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Benefits of Tai Chi Exercise Among Adults With Chronic Heart Failure: A Systematic Review and Meta-Analysis. J Cardiovasc Nurs 2020; 35:423-434. [PMID: 32544110 DOI: 10.1097/jcn.0000000000000703] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Exercise-based cardiac rehabilitation is safe and effective for adults with chronic heart failure (CHF), yet services are greatly underutilized. However, tai chi is a popular and safe form of exercise among older adults with chronic health conditions. OBJECTIVE A systematic review and meta-analysis was conducted to examine the benefits of tai chi exercise among persons with CHF. METHODS An electronic literature search of 10 databases (Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Embase, OpenGrey, PsycARTICLES, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science) was conducted from January 1, 2004, to August 1, 2019. Clinical trials that examined tai chi exercise, were published in English or German languages, and conducted among participants with CHF were included. Comprehensive Meta-Analysis version 2.0 software (Biostat, Inc) was used to calculate effect sizes (ie, Hedges g) and 95% confidence intervals using random effects models. RESULTS A total of 6 studies met the inclusion criteria, enrolling 229 participants (mean age, 68 years; 28% women; mean ejection fraction = 37%). At least 3 studies reported outcomes for exercise capacity (n = 5 studies), quality of life (n = 5 studies), depression (n = 4 studies), and b-type natriuretic peptide (n = 4 studies), allowing for meta-analysis. Compared with controls, tai chi participants had significantly better exercise capacity (g = 0.353; P = .026, I = 32.72%), improved quality of life (g = 0.617; P = .000, I = 0%), with less depression (g = 0.627; P = .000, I = 0%), and decreased b-type natriuretic peptide expression (g = 0.333; P = .016, I = 0%). CONCLUSION Tai chi can be easily integrated into existing cardiac rehabilitation programs. Further research is needed with rigorous study designs and larger samples before widespread recommendations can be made.
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Luo XC, Liu J, Fu J, Yin HY, Shen L, Liu ML, Lan L, Ying J, Qiao XL, Tang CZ, Tang Y. Effect of Tai Chi Chuan in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Front Oncol 2020; 10:607. [PMID: 32391277 PMCID: PMC7191057 DOI: 10.3389/fonc.2020.00607] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 04/02/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Tai Chi Chuan(TCC), as a mind-body exercise, may have a positive impact on physical function and psychological well-being in breast cancer patients. The latest systematic review and meta-analysis of TCC for breast cancer was made 4 years ago and some new clinical trials about it were published. We remade a systematic review and meta-analysis to evaluate the effect of TCC in breast cancer patients. Methods: In this systematic review and meta-analysis, we searched MEDLINE (via PubMed), EMBASE (via embase.com), CENTRAL, CNKI, COVIP, Wanfang, Chaoxing, CiNii, J-SSTAGE, DBpia, and ThaiJO with no language restrictions from inception to December 31, 2018 (updated on February 16, 2020), for randomized clinical trials comparing TCC with non-exercised therapy in breast cancer patients. The primary outcome was quality of life in patients with breast cancer and data pooled by a random-effects model. Subgroup analyses were conducted to estimate the effect of different durations of TCC for breast cancer patients. This study was registered in PROSPERO, number CRD 4201810326. Results: Fifteen articles involving a total of 885 breast cancer participants were included in this review. Compared with non-exercised therapy, TCC had a significant effect on quality of life in breast cancer patients (SMD = 0.37, 95% CI 0.15–0.59, p = 0.001), and subgroup analysis found that TCC showed beneficial effect in 12 weeks and 25 weeks (12 weeks: SMD = 0.40, 95% CI 0.19–0.62, p = 0.0003; 25 weeks: SMD = 0.38, 95% CI 0.15–0.62, p = 0.002). Meta-analyses of secondary outcomes showed that 3 weeks TCC increased shoulder function (SMD = 1.08, 95% CI 0.28–1.87, p = 0.008), 12 weeks TCC improved pain (SMD = 0.30, 95% CI 0.08–0.51, p = 0.007), shoulder function (SMD = 1.34, 95% CI 0.43–2.25, p = 0.004), strength of arm (SMD = 0.44, 95% CI 0.20–0.68, p = 0.0004), and anxiety (MD = −4.90, 95% CI −7.83 to −1.98, p = 0.001) in breast cancer patients compared with the control group. Conclusions: TCC appears to be effective on some physical and psychological symptoms and improves the quality of life in patients with breast cancer. Additional randomized controlled trials with a rigorous methodology and low risk of bias are needed to provide more reliable evidence.
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Affiliation(s)
- Xiao-Chao Luo
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jie Liu
- Sichuan Provincial People's Hospital, Chengdu, China
| | - Jia Fu
- Medical & Nursing School, Chengdu University, Chengdu, China
| | - Hai-Yan Yin
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Shen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Mai-Lan Liu
- The School of Acupuncture, Moxibustion & Tuina, Hunan University of Traditional Chinese Medicine, Changsha, China
| | - Lei Lan
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Key Laboratory of Sichuan Province for Acupuncture & Chronobiology, Chengdu, China
| | - Jian Ying
- Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Xiu-Lan Qiao
- Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Chun-Zhi Tang
- School of Acupuncture & Rehabilitation Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Yong Tang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Medical & Nursing School, Chengdu University, Chengdu, China.,Key Laboratory of Sichuan Province for Acupuncture & Chronobiology, Chengdu, China
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Stroke Survivors' Feelings and Perceptions of Their Recovery After a Tai Chi Exercise Intervention: A Qualitative Descriptive Study. J Cardiovasc Nurs 2020; 35:468-474. [PMID: 32251038 DOI: 10.1097/jcn.0000000000000667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Most tai chi studies conducted among stroke survivors have focused on physical functioning, whereas inclusion of stroke survivors' feelings and perceptions of participating in tai chi is lacking. OBJECTIVE The aim of this study was to identify stroke survivors' feelings and perceptions of participating in a tai chi intervention during their poststroke recovery. METHODS This qualitative descriptive study examined stories from community-dwelling stroke survivors, collected as part of a larger randomized clinical trial. To examine these stories, an inductive content analysis approach was used with a priori theoretical codes (and subcodes): (1) Feelings (confidence, enjoy, hopeful, helpful, other) and (2) Perceptions of Impact (physical abilities, mental/cognitive abilities, challenges, other). Lincoln and Guba's criteria were followed to ensure trustworthiness of the study findings. RESULTS Participants (n = 17) were on average 71 years old (range, 54-87 years), mainly men (65%), and had the option of writing their own story or having someone write it for them. Stories from these stroke survivors revealed feelings of confidence (n = 4), enjoyment (n = 7), hope (n = 1), and helpfulness (n = 15). Perceptions of the impact of tai chi on their poststroke recovery process identified improved physical abilities (n = 23), better mental/cognitive abilities (n = 12), moving forward (n = 7), and developing friendships (n = 4), with few challenges (n = 1). CONCLUSIONS Using storytelling, healthcare providers can discuss the benefits of tai chi and then relate the feelings and perceptions of other stroke survivors' experiences to encourage engagement in regular physical activity to aid in the poststroke recovery process.
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Easwaran K, Gopalasingam Y, Green DD, Lach V, Melnyk JA, Wan C, Bartlett DJ. Effectiveness of Tai Chi for health promotion for adults with health conditions: a scoping review of Meta-analyses. Disabil Rehabil 2020; 43:2978-2989. [PMID: 32070137 DOI: 10.1080/09638288.2020.1725916] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose: To complete a scoping review of meta-analyses summarizing evidence of the effectiveness of Tai Chi for adults with health conditions.Materials and Methods: Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health and the Cochrane Library from database inception to early September 2018. Multistage deduplication and screening processes identified full-length, unique, peer-reviewed meta-analyses. Two people independently appraised 42 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables.Results: "High" and "moderate" quality evidence indicates that Tai Chi can significantly benefit adults with health conditions including cancers, chronic obstructive pulmonary disease, coronary heart disease, depression, heart failure, hypertension, low back pain, osteoarthritis, osteoporosis, Parkinson's Disease and stroke. Outcomes included significant improvements in activities of daily living, balance, exercise capacity, gait, mastery, mental health, mobility, motor function, participation in daily life, physical function, quality of life, range of motion, and strength; with reductions in blood pressure, body mass index, depression, disability, dyspnea, falls, fatigue, pain, stiffness, and waist circumference.Conclusions: Healthcare providers now have information to advise clients with health conditions on the effectiveness of Tai Chi for overall health promotion.IMPLICATIONS FOR REHABILITATIONTai Chi is a form of safe, enjoyable, light-to-moderate aerobic physical activity for adults that is inexpensive to implement in diverse community settings.Adults with health conditions require physical activity for prevention of secondary impairments and over-all health promotion.This scoping review of meta-analyses elucidates "high" and "moderate" quality evidence of the effectiveness of Tai Chi in improving important outcomes for people with numerous health conditions.This information can be useful for healthcare providers who wish to recommend effective community-based physical activity to clients they are serving.
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Affiliation(s)
- Kobena Easwaran
- Physical Therapy, Elborn College, Western University, London, Canada
| | | | - Danielle D Green
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Veronica Lach
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Jordan A Melnyk
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Christina Wan
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Doreen J Bartlett
- Physical Therapy, Elborn College, Western University, London, Canada
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Zhong D, Xiao Q, Xiao X, Li Y, Ye J, Xia L, Zhang C, Li J, Zheng H, Jin R. Tai Chi for improving balance and reducing falls: An overview of 14 systematic reviews. Ann Phys Rehabil Med 2020; 63:505-517. [PMID: 31981834 DOI: 10.1016/j.rehab.2019.12.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 12/27/2019] [Accepted: 12/28/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Falls play a pivotal role in the cause of injury or death and have become a public health problem, especially for older people. Tai Chi may be an effective approach to improving balance and reducing falls. However, the conclusions of systematic reviews (SRs) have been inconsistent and the quality needs to be appraised critically. OBJECTIVE To provide an overview of the methodological quality, risk of bias and reporting quality as well as quality of evidence of SRs of Tai Chi for improving balance and reducing falls. METHODS We conducted a systematic search of English- and Chinese-language SRs in 8 electronic databases, from inception to October 2019. The methodological quality, risk of bias, reporting quality and the quality of evidence were independently assessed by 2 reviewers who used the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Risk of Bias in Systematic reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Grades of Recommendations, Assessment, Development and Evaluation (GRADE). Primary outcomes were fall rate and the Berg Balance Scale score in older people and people with Parkinson disease. Secondary outcomes included these outcomes in stroke, osteoarthritis and heart failure. RESULTS A total of 14 relevant SRs were included: 13 were rated critically low quality and 1 was rated low quality by AMSTAR 2. By the ROBIS, all SRs were rated low risk in Phase 1 (assessing relevance) and Domain 1 of Phase 2 (study eligibility criteria). With regard to Domain 2, assessing the identification and selection of studies, 3 (21.4%) SRs were rated low risk. Eleven (71.4%) were rated low risk in Domain 3 (data collection and study appraisal), 11 (71.4%) were rated low risk in Domain 4 (synthesis and findings), and 9 (64.3%) were rated low risk in Phase 3 (risk of bias in the review). According to PRISMA, the reporting was relatively complete, but there were still some reporting flaws in the topic of protocol and registration (2/14, 14.3%), search strategy (5/14, 35.7%), risk of bias (6/14, 42.9%), additional analyses (6/14, 42.9%) and funding (4/14, 28.6%). Among the 14 SRs, Tai Chi had benefits for improving balance and reducing falls in older people and people with Parkinson disease; however, no definitive conclusions could be drawn for its effectiveness in stroke, osteoarthritis and heart failure. The level of evidence for fall rate was "moderate" to "high" for older people and "low" for those with Parkinson disease. The level of evidence of the Berg Balance Scale was "low" to "moderate" for older people and "low" for those with Parkinson disease. Among the downgraded factors, imprecision was the most common, followed by inconsistency and publication bias. CONCLUSIONS Tai Chi may be beneficial for improving balance and reducing falls in older people and those with Parkinson disease. Because of limitations and inconsistent conclusions, further rigorous, normative and comprehensive SRs are needed to provide robust evidence for definitive conclusions.
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Affiliation(s)
- Dongling Zhong
- Chengdu University of Traditional Chinese Medicine, Chengdu, PR China
| | - Qiwei Xiao
- Chengdu University of Traditional Chinese Medicine, Chengdu, PR China
| | - Xili Xiao
- Department of Ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, PR China
| | - Yuxi Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, PR China
| | - Jing Ye
- Chengdu University of Traditional Chinese Medicine, Chengdu, PR China
| | - Lina Xia
- Chengdu University of Traditional Chinese Medicine, Chengdu, PR China
| | - Chi Zhang
- Chengdu University of Traditional Chinese Medicine, Chengdu, PR China
| | - Juan Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, PR China.
| | - Hui Zheng
- Chengdu University of Traditional Chinese Medicine, Chengdu, PR China.
| | - Rongjiang Jin
- Chengdu University of Traditional Chinese Medicine, Chengdu, PR China.
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Borisovskaya A, Chmelik E, Karnik A. Exercise and Chronic Pain. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:233-253. [PMID: 32342462 DOI: 10.1007/978-981-15-1792-1_16] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this chapter, we describe the impact and etiology of chronic pain, the associated changes in the nervous system, and the mechanisms by which exercise may be able to affect and reverse these changes. Evidence for efficacy of exercise in different conditions associated with chronic pain is presented, with focus on chronic low back pain, fibromyalgia, osteoarthritis, rheumatoid arthritis, and migraines. While the efficacy of exercise and level of evidence supporting it vary in different diseases, exercise has direct and indirect benefits for most patients suffering from chronic pain. Effective exercise regimens include education and cognitive restructuring to promote behavioral activation and reconceptualization of what pain means, with the goal of gradually reversing the vicious cycle of pain, inertia, sedentary behavior, and worsening disability. Long-term, consistent, individualized exercise-based treatment approaches are most likely to result in improvements in pain and function.
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Affiliation(s)
- Anna Borisovskaya
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
- Veterans Administration Medical Center, Seattle, WA, USA.
| | - Elizabeth Chmelik
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Veterans Administration Medical Center, Seattle, WA, USA
| | - Ashwin Karnik
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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Nolan CM, Rochester CL. Exercise Training Modalities for People with Chronic Obstructive Pulmonary Disease. COPD 2019; 16:378-389. [PMID: 31684769 DOI: 10.1080/15412555.2019.1637834] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Exercise training confers health benefits for people with chronic obstructive pulmonary disease (COPD). This article reviews the evidence for several exercise training modalities shown to be beneficial among individuals with COPD. These modalities include aerobic, resistance, nonlinear periodized, upper limb and balance training, as well as yoga, Tai Chi, inspiratory muscle training, whole body vibration training and neuromuscular electrical stimulation. The literature pertaining to each modality was critically reviewed, and information on the rationale, mechanism(s) of action (where known), benefits, and exercise prescription is described to facilitate easy implementation into clinical practice.
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Affiliation(s)
- Claire M Nolan
- Harefield Respiratory Research Unit, Royal Brompton and Harefield NHS Foundation Trust, UK.,Harefield Pulmonary Rehabilitation Unit, Royal Brompton and Harefield NHS Foundation Trust, UK
| | - Carolyn L Rochester
- Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA.,VA Connecticut Healthcare System, West Haven, CT, USA
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The safety of tai chi: A meta-analysis of adverse events in randomized controlled trials. Contemp Clin Trials 2019; 82:85-92. [DOI: 10.1016/j.cct.2019.06.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 04/23/2019] [Accepted: 06/19/2019] [Indexed: 02/06/2023]
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Ramirez-Garcia MP, Gagnon MP, Colson S, Côté J, Flores-Aranda J, Dupont M. Mind-body practices for people living with HIV: a systematic scoping review. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:125. [PMID: 31185970 PMCID: PMC6560810 DOI: 10.1186/s12906-019-2502-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/15/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Mind-body practices are frequently used by people living with HIV to reduce symptoms and improve wellbeing. These include Tai Chi, Qigong, yoga, meditation, and all types of relaxation. Although there is substantial research on the efficacy of mind-body practices in people living with HIV, there is no summary of the available evidence on these practices. The aim of this scoping review is to map available evidence of mind-body practices in people living with HIV. METHODS The Arksey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005) methodological framework was used. A search of 16 peer-review and grey literature databases, websites, and relevant journals (1983-2015) was conducted. To identify relevant studies, two reviewers independently applied the inclusion criteria to all abstracts or full articles. Inclusion criteria were: participants were people living with HIV; the intervention was any mind-body practice; and the study design was any research study evaluating one or several of these practices. Data extraction and risk of bias assessment were performed by one reviewer and checked by a second, as needed, using the criteria that Cochrane Collaboration recommends for systematic reviews of interventions (Higgins and Green, Cochrane handbook for systematic reviews of intervention. 2011). A tabular and narrative synthesis was carried out for each mind-body practice. RESULTS One hundred thirty-six documents drawing on 84 studies met the inclusion criteria. The most widely studied mind-body practice was a combination of least three relaxation techniques (n = 20), followed in declining order by meditation (n = 17), progressive muscle relaxation (n = 10), yoga (n = 9) and hypnosis (n = 8). Slightly over half (47/84) of studies used a RCT design. The interventions were mainly (46/84) conducted in groups and most (51/84) included daily individual home practice. All but two studies were unblinded to participants. CONCLUSION The amount of available research on mind-body practices varies by practice. Almost half of the studies in this review were at high risk of bias. However, mindfulness, a combination of least three relaxation techniques and cognitive behavioral strategies, and yoga show encouraging results in decreasing physical and psychological symptoms and improving quality of life and health in people living with HIV. More rigorous studies are necessary to confirm the results of Tai Chi, Qigong, and some relaxation techniques.
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Affiliation(s)
- Maria Pilar Ramirez-Garcia
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center of the Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Marie-Pier Gagnon
- Faculty of Nursing, Université Laval, Québec, Canada
- Research Center of the Centre Hospitalier Universitaire, Québec, Canada
| | - Sébastien Colson
- Faculty of Medicine, Aix Marseille Université, Marseille, France
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center of the Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Jorge Flores-Aranda
- University Institute on Addiction, Montreal-Island-South-Center Integrated University Health and Social Services Centre, Montréal, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Canada
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Gao L, Si D, Bao H, Yu M, Sun H, Damchaaperenlei D, Yan Y, Shi Q, Li Y. Tai Chi for the treatment of chronic obstructive pulmonary disease: A systematic review protocol. Medicine (Baltimore) 2019; 98:e16097. [PMID: 31261524 PMCID: PMC6617485 DOI: 10.1097/md.0000000000016097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increasing morbidity and mortality that cause huge social and economic loss. Although recommended by guidelines, pulmonary rehabilitation has not been widely applied in clinics because of its inherent limitations. Free from restrictions of specific training venues and equipment, Tai Chi, as a kind of pulmonary rehabilitation, has been used to cure the COPD, yet the efficacy and safety of Tai Chi remains to be assessed. In this study, we aim to draw up a protocol for systematic review to evaluate the efficacy and safety of Tai Chi for COPD. METHODS We will search the following electronic databases from inception to December 31, 2018: PubMed, Web of Science, Medline, Cochrane Central Register of Controlled Trials, Springer, EMBASE, the China National Knowledge Infrastructure Database, Wan Fang Database, the Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. Clinical trial registrations, potential gray literatures, relevant conference abstracts and reference list of identified studies will also be searched. The literature selection, data extraction, and quality assessment will be completed by 2 independent authors. Either the fixed-effects or random-effects model will be used for data synthesis based on the heterogeneity test. Changes in lung function will be evaluated as the primary outcome. Symptom assessment, quality of life (SGRQ), medication usage, exacerbations, and adverse events will be assessed as the secondary outcomes. The RevMan V.5.3.5 will be used for Meta-analysis. RESULTS This study will provide a synthesis of current evidence of Tai Chi for COPD from several aspects, such as lung function, SGRQ, medication usage, exacerbations, and adverse events. CONCLUSION The conclusion of our study will provide updated evidence to judge whether Tai Chi is an effective solution to COPD patients. PROSPERO REGISTRATION NUMBER PROSPERO CRD42019122791.
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Affiliation(s)
- Longxia Gao
- Beijing University of Chinese Medicine, Beijing
| | - Dongxu Si
- Beijing University of Chinese Medicine, Beijing
| | - Haipeng Bao
- Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine, Hohhot
| | - MingXia Yu
- Beijing University of Chinese Medicine, Beijing
| | - Huizhuo Sun
- Beijing University of Chinese Medicine, Beijing
| | | | - Yue Yan
- The 2nd Department of Pulmonary Disease in TCM, The Key Unit of SATCM Pneumonopathy Chronic Cough and Dyspnea, Beijing Key Laboratory of Prevention and Treatment of Allergic Diseases with TCM (No. BZ0321), Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Qi Shi
- The 2nd Department of Pulmonary Disease in TCM, The Key Unit of SATCM Pneumonopathy Chronic Cough and Dyspnea, Beijing Key Laboratory of Prevention and Treatment of Allergic Diseases with TCM (No. BZ0321), Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Youlin Li
- The 2nd Department of Pulmonary Disease in TCM, The Key Unit of SATCM Pneumonopathy Chronic Cough and Dyspnea, Beijing Key Laboratory of Prevention and Treatment of Allergic Diseases with TCM (No. BZ0321), Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
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Zhong D, Xiao Q, He M, Li Y, Ye J, Zheng H, Xia L, Zhang C, Liang F, Li J, Jin R. Tai Chi for improving balance and reducing falls: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e15225. [PMID: 31027069 PMCID: PMC6831220 DOI: 10.1097/md.0000000000015225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION To investigate the effectiveness and safety of Tai Chi for improving balance and reducing falls on people. METHODS AND ANALYSIS The following databases will be searched: China Biology Medicine (CBM), China National Knowledge infrastructure (CNKI), Wan Fang Data, the Chinese Science and Technology Periodical Database (VIP), Medline, EMBASE, Web of Science, The Cochrane Library from inception to March 2019. All randomized controlled trials (RCTs) utilized Tai Chi to improve balance ability and reduce falls will be included. Primary outcomes are the fall-related indicators, including the number of falls, fall rate, and other fall-related outcomes. Additional outcomes include the Berg Balance Scale (BBS), standing-walk test, single-legged time, or other balance-related outcomes. Study selection, data extraction, and quality assessment will be performed independently by 2 reviewers. Assessment of risk of bias and data synthesis will be performed using Review Manager V5.3 software. ETHICS AND DISSEMINATION The findings of this systematic review will be disseminated through peer-reviewed publication or conference presentations.Trial registration number PROSPERO CRD42019127810.
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Affiliation(s)
| | - Qiwei Xiao
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Mingxing He
- School of Health Preservation and Rehabilitation
| | - Yuxi Li
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing Ye
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hui Zheng
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Lina Xia
- School of Health Preservation and Rehabilitation
| | - Chi Zhang
- School of Health Preservation and Rehabilitation
| | - Fanrong Liang
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Juan Li
- School of Health Preservation and Rehabilitation
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Zhang Y, Chai Y, Pan X, Shen H, Wei X, Xie Y. Tai chi for treating osteopenia and primary osteoporosis: a meta-analysis and trial sequential analysis. Clin Interv Aging 2019; 14:91-104. [PMID: 30655662 PMCID: PMC6322510 DOI: 10.2147/cia.s187588] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The aim of this meta-analysis was to evaluate the efficacy of Tai chi (TC) as an adjuvant treatment for osteopenia and primary osteoporosis. Methods We went through eight databases to identify relevant randomized controlled trials that compared TC with a control group. The primary outcome was osteoporosis-related fractures (fracture incidence). Meta-analyses and trial sequential analyses (TSA) were conducted using RevMan 5.3 and TSA 0.9. Results Fifteen randomized controlled trials involving a total of 857 patients were included in the analyses. No trials reported primary outcome; however, bone mineral density (BMD) values differed significantly in subgroup 1 (TC vs no treatment; weighted mean difference [WMD] =0.05 g/cm2, 95% CI 0.03 to 0.07; P<0.00001; P for heterogeneity =0.22, I2=22%) and subgroup 2 (TC vs conventional treatments; WMD =0.16 g/cm2, 95% CI 0.11 to 0.21; P<0.00001; P for heterogeneity =0.008, I2=75%). In addition, two trials compared TC with conventional treatments, which found a significant difference in bone gla protein (standardized mean difference =−1.18, 95% CI −1.66 to −0.70; P<0.00001; P for heterogeneity =0.58, I2=75%). The results of the BMD were confirmed by TSA. Also, TC may have a certain effect on the relief of osteoporotic pain (WMD = −2.61, 95% CI −3.51 to −1.71; WMD = −1.39, 95% CI −2.01 to −0.77). However, it did not promote the quality of life, level of serum calcium, serum phosphorus, and also had no effect on bone turnover markers. Conclusion Although there is no study monitoring fracture incidence, TC may be beneficial for patients in improving BMD values, level of bone gla protein, and relieving osteoporotic pain. However, due to the low methodological quality, current evidence for treating osteopenia and primary osteoporosis through TC is insufficient.
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Affiliation(s)
- Yili Zhang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China, .,School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yan Chai
- Department of Epidemiology, University of California, Los Angeles, CA, USA
| | - Xiaojie Pan
- Department of Human Nutrition and Health, Wageningen University and Health, Wageningen, The Netherlands
| | - Hao Shen
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China,
| | - Xu Wei
- Department of Scientific Research, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China,
| | - Yanming Xie
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China,
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Exercise and gut microbiota: clinical implications for the feasibility of Tai Chi. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018; 15:270-281. [PMID: 28659231 DOI: 10.1016/s2095-4964(17)60342-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Recent studies have shown exercise is associated with changes in the gut microbiota in humans as well as in experimental animals. Tai Chi is an exercise that integrates a martial art, deep breathing and mediation, and has various beneficial effects for health. This review summarizes current knowledge and recent literature on the association between exercise and gut microbiota, and explores the feasibility of Tai Chi for improving gut microbiota composition and function. PubMed/MEDLINE was used to search the English literature for the keywords exercise and gut microbiota. Fourteen relevant studies were identified. In humans, exercise increases the gut microbial diversity. However, the evidence for this association is weak, as previous studies were small-scale, non-controlled studies of short duration or cross-sectional design. In animals, exercise alters the composition of gut microbiota, with some studies suggesting exercise increases the Bacteroidetes/Firmicutes ratio. However, these results are controversial, partly because host genetics and physical fitness also influence gut microbiota. Furthermore, the intensity of exercise may play a key role in how exercise affects gut microbiota. Tai Chi is a moderate-intensity exercise that improves immune function and inflammation of the gut. Tai Chi may also affect gut microbiota through vagal modulation and mediating the hypothalamic-pituitary-adrenal axis. However, no studies have investigated the association between Tai Chi and gut microbiota. Well designed studies exploring the effects of Tai Chi on gut microbiota are needed.
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Gendron LM, Nyberg A, Saey D, Maltais F, Lacasse Y. Active mind-body movement therapies as an adjunct to or in comparison with pulmonary rehabilitation for people with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2018; 10:CD012290. [PMID: 30306545 PMCID: PMC6517162 DOI: 10.1002/14651858.cd012290.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Active mind-body movement therapies (AMBMTs), including but not limited to yoga, tai chi, and qigong, have been applied as exercise modalities for people with chronic obstructive pulmonary disease (COPD). AMBMT strategies have been found to be more effective than usual care; however, whether AMBMT is inferior, equivalent, or superior to pulmonary rehabilitation (PR) in people with COPD remains to be determined. OBJECTIVES To assess the effects of AMBMTs compared with, or in addition to, PR in the management of COPD. SEARCH METHODS We searched the Cochrane Airways Group Specialised Register of trials and major Chinese databases, as well as trial registries from inception to July 2017. In addition, we searched references of primary studies and review articles. We updated this search in July 2018 but have not yet incorporated these results. SELECTION CRITERIA We included (1) randomised controlled trials (RCTs) comparing AMBMT (i.e. controlled breathing and/or focused meditation/attention interventions for which patients must actively move their joints and muscles for at least four weeks with no minimum intervention frequency) versus PR (any inpatient or outpatient, community-based or home-based rehabilitation programme lasting at least four weeks, with no minimum intervention frequency, that included conventional exercise training with or without education or psychological support) and (2) RCTs comparing AMBMT + PR versus PR alone in people with COPD. Two independent review authors screened and selected studies for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, extracted outcome data, and assessed risk of bias. We contacted study authors if necessary to ask them to provide missing data. We calculated mean differences (MDs) using a random-effects model. MAIN RESULTS We included in the meta-analysis 10 studies with 762 participants across one or more comparisons. The sample size of included studies ranged from 11 to 206 participants. Nine out of 10 studies involving all levels of COPD severity were conducted in China with adults from 55 to 88 years of age, a higher proportion of whom were male (78%). Nine out of 10 studies provided tai chi and/or qigong programmes as AMBMT, and one study provided yoga. Overall, the term 'PR' has been uncritically applied in the vast majority of studies, which limits comparison of AMBMT and PR. For example, eight out of 10 studies considered walking training as equal to PR and used this as conventional exercise training within PR. Overall study quality for main comparisons was moderate to very low mainly owing to imprecision, indirectness (exercise component inconsistent with recommendations), and risk of bias issues. The primary outcomes for our review were quality of life, dyspnoea, and serious adverse events.When researchers compared AMBMT versus PR alone (mainly unstructured walking training), statistically significant improvements in disease-specific quality of life (QoL) (St. George's Respiratory Questionnaire (SGRQ) total score) favoured AMBMT: mean difference (MD) -5.83, 95% confidence interval (CI) -8.75 to -2.92; three trials; 249 participants; low-quality evidence. The common effect size, but not the 95% CI around the pooled treatment effect, exceeded the minimal clinically important difference (MCID) of minus four. The COPD Assessment Test (CAT) also revealed statistically significant improvements favouring AMBMT over PR, with scores exceeding the MCID of three, with an MD of 6.58 units (95% CI -9.16 to - 4.00 units; one trial; 74 participants; low-quality evidence). Results show no between-group differences with regard to dyspnoea measured by the modified Medical Research Council Scale (MD 0.00 units, 95% CI -0.37 to 0.37; two trials; 127 participants; low-quality evidence), the Borg Scale (MD 0.44 units, 95% CI -0.88 to 0.00; one trial; 139 participants; low-quality evidence), or the Chronic Respiratory Questionnaire (CRQ) Dyspnoea Scale (MD -0.21, 95% CI -2.81 to 2.38; one trial; 11 participants; low-quality evidence). Comparisons of AMBMT versus PR alone did not include assessments of generic quality of life, adverse events, limb muscle function, exacerbations, or adherence.Comparisons of AMBMT added to PR versus PR alone (mainly unstructured walking training) revealed significant improvements in generic QoL as measured by Short Form (SF)-36 for both the SF-36 general health summary score (MD 5.42, 95% CI 3.82 to 7.02; one trial; 80 participants; very low-quality evidence) and the SF-36 mental health summary score (MD 3.29, 95% CI 1.45 to 4.95; one trial; 80 participants; very low-quality evidence). With regard to disease-specific QoL, investigators noted no significant improvement with addition of AMBMT to PR versus PR alone (SGRQ total score: MD -2.57, 95% CI -7.76 to 2.62 units; one trial; 192 participants; moderate-quality evidence; CRQ Dyspnoea Scale score: MD 0.04, 95% CI -2.18 to 2.26 units; one trial; 80 participants; very low-quality evidence). Comparisons of AMBMT + PR versus PR alone did not include assessments of dyspnoea, adverse events, limb muscle function, exacerbations, or adherence. AUTHORS' CONCLUSIONS Given the quality of available evidence, the effects of AMBMT versus PR or of AMBMT added to PR versus PR alone in people with stable COPD remain inconclusive. Evidence of low quality suggests better disease-specific QoL with AMBMT versus PR in people with stable COPD, and evidence of very low quality suggests no differences in dyspnoea between AMBMT and PR. Evidence of moderate quality shows that AMBMT added to PR does not result in improved disease-specific QoL, and evidence of very low quality suggests that AMBMT added to PR may lead to better generic QoL versus PR alone. Future studies with adequate descriptions of conventional exercise training (i.e. information on duration, intensity, and progression) delivered by trained professionals with a comprehensive understanding of respiratory physiology, exercise science, and the pathology of COPD are needed before definitive conclusions can be drawn regarding treatment outcomes with AMBMT versus PR or AMBMT added to PR versus PR alone for patients with COPD.
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Affiliation(s)
- Louis McCusky Gendron
- Université LavalInstitut Universitaire de Cardiologie et de Pneumologie de QuébecQuébecQCCanada
| | - Andre Nyberg
- Université LavalInstitut Universitaire de Cardiologie et de Pneumologie de QuébecQuébecQCCanada
| | - Didier Saey
- Université LavalInstitut Universitaire de Cardiologie et de Pneumologie de QuébecQuébecQCCanada
| | - François Maltais
- Université LavalInstitut Universitaire de Cardiologie et de Pneumologie de QuébecQuébecQCCanada
| | - Yves Lacasse
- Université LavalInstitut Universitaire de Cardiologie et de Pneumologie de QuébecQuébecQCCanada
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Innes KE, Selfe TK, Kandati S, Wen S, Huysmans Z. Effects of Mantra Meditation versus Music Listening on Knee Pain, Function, and Related Outcomes in Older Adults with Knee Osteoarthritis: An Exploratory Randomized Clinical Trial (RCT). EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:7683897. [PMID: 30245732 PMCID: PMC6136530 DOI: 10.1155/2018/7683897] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/31/2018] [Accepted: 08/08/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Disease-modifying treatments for OA remain elusive, and commonly used medications can have serious side effects. Although meditation and music listening (ML) have been shown to improve outcomes in certain chronic pain populations, research in OA is sparse. In this pilot RCT, we explore the effects of two mind-body practices, mantra meditation (MM) and ML, on knee pain, function, and related outcomes in adults with knee OA. METHODS Twenty-two older ambulatory adults diagnosed with knee OA were randomized to a MM (N=11) or ML program (N=11) and asked to practice 15-20 minutes, twice daily for 8 weeks. Core outcomes included knee pain (Knee Injury and Osteoarthritis Outcome Score [KOOS] and Numeric Rating Scale), knee function (KOOS), and perceived OA severity (Patient Global Assessment). Additional outcomes included perceived stress (Perceived Stress Scale), mood (Profile of Mood States), sleep (Pittsburgh Sleep Quality Index), and health-related quality of life (QOL, SF-36). Participants were assessed at baseline and following completion of the program. RESULTS Twenty participants (91%) completed the study (9 MM, 11 ML). Compliance was excellent; participants completed an average of 12.1±0.83 sessions/week. Relative to baseline, participants in both groups demonstrated improvement post-intervention in all core outcomes, including knee pain, function, and perceived OA severity, as well as improvement in mood, perceived stress, and QOL (Physical Health) (p's≤0.05). Relative to ML, the MM group showed greater improvements in overall mood and sleep (p's≤0.04), QOL-Mental Health (p<0.07), kinesiophobia (p=0.09), and two domains of the KOOS (p's<0.09). CONCLUSIONS Findings of this exploratory RCT suggest that a simple MM and, possibly, ML program may be effective in reducing knee pain and dysfunction, decreasing stress, and improving mood, sleep, and QOL in adults with knee OA.
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Affiliation(s)
- Kim E. Innes
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Terry Kit Selfe
- Department of Biomedical and Health Information Services, Health Science Center Libraries, University of Florida, Gainesville, FL, USA
| | - Sahiti Kandati
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
- School of Dentistry, SUNY-Buffalo, Buffalo, NY, USA
| | - Sijin Wen
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Zenzi Huysmans
- College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, WV, USA
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Xu L, Feng F, Li Z, Wang Z, Liu Q. A Tai Chi workout a day, keeps the doctor away. Eur J Prev Cardiol 2018; 25:1562. [PMID: 29863404 DOI: 10.1177/2047487318781108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Li Xu
- 1 Biomedical Center, School of Life Sciences, Sun Yat-sen University, Guangzhou, China.,2 Guangdong Provincial Key Laboratory of Improved Variety Reproduction in Aquatic Economic Animals, State Key Laboratory of Biocontrol, Sun Yat-sen University, Guangzhou, China.,3 Lab of Microbial Metabolic Engineering and Synthetic Biology, Sun Yat-sen University, Guangzhou, China
| | - Fan Feng
- 1 Biomedical Center, School of Life Sciences, Sun Yat-sen University, Guangzhou, China.,2 Guangdong Provincial Key Laboratory of Improved Variety Reproduction in Aquatic Economic Animals, State Key Laboratory of Biocontrol, Sun Yat-sen University, Guangzhou, China.,3 Lab of Microbial Metabolic Engineering and Synthetic Biology, Sun Yat-sen University, Guangzhou, China
| | - Zijin Li
- 1 Biomedical Center, School of Life Sciences, Sun Yat-sen University, Guangzhou, China.,2 Guangdong Provincial Key Laboratory of Improved Variety Reproduction in Aquatic Economic Animals, State Key Laboratory of Biocontrol, Sun Yat-sen University, Guangzhou, China.,3 Lab of Microbial Metabolic Engineering and Synthetic Biology, Sun Yat-sen University, Guangzhou, China
| | - Zhixue Wang
- 1 Biomedical Center, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Qiuyun Liu
- 1 Biomedical Center, School of Life Sciences, Sun Yat-sen University, Guangzhou, China.,2 Guangdong Provincial Key Laboratory of Improved Variety Reproduction in Aquatic Economic Animals, State Key Laboratory of Biocontrol, Sun Yat-sen University, Guangzhou, China.,3 Lab of Microbial Metabolic Engineering and Synthetic Biology, Sun Yat-sen University, Guangzhou, China
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Polkey MI, Qiu ZH, Zhou L, Zhu MD, Wu YX, Chen YY, Ye SP, He YS, Jiang M, He BT, Mehta B, Zhong NS, Luo YM. Tai Chi and Pulmonary Rehabilitation Compared for Treatment-Naive Patients With COPD. Chest 2018; 153:1116-1124. [DOI: 10.1016/j.chest.2018.01.053] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/25/2018] [Accepted: 01/30/2018] [Indexed: 10/17/2022] Open
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Hägglund L, Boman K, Brännström M. A mixed methods study of Tai Chi exercise for patients with chronic heart failure aged 70 years and older. Nurs Open 2018; 5:176-185. [PMID: 29599993 PMCID: PMC5867290 DOI: 10.1002/nop2.127] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 12/29/2017] [Indexed: 01/25/2023] Open
Abstract
Aims and objectives This study aimed to evaluate Tai Chi group training among patients with chronic heart failure (CHF) aged 70 years and older. Background Physical activity is recommended for CHF treatment. Tai Chi is found to be beneficial to different patient groups, although few studies focus on older patients with CHF. Design A mixed methods study. Participants were randomly assigned to Tai Chi training twice a week for 16 weeks (N = 25) or control (N = 20). Quantitative data were collected at baseline, at the end of the training period and 6 months after training, assessing self‐rated fatigue and quality of life, natriuretic peptides and physical performance. Individual qualitative interviews were conducted with participants (N = 10) in the Tai Chi training group. Results No statistical differences between the Tai Chi training group and the control group in quality of life or natriuretic peptides was found. After 16 weeks, the training group tended to rate more reduced activity and the control group rated more mental fatigue. Participants in the training group rated increased general fatigue at follow‐up compared with baseline. Qualitative interviews showed that Tai Chi training was experienced as a new, feasible and meaningful activity. The importance of the leader and the group was emphasized. Improvements in balance were mentioned and there was no physical discomfort. Conclusion Tai Chi was experienced as a feasible and meaningful form of physical exercise for patients with CHF aged over 70 years despite lack of achieved health improvement. Further investigations, using feasibility and meaningfulness as outcome variables seems to be useful.
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Affiliation(s)
| | - Kurt Boman
- Department of Medicine-Geriatric Skellefteå County Hospital Skellefteå Sweden.,Department of Public Health and Clinical Medicine Umeå University Umeå Sweden
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Tai Chi Beyond Balance and Fall Prevention: Health Benefits and Its Potential Role in Combatting Social Isolation in the Aging Population. CURRENT GERIATRICS REPORTS 2018. [DOI: 10.1007/s13670-018-0233-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Lee AC, Harvey WF, Price LL, Han X, Driban JB, Iversen MD, Desai SA, Knopp HE, Wang C. Dose-Response Effects of Tai Chi and Physical Therapy Exercise Interventions in Symptomatic Knee Osteoarthritis. PM R 2018; 10:712-723. [PMID: 29407226 DOI: 10.1016/j.pmrj.2018.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 01/05/2018] [Accepted: 01/17/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Therapeutic exercise is a currently recommended nonpharmacological treatment for knee osteoarthritis (KOA). The optimal treatment dose (frequency or duration) has not been determined. OBJECTIVE To examine dose-response relationships, minimal effective dose, and baseline factors associated with the timing of response from 2 exercise interventions in KOA. DESIGN Secondary analysis of a single-blind, randomized trial comparing 12-week Tai Chi and physical therapy exercise programs (Trial Registry #NCT01258985). SETTING Urban tertiary care academic hospital PARTICIPANTS: A total of 182 participants with symptomatic KOA (mean age 61 years; BMI 32 kg/m2, 70% female; 55% white). METHODS We defined dose as cumulative attendance-weeks of intervention, and treatment response as ≥20% and ≥50% improvement in pain and function. Using log-rank tests, we compared time-to-response between interventions, and used Cox regression to examine baseline factors associated with timing of response, including physical and psychosocial health, physical performance, outcome expectations, self-efficacy, and biomechanical factors. MAIN OUTCOME MEASURES Weekly Western Ontario and McMasters Osteoarthritis Index (WOMAC) pain (0-500) and function (0-1700) scores. RESULTS Both interventions had an approximately linear dose-response effect resulting in a 9- to 11-point reduction in WOMAC pain and a 32- to 41-point improvement in function per attendance-week. There was no significant difference in overall time-to-response for pain and function between treatment groups. Median time-to-response for ≥20% improvement in pain and function was 2 attendance-weeks and for ≥50% improvement was 4-5 attendance-weeks. On multivariable models, outcome expectations were independently associated with incident function response (hazard ratio = 1.47, 95% confidence interval 1.004-2.14). CONCLUSIONS Both interventions have approximately linear dose-dependent effects on pain and function; their minimum effective doses range from 2-5 weeks; and patient perceived benefits of exercise influence the timing of response in KOA. These results may help clinicians to optimize patient-centered exercise treatments and better manage patient expectations. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Augustine C Lee
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA.,Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.,Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, and Section of Clinical Sciences, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA.,Department of Physical Medicine and Rehabilitation, Tufts Medical Center, Boston, MA.,Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111
| | - William F Harvey
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA.,Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.,Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, and Section of Clinical Sciences, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA.,Department of Physical Medicine and Rehabilitation, Tufts Medical Center, Boston, MA.,Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111
| | - Lori Lyn Price
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA.,Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.,Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, and Section of Clinical Sciences, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA.,Department of Physical Medicine and Rehabilitation, Tufts Medical Center, Boston, MA.,Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111
| | - Xingyi Han
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA.,Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.,Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, and Section of Clinical Sciences, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA.,Department of Physical Medicine and Rehabilitation, Tufts Medical Center, Boston, MA.,Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111
| | - Jeffrey B Driban
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA.,Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.,Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, and Section of Clinical Sciences, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA.,Department of Physical Medicine and Rehabilitation, Tufts Medical Center, Boston, MA.,Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111
| | - Maura D Iversen
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA.,Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.,Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, and Section of Clinical Sciences, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA.,Department of Physical Medicine and Rehabilitation, Tufts Medical Center, Boston, MA.,Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111
| | - Sima A Desai
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA.,Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.,Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, and Section of Clinical Sciences, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA.,Department of Physical Medicine and Rehabilitation, Tufts Medical Center, Boston, MA.,Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111
| | - Hans E Knopp
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA.,Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.,Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, and Section of Clinical Sciences, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA.,Department of Physical Medicine and Rehabilitation, Tufts Medical Center, Boston, MA.,Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111
| | - Chenchen Wang
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA.,Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.,Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, and Section of Clinical Sciences, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA.,Department of Physical Medicine and Rehabilitation, Tufts Medical Center, Boston, MA.,Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111
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Jiménez-Martín PJ, Liu H, Meléndez Ortega A. The importance of differentiating the three modalities of Tai Chi Chuan practice in clinical trials – A critical review. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2017.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lee AC, Harvey WF, Wong JB, Price LL, Han X, Chung M, Driban JB, Morgan LPK, Morgan NL, Wang C. Effects of Tai Chi versus Physical Therapy on Mindfulness in Knee Osteoarthritis. Mindfulness (N Y) 2017; 8:1195-1205. [PMID: 28959369 PMCID: PMC5612617 DOI: 10.1007/s12671-017-0692-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Tai Chi mind-body exercise is widely believed to improve mindfulness through incorporating meditative states into physical movements. A growing number of studies indicate that Tai Chi may improve health in knee osteoarthritis (OA), a chronic pain disease and a primary cause of global disability. However, little is known about the contribution of mindfulness to treatment effect of Tai Chi practice. Therefore, our purpose was to investigate the effect of Tai Chi mind-body practice compared to physical therapy (PT) on mindfulness in knee OA. Adults with radiographic-confirmed, symptomatic knee OA were randomized to either 12 weeks (twice weekly) of Tai Chi or PT. Participants completed the Five Facet Mindfulness Questionnaire (FFMQ) before and after intervention along with commonly-used patient-reported outcomes for pain, physical function, and other health-related outcomes. Among 86 participants (74% female, 48% white, mean age 60 years, 85% at least college educated), mean total FFMQ was 142±17. Despite substantial improvements in pain, function, and other health-related outcomes, each treatment group's total FFMQ did not significantly change from baseline (Tai Chi= 0.76, 95% CI: -2.93, 4.45; PT= 1.80, 95% CI: -2.33, 5.93). The difference in total FFMQ between Tai Chi and PT was not significant (-1.04 points, 95% CI: -6.48, 4.39). Mindfulness did not change after Tai Chi or PT intervention in knee OA, which suggests that Tai Chi may not improve health in knee OA through cultivating mindfulness. Further study is needed to identify underlying mechanisms of effective mind-body interventions among people with knee OA.
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Affiliation(s)
- Augustine C. Lee
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - William F. Harvey
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - John B. Wong
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
- Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
- Division of Clinical Decision Making, Department of Medicine, Tufts Medical Center, Boston, MA, USA
| | - Lori Lyn Price
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
- Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | - Xingyi Han
- Department of Public Health and Community Medicine, Tufts University, Boston, MA, USA
| | - Mei Chung
- Department of Public Health and Community Medicine, Tufts University, Boston, MA, USA
| | - Jeffrey B. Driban
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | | | - Nani L. Morgan
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Chenchen Wang
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
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Lee AC, Harvey WF, Price LL, Han X, Driban JB, Wong JB, Chung M, McAlindon TE, Wang C. Mindfulness Is Associated With Treatment Response From Nonpharmacologic Exercise Interventions in Knee Osteoarthritis. Arch Phys Med Rehabil 2017; 98:2265-2273.e1. [PMID: 28506776 DOI: 10.1016/j.apmr.2017.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/07/2017] [Accepted: 04/17/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the association between baseline mindfulness and response from exercise interventions in knee osteoarthritis (OA). DESIGN Cohort study; responder analysis of a clinical trial subset. SETTING Urban tertiary care academic hospital. PARTICIPANTS Participants with symptomatic, radiographic knee OA (N=86; mean age, 60y; 74% female; 48% white). INTERVENTIONS Twelve weeks (twice per week) of Tai Chi or physical therapy exercise. MAIN OUTCOME MEASURES Treatment response was defined using Osteoarthritis Research Society International criteria indicating meaningful improvements in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, WOMAC function, or Patient Global Assessment scores. At baseline, participants completed the Five Facet Mindfulness Questionnaire (mean total score, 142±17) and were grouped into 3 categories of total mindfulness: higher, medium, or lower. Relative risk (RR) ratios were used to compare treatment response across groups. RESULTS Participants with higher total mindfulness were 38% (95% confidence interval [CI], 1.05-1.83) more likely to meet responder criteria than those with lower mindfulness. We found no significant difference between medium and lower mindfulness groups (RR=1.0; 95% CI, 0.69-1.44). Among the 5 mindfulness facets, medium acting-with-awareness was 46% (95% CI, 1.09-1.96) more likely to respond than lower acting-with-awareness, and higher acting-with-awareness was 34% more likely to respond, but this did not reach significance (95% CI, 0.97-1.86). CONCLUSIONS In this study, higher mindfulness, primarily driven by its acting-with-awareness facet, was significantly associated with a greater likelihood of response to nonpharmacologic exercise interventions in knee OA. This suggests that mindfulness-cultivating interventions may increase the likelihood of response from exercise.
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Affiliation(s)
- Augustine C Lee
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA
| | - William F Harvey
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA
| | - Lori Lyn Price
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA
| | - Xingyi Han
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
| | - Jeffrey B Driban
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA
| | - John B Wong
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA; Division of Clinical Decision Making, Department of Medicine, Tufts Medical Center, Boston, MA
| | - Mei Chung
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
| | - Timothy E McAlindon
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA
| | - Chenchen Wang
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA.
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Brosseau L, Taki J, Desjardins B, Thevenot O, Fransen M, Wells GA, Imoto AM, Toupin-April K, Westby M, Gallardo ICÁ, Gifford W, Laferrière L, Rahman P, Loew L, Angelis GD, Cavallo S, Shallwani SM, Aburub A, Bennell KL, Van der Esch M, Simic M, McConnell S, Harmer A, Kenny GP, Paterson G, Regnaux JP, Lefevre-Colau MM, McLean L. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs. Clin Rehabil 2017; 31:582-595. [PMID: 28183188 DOI: 10.1177/0269215517691083] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To identify effective mind-body exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning non-traditional land-based exercises for knee osteoarthritis. METHODS A systematic search and adapted selection criteria included comparative controlled trials with mind-body exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement). RESULTS The four high-quality studies identified demonstrated that various mind-body exercise programs are promising for improving the management of knee osteoarthritis. Hatha Yoga demonstrated significant improvement for pain relief (Grade B) and physical function (Grade C+). Tai Chi Qigong demonstrated significant improvement for quality of life (Grade B), pain relief (Grade C+) and physical function (Grade C+). Sun style Tai Chi gave significant improvement for pain relief (Grade B) and physical function (Grade B). CONCLUSION Mind-body exercises are promising approaches to reduce pain, as well as to improve physical function and quality of life for individuals with knee osteoarthritis.
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Affiliation(s)
- Lucie Brosseau
- 1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Jade Taki
- 2 Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Brigit Desjardins
- 3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Odette Thevenot
- 3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Marlene Fransen
- 4 Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - George A Wells
- 5 School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Karine Toupin-April
- 7 Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, Faculty of Medicine and School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Marie Westby
- 8 Mary Pack Arthritis Program, Vancouver Coastal Health, Department of Physical Therapy, University of British Columbia, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | | | - Wendy Gifford
- 10 School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Lucie Laferrière
- 11 Canadian Forces Health Services Group Headquarters, National Defense, Ottawa, Ontario, Canada
| | - Prinon Rahman
- 12 Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Laurianne Loew
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Gino De Angelis
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Sabrina Cavallo
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Ala' Aburub
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Kim L Bennell
- 14 Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Martin Van der Esch
- 15 Department of Rehabilitation, Reade Centre for Rehabilitation and Rheumatology, Amsterdam, Netherlands, Faculty of Health. ACHIEVE, Centre of Applied Research and School of Physiotherapy, University of Applied Sciences, Amsterdam, Netherlands
| | - Milena Simic
- 16 Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Sara McConnell
- 17 Department of Medicine, St. Joseph's Health Care Centre, Toronto, Ontario, Canada
| | - Alison Harmer
- 18 Faculty of Health Sciences, Clinical and Rehabilitation Sciences Research Group, University of Sydney, Sydney, Australia
| | - Glen P Kenny
- 3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Gail Paterson
- 19 The Arthritis Society, Ottawa Office, Ontario Division, Ottawa, Ontario, Canada
| | - Jean-Philippe Regnaux
- 20 Centre de recherche Epidémiologie et Biostatistique, Hôpital Hôtel-Dieu, Paris, France
| | | | - Linda McLean
- 1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Bruckenthal P, Marino MA, Snelling L. Complementary and Integrative Therapies for Persistent Pain Management in Older Adults: A Review. J Gerontol Nurs 2016; 42:40-48. [DOI: 10.3928/00989134-20161110-08] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 10/27/2016] [Indexed: 01/17/2023]
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Luo X, Zhang J, Castelberg R, Wu T, Yu P, He C, Wang P. The Effects of Traditional Chinese Exercise in Patients with Chronic Obstructive Pulmonary Disease: A Meta-Analysis. PLoS One 2016; 11:e0161564. [PMID: 27589054 PMCID: PMC5010221 DOI: 10.1371/journal.pone.0161564] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 08/08/2016] [Indexed: 02/05/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. However, several studies that have assessed the role of traditional Chinese exercise in the management of this disease include broad variations in sample sizes and results. Therefore, this meta-analysis was conducted to assess the effects of traditional Chinese exercise on patients with COPD. Methods Two investigators independently identified and extracted data from selected articles. A computerized search of electronic databases through August 2015 was conducted. Mean differences (MDs) and 95% confidence intervals (CIs) were calculated to analyze the combined data. The methodological quality was evaluated using the Cochrane risk-of-bias tool. Heterogeneity was assessed with the I2 test. Results Ten randomized, controlled trials (RCTs) involving 622 patients met the inclusion criteria. There were significant improvements in the 6-minute walking distance test (6 MWD;MWD = 12.10 m; 95% CI, 7.56–16.65 m; p<0.001); forced expiratory volume in one second (FEV1% predicted; WMD = 9.02; 95% CI, 6.80–11.23; p<0.00001); forced expiratory volume in 1 second/forced vital capacity (FEV(1)/FVC) ratio (Tiffenau Index; WMD = 6.67; 95% CI, 5.09–8.24; p<0.00001); and quality of life, as evaluated by the Chronic Respiratory Disease Questionnaire (CRDQ; WMD = 0.85 score; 95% CI, 0.52–1.18; p<0.00001). Conclusions Traditional Chinese exercise could provide an effective alternative method for managing COPD. Larger and higher-quality trials are required.
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Affiliation(s)
- Xiaotian Luo
- Department of Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
- Department of Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan, PR China
| | - Jifeng Zhang
- Department of General surgery Medicine, Datong Second People’s Hospital, Datong, Shanxi, PR China
| | - Rachel Castelberg
- Department of Physical Therapy, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, United States of America
| | - Tao Wu
- Department of Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
| | - Pengming Yu
- Department of Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
| | - Chengqi He
- Department of Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
- Department of Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan, PR China
- * E-mail: (PW); (CQH)
| | - Pu Wang
- Department of Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
- Department of Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan, PR China
- * E-mail: (PW); (CQH)
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Fu JJ, Min J, Yu PM, McDonald VM, Mao B. Study design for a randomised controlled trial to explore the modality and mechanism of Tai Chi in the pulmonary rehabilitation of chronic obstructive pulmonary disease. BMJ Open 2016; 6:e011297. [PMID: 27491669 PMCID: PMC4985849 DOI: 10.1136/bmjopen-2016-011297] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/22/2016] [Accepted: 07/13/2016] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Although pulmonary rehabilitation (PR) is associated with significant clinical benefits in chronic obstructive pulmonary disease (COPD) and has been recommended by guidelines, PR with conventional exercise training has not been widely applied in the clinic because of its inherent limitations. Alternative exercise such as Tai Chi has been investigated and the results are promising. However, the strengths and weaknesses of the exercise modality of Tai Chi, conventional PR and a combination of Tai Chi and conventional PR and the possible mechanisms underlying Tai Chi exercise remain unclear. This study aims to address the above research gaps in a well-designed clinical trial. METHODS AND ANALYSIS This study is a single-blind, randomised controlled trial. Participants with stable COPD will be recruited and randomly assigned to one of four groups receiving Tai Chi exercise, conventional PR using a total body recumbent stepper (TBRS), combined Tai Chi and TBRS, or usual care (control) in a 1:1:1:1 ratio. Participants will perform 30 min of supervised exercise three times a week for 8 weeks; they will receive sequential follow-ups until 12 months after recruitment. The primary outcome will be health-related quality of life as measured by the St George's Respiratory Questionnaire. Secondary outcomes will include 6 min walking distance, pulmonary function, the modified Medical Research Council Dyspnoea Scale, the COPD Assessment Test, the Hospital Anxiety and Depression Scale, the Berg Balance Scale, exacerbation frequency during the study period, and systemic inflammatory and immune markers. ETHICS AND DISSEMINATION Ethics approval has been granted by the Clinical Trial and Biomedical Ethics Committee of West China Hospital of Sichuan University (No TCM-2015-82). Written informed consent will be obtained from each participant before any procedures are performed. The study findings will be published in peer-reviewed journals and presented at national and international conferences. TRIAL REGISTRATION NUMBER ChiCTR-IOR-15006874; Pre-results.
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Affiliation(s)
- Juan-Juan Fu
- Respiratory Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Min
- Respiratory Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Peng-Ming Yu
- Department of Rehabilitation, West China Hospital, Sichuan University, Chengdu, China
| | - Vanessa M McDonald
- Priority Research Centre for Asthma and Respiratory Diseases, University of Newcastle, Newcastle, New South Wales, Australia
- Faculty of Health, School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| | - Bing Mao
- Respiratory Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
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