 91±5 bpm and 129±7 bpm, respectively. At the peak exercise and the ventilatory threshold (VeT), TCC group displayed highest oxygen uptake [Formula: see text], O2pulse and work rate among the three groups. The Qigong group also showed higher oxygen uptake and O2pulse than the control group. At the same relative exercise intensity, the Qigong group had the highest tidal volume among the three groups. In conclusion, Qigong and TCC show a beneficial effect to aerobic capacity in older individuals, but TCC displays a better training effect than Qigong due to its higher exercise intensity. However, Qigong can enhance breathing efficiency during exercise due to the training effect of diaphragmatic breathing.

Effects of Extended Tai Chi Intervention on Balance and Selected Motor Functions of the Elderly

Balance ability decreases with age, which results in an increased risk of falls for people over age 65. Tai Chi exercise appears to offer potential benefits in the reduction of falls for the elderly. The purpose of the present study was to examine the effects of extended (6- and 12-month) Tai Chi exercise interventions on balance and selected motor functions for senior citizens. Forty-seven subjects were recruited from two local senior centers. Twenty of them ( M = 71.8 years, SD = 7.1), 11 in the Tai Chi exercise group and 9 in the control group, completed the pre-, mid- and post-tests over 12 months on five selected functional performance tests: static balance, dynamic balance, choice reaction time, heel-rise strength, and ankle flexibility. The Tai Chi group was provided with a one-hour Tai Chi exercise session per week for 12 months; the control group did not participate in any exercise program. Results showed that static balance improved significantly after a 6-month Tai Chi intervention. Moreover, the Tai Chi group maintained a higher level in the test performance compared with the control group at the end of the 12-month intervention, but there was no significant difference between the two groups. Data suggested that Tai Chi exercise intervention could produce a positive influence on balance control for the elderly over a prolonged period, but not on muscle strength and ankle flexibility.

Tai Chi, arterial compliance, and muscle strength in older adults

BACKGROUND

Aerobic exercise can alleviate the declines in arterial compliance common in older adults. However, when combined with strength training, aerobic exercise may not reduce arterial compliance. Tai Chi practice has been found to improve muscle strength and cardiopulmonary function in older subjects, but whether or not it improves arterial compliance is not known. The primary aim of this study was to investigate whether Tai Chi practitioners have better arterial compliance and muscle strength.

DESIGN

Twenty-nine older Tai Chi practitioners (73.7 ± 4.5 years) and 36 healthy control subjects (71.4 ± 6.6 years) participated in this cross-sectional study.

METHODS

The participants were independent in their daily living activities. They were screened for apparent cardiovascular disease and underwent arterial compliance testing and isokinetic knee muscle strength testing at 30°/s.

RESULTS

Tai Chi practitioners showed significantly better haemodynamic parameters than the controls as indexed by larger and small artery compliance. They also demonstrated greater eccentric muscle strength in both knee extensors and flexors.

CONCLUSION

The findings of better muscle strength without jeopardizing arterial compliance suggests that Tai Chi could be a suitable exercise for older persons to improve both cardiovascular function and muscle strength.

The effects of Tai Chi training on physical fitness, perceived health, and blood pressure in elderly Vietnamese

Objective

Evaluating the effects of Tai Chi exercise on physical fitness, blood pressure, and perceived health in community-dwelling elderly.

Design

A randomized controlled trial.

Setting

Community-dwelling elderly in Vinh city, Vietnam.

Participants

Ninety-six community-dwelling participants aged 60 to 79 years (68.9 ± 5.1 years) were recruited.

Intervention

Subjects were divided randomly into two groups: Tai Chi and Control groups. Participants in the Tai Chi group (aged 69.02 ± 5.16 years) attended a 60-minute Tai Chi practice session twice a week for 6 months. The session consisted of a 15-minute warm-up and a 15-minute cool-down period. The Control group (aged 68.72 ± 4.94 years) maintained routine daily activities.

Outcome measures

The Senior Fitness Test and Short-Form 36® (SF-36®) are primary outcome measures.

Results

After 24 weeks of the Tai Chi training program, the intervention group showed significant decrease in systole of 12 mmHg and heart rate 6.46 bpm. Body mass index and waist–hip ratio were also reduced by 1.23 and 0.04, respectively. The Senior Fitness Test and SF-36 showed significant improvement.

Conclusion

In this randomized controlled trial study, Tai Chi is beneficial to improve systole blood pressure, heart rate, body mass index, waist–hip ratio, perceived health, and physical fitness. Assessment of the effects of Tai Chi may be focused more on chronic disease with a long-term training program in the future.

Effects of tai chi on lower-limb myodynamia in the elderly people: a meta-analysis

OBJECTIVE

To assess the effects of Tai Chi (Chinese shadow boxing exercise) for improving the lower-limb muscle strength in elderly people.

METHODS

The PUBMED database (from 1950), EMBASE-ASP database (from 1974), Cochrane Library (from 1991), Elsevier sciences database (from 1990), OVID full text database (from 1997), Springer-link database (from 1997), The National Research Register database, ISI Web of knowledge (from 1963), Chinese Medical Citation Index/Chinese Medical Current Contents (CMCI/CMCC, from 1989), China Knowledge Resource Integrated Database (CNKI, from 1915), VIP database (from 1989), and Wanfang database (from 1977) have been searched only for the English and Chinese literatures updated to 10-30-2010. Two researchers independently assessed the methodological quality of studies, extracted and checked the data one another according to the include/exclude standards. Disagreement was resolved by discussions or with the third person. The Review Manage Software 5.0 was used for Meta-analysis.

RESULTS

Eventually, 2 randomized controled studies and 2 non-randomized controled studies met the inclusion criteria, with 163 subjects involved in the present meta-analysis. The meta-analysis demonstrated that Tai Chi exercise could improve the ankle flexor/extensor muscle strength and the knee extensor/flexor muscle strength, tested with an isokinetic dynamometer. The limb muscle strength increased significantly after Tai Chi exercise (P < 0.01).

CONCLUSION

The meta-analysis favours Tai Chi exercise for improving the lower-limb muscle strength in the older people.

Effectiveness of coordination exercise in improving cognitive function in older adults: a prospective study

Background:

Studies on the effect of a low intensity coordination exercise on the elderly with limited mobility are sparse. This prospective study attempted to compare the effectiveness of a customized coordination exercise and a strength exercise in improving the cognitive functioning and physical mobility on the elderly.

Methods:

Participants from two centers for the elderly were allocated to practice either an 8-week coordination training (CT) program or an 8-week towel exercise (TE) program. The Chinese Mini-Mental State Examination and Chinese Dementia Rating Scale (CDRS) were used to measure cognitive functioning of participants, and Timed Up-and-Go test for physical mobility. These assessments were administered before and after the program.

Results:

Paired t-tests showed that the CDRS scores of the CT group improved significantly from 114.8 at pre-test to 119.3 after training (P = 0.045). The CDRS scores of the TE group also improved from 114.9 at pre-test to 116.9 after training.

Conclusion:

Findings from this prospective study demonstrated that low-intensity level mind-body exercise could be beneficial to the cognitive functioning of older adults.

Subjective experiences of older adults practicing taiji and qigong

This article presents a qualitative study following a 6-month Taiji (T'ai Chi)/Qigong (Ch'i Kung) intervention for older adults. The researchers conducted in-depth interviews of eight selected participants who elected to continue practicing Taiji after the intervention ended, in order to explore their subjective experiences of Taiji's effects and their motivations for continuing to practice. We created a Layers Model to capture the significance and meaning of the multidimensionality of their reported experiences. Participants not only reported simple benefits along five dimensions of experience (physical, mental, emotional, social and spiritual) but also described complex multidimensional experiences. Overall findings indicate that participants derived a very wide variety of perceived benefits, the most meaningful being a felt sense of body-mind-spirit integration. Our results support the important role of qualitative studies in researching the effects of Taiji and Qigong.

Tai chi exercise in patients with chronic heart failure: a randomized clinical trial

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 standard care, improves functional capacity and quality of life in patients with HF.

METHODS

A single-blind, multisite, parallel-group, randomized controlled trial evaluated 100 outpatients 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 Questionnaire).

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 Questionnaire, -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 clinicaltrials.gov Identifier: NCT00110227.

Physical activity and cognition in older adults: the potential of Tai Chi Chuan

The purpose of this article is to review the potential of Tai Chi Chuan as a mode of physical activity that could have cognitive benefits for older adults and to provide potential directions for future research. A brief introduction to Tai Chi Chuan and its related physical benefits is provided. In addition, the empirical literature related to Tai Chi Chuan and cognition is reviewed. Potential mediators of the relationship between Tai Chi Chuan and cognition, including physical resources, disease status, and mental resources, are discussed. Based on the limitations of the extant literature, it is argued that future research in this area must provide more detailed descriptions of Tai Chi Chuan, particularly in terms of intensity and program progression. Consideration of the specific type of cognition that is expected to benefit is also encouraged, and approaches for further efforts to understand how Tai Chi Chuan affects cognition are recommended.

The development of a Tai Chi exercise regimen for the prevention of conditions requiring long-term care in Japan

This study was to examine an effect of such an exercise program on preventing conditions requiring long-term care in the Japanese frail elderly who participated in a Tai Chi Yuttari-exercise program. The first-intervention group underwent an intervention program by participating in a Tai Chi Yuttari-exercise session once a week for 3 months. Each session lasted 90 min including a break time. Moreover, the subjects received a video recording of the exercise, and instructions to carry out the exercise at home. The same program was administered to the second-intervention group. Physical function improved significantly in the first-intervention group, with single-leg balance (SLB) increasing, and trunk anteflexion increasing after the intervention program. Furthermore, the total score of the Motor Fitness Scale (MFS) improved significantly. On the other hand, mono- and multi-variate analyses showed no significant differences observed in the second-intervention group during the study period. A careful interpretation of the results suggests that Tai Chi Yuttari-exercise improves physical function and ability for frail elderly individuals and could reduce the need for long-term care.

Tai chi and rheumatic diseases

Tai chi is a complex multicomponent mind-body exercise. Many studies have provided evidence that tai chi benefits patients with a variety of chronic disorders. This form of mind-body exercise enhances cardiovascular fitness, muscular strength, balance, and physical function and seems to be associated with reduced stress, anxiety, and depression and improved quality of life. Thus, despite certain limitations in the evidence, tai chi can be recommended to patients with osteoarthritis, rheumatoid arthritis, and fibromyalgia as a complementary and alternative medical approach. This article overviews the current knowledge about tai chi to better inform clinical decision making for rheumatic patients.

Comparison of telecommunication, community, and home-based Tai Chi exercise programs on compliance and effectiveness in elders at risk for falls

OBJECTIVE

To compare the adherence to and effectiveness of Tai Chi exercise program through a live, interactive, telecommunication-based exercise (Tele-ex) with that of a similar program through a community center-based exercise (Comm-ex) and a home video-based exercise (Home-ex) among community-dwelling elders who are at risk for falls.

DESIGN

Three groups randomized controlled trial with pretests and posttests.

SETTING

Exercise programs were community-based, and the outcome measures were laboratory-based.

PARTICIPANTS

Adults (N=64) age 65+ years with positive fall history in the previous year and/or significant fear of falling.

INTERVENTION

A 24-form, Yang-style Tai Chi for 15 weeks, 3 hours a week.

MAIN OUTCOME MEASURES

Exercise compliance, number of falls, fear of falling (Activities-specific Balance Confidence [ABC] score), self-perceived health (Medical Outcomes Study 36-Item Short Form Health Survey [SF-36]), Timed Up & Go (TUG), single leg stance (SLS), and body sway during quiet stance (medial-lateral foot center of pressure [ML-COP]).

RESULTS

Tele-ex and Comm-ex groups demonstrated significantly higher exercise attendance and in-class practice time than the Home-ex group (P<.01) and significant reductions in the mean number of falls and injurious falls (P<.01). There were significant improvements posttraining in SLS, ABC, ML-COP, and Physical Health subscore of the SF-36 (P<.05). Both Tele-ex and Comm-ex groups demonstrated larger improvements than the Home-ex group in TUG, ML-COP, and the Social Function, Mental Health, and Physical Health subscores of the MOS SF-36.

CONCLUSION

Compared with the Home-ex, the Tele-ex and Comm-ex groups are better in exercise compliance, fall reduction and balance and health improvements. Tele-ex is an effective, affordable, and acceptable choice of exercise for elders.

Effects of Tai Chi and Western exercise on physical and cognitive functioning in healthy community-dwelling older adults

OBJECTIVE

To compare the effects of Tai Chi (TC, n = 37) and Western exercise (WE, n = 39) with an attention-control group (C, n = 56) on physical and cognitive functioning in healthy adults age 69 +/- 5.8 yr, in a 2-phase randomized trial.

METHODS

TC and WE involved combined class and home-based protocols. Physical functioning included balance, strength, flexibility, and cardiorespiratory endurance. Cognitive functioning included semantic fluency and digit-span tests. Data were analyzed using intention-to-treat analysis.

RESULTS

At 6 mo, WE had greater improvements in upper body flexibility (F = 4.67, p = .01) than TC and C. TC had greater improvements in balance (F = 3.36, p = .04) and a cognitive-function measure (F = 7.75, p < .001) than WE and C. The differential cognitive-function improvements observed in TC were maintained through 12 mo.

CONCLUSION

The TC and WE interventions resulted in differential improvements in physical functioning among generally healthy older adults. TC led to improvement in an indicator of cognitive functioning that was maintained through 12 mo.