The effects of tai chi on depression, anxiety, and psychological well-being: a systematic review and meta-analysis

A META analysis and systematic review of the effects of exercise interventions on middle-aged and elderly patients with depression

OBJECTIVE

This study sought to conduct a meticulous systematic review, delving into the efficacy of exercise interventions on depressive symptoms among middle-aged and older adults. Additionally, we aimed to scrutinize the nuanced influence of various intervention factors on the intricate relationship between exercise and depressive symptoms within this demographic.

METHODS

Our investigation involved an extensive search across multiple databases, including PubMed, Embase, Web of Science, and the Cochrane Library, spanning from the inception of these repositories to December 2023. Following a rigorous screening process, we identified and included 12 papers, encompassing a total of 994 subjects.

RESULTS

The meta-analysis unveiled a compelling overall effect size of exercise interventions on depressive symptoms in middle-aged and older individuals, represented by SMD = -0.41, with a 95% confidence interval of [-0.60, -0.22], and P < 0.0001. This statistical evidence underscores the significant and positive impact of exercise interventions on ameliorating depressive symptoms in this demographic. However, a degree of heterogeneity among studies was observed, with I2 = 48% and P = 0.03.

CONCLUSION

The comprehensive synthesis of outcomes elucidates the pronounced positive effect of exercise interventions in enhancing depressive symptoms among middle-aged and older adults. Specifically, the gentle and balanced exercise series emerges as particularly efficacious in mitigating depression. Furthermore, individual exercises stand out as more effective, with optimal results noted for moderate exercise sessions lasting 30 to 60 minutes. Our findings also highlight the superiority of short-term interventions, followed by medium- and long-term exercise interventions, in terms of efficacy. Nevertheless, recognizing the inherent heterogeneity and potential limitations of our study, we advocate for future large-scale, comprehensive investigations to validate these findings. Additionally, optimizing exercise intervention protocols necessitates a more nuanced understanding, urging further research endeavors to refine strategies aimed at improving depressive symptoms in middle-aged and older adults.

Effects of Tai Chi on physical performance, sleep, and quality of life in older adults with mild to moderate cognitive impairment

BACKGROUND

Exercise is a promising nonpharmacological intervention to delay the progression of cognitive impairment and improve physical function and sleep quality in patients, but the evidence remains inconclusive.

AIMS

To compare the therapeutic efficacy of an exercise intervention on physical performance, sleep efficiency, and quality of life in older adults with cognitive impairment.

DESIGN

A three-arm randomized controlled trial.

METHODS

This study recruited 81 older adults with mild to moderate cognitive impairment at a nursing home from December 2020 to July 2021. Participants were screened and randomized into three groups: a tai chi intervention group (n = 27), a conventional exercise intervention group (n = 27), and a waitlist control group with no intervention (n = 27). The intervention groups underwent 12 weeks of exercise intervention. Participants were assessed at weeks 0, 6, and 12. The primary outcome was the Short Physical Performance Battery score, and the secondary outcomes were sleep efficiency and quality of life. Statistical analysis was conducted with generalized estimating equations (GEEs).

RESULTS

The mean age of the participants was 81.0 ± 7.4 years. The GEE analysis revealed that the Short Physical Performance Battery score, sleep efficiency, and quality of life were significantly higher in both intervention groups than in the control group at week 12, and physical performance improved significantly more in the tai chi group than in the conventional exercise group.

CONCLUSIONS

Both exercise interventions improved physical performance, sleep efficiency, and quality of life in older adults with mild to moderate cognitive impairment. According to our results, tai chi may be a more effective therapeutic approach for cognitive impairment than conventional exercise.

TRIAL REGISTRATION

University Hospital Medical Information Network number UMIN000042051. Registered 01/12/2020.

Promoting workplace psychological wellbeing through Yoga and Tai Chi classes in female university employees

Introduction

Academic environments are known for their high demands, often resulting in significant distress among employees. Thus, identifying effective intervention strategies to mitigate workplace stress is essential. The present study aims to evaluate the potential benefits of mind-body interventions (i.e., Yoga and Tai Chi) on the psychological wellbeing and perceived mental and physical health of female university employees.

Methods

A total of 166 female university employees and faculty members participated in 10 sessions of Tai Chi or Yoga. They completed self-report questionnaires assessing ruminative thoughts, somatic anxiety, general distress, perceived physical and mental health, and assertive and cooperative behaviors before and after the 10 Tai Chi/Yoga sessions. Additionally, participants completed a state anxiety questionnaire before and after Tai Chi/Yoga second and second-to-last lessons.

Results

Results showed significant differences between scores pre and post Tai Chi and Yoga programs, with lower ruminative thoughts (p = 0.007), lower somatic anxiety (p < 0.001), and higher perceived mental health (p = 0.038) at the end of the programs (i.e., after 10 sessions) compared to the beginning. Moreover, significant differences were found in state anxiety scores, with a reduction in state anxiety at the end of the second (p < 0.001) and second-to-last (p < 0.001) lessons compared to the start.

Conclusion

Our findings highlight the potential positive impact of Tai Chi and Yoga programs on the psychological wellbeing and perceived mental health of female university employees. Immediate reductions in state anxiety following single sessions further underscore the potential of these practices for short-term stress relief. Overall, the results support the implementation of mind-body practices in workplace settings to promote a healthier work environment.

Personality traits and levels of anxiety and depression among martial artists: a cross-sectional study

BACKGROUND

In recent years, fighting arts (e.g., Karate, Judo, Jujitsu, Boxe) have gained broader attention due to their multiple benefits, involving both physical and psychological enhancements for practitioners. Despite that, studies revolving around specific psychological characteristics such as personality traits are scarce. This study explored potential connections between the personality traits of practitioners and the specific fighting art they engage in, and investigated levels of anxiety and depression in fighting artists.

METHODS

A web-based cross-sectional survey instrument was developed and disseminated across the entire Italian territory. Participants were eligible if adults (> 18 years old) engaged in any fighting arts for a minimum of one year, with no additional restrictions. The survey employed the Big Five Inventory (BFI) with 44 questions to explore personality traits using the OCEAN model, and the Hospital Anxiety and Depression Scale (HADS) to explore anxiety and depression levels.

RESULTS

A total of 770 questionnaires were collected from July to September 2023. Participants were mainly men (M = 571, 74.5%; F = 199, 25.8%; mean age 45.2 ± 14.8), and most of the participants practised in the North of Italy (N = 493, 64.0%). The mean age of practice was 28.5 ± 14.9 years and the most practised fighting arts were Judo (N = 349, 45.3%), Karate (N = 272, 35.3%) and Jujitsu (N = 42, 5.5%). Personality traits were identified as openness, conscientiousness, extroversion, agreeableness, neuroticism and the results were as follows: O) 40.1 ± 6.30; C) 37.1 ± 5.78; E) 28.2 ± 5.64; A) 35.1 ± 5.08; N) 19,8 ± 5,51. Anxiety and depression scored respectively 5.93 ± 3.14 and 3.67 ± 2.74.

CONCLUSIONS

Fighting artists exhibit elevated levels of positive personality traits, such as openness, conscientiousness, extraversion, and agreeableness. Conversely, neuroticism tends to be lower among them. Moreover, anxiety and depression levels among fighting artists are lower than the Italian normative values. Fighting arts, particularly Karate and Judo, emerge as promising avenues for adults seeking innovative or complementary strategies to foster positive personality traits (e.g., openness, conscientiousness) while mitigating anxiety and depression. Future studies could explore other personality traits, including Machiavellianism, and explore additional psychological characteristics such as aggressiveness to provide a more comprehensive understanding.

Effects of Tai Chi and Qigong on Heart Rate Variability: A Systematic Review and Meta-Analysis

Background:

Intervention studies examining meditative movement (MM) often demonstrate benefits on physiological and psychological health. A potential mechanism associated with these outcomes is heart rate variability (HRV), an important neurophysiological biomarker of optimal and resilient health and functioning.

Objective:

We aimed to synthesize existing literature on the effects of two related forms of MM, Tai Chi (TC) and Qigong (QG) on HRV parameters in adult populations.

Methods:

Following PRISMA guidelines and Cochrane Collaboration recommendations, four databases (MEDLINE, Google Scholar, Academic Search Premier, and PubMed) were searched for articles (through December 15, 2023) that included TC and/or movement-based QG intervention versus any control condition (active or inactive) and reported at least one HRV outcome. Two reviewers independently completed study selection, data extraction, and risk-of-bias assessment.

Results:

We identified 148 for potential inclusion. After removing 61 duplicates, 87 full-text reviews yielded 23 articles, and 16 qualified for meta-analysis based on common HRV outcomes. Meta-analyses indicated a significant overall effect of TC/QG interventions on high-frequency power and standard deviation of the beat-to-beat intervals (SDNN), two critical HRV parameters, compared with control conditions: for HF power, standardized mean difference (SMD) = 0.29, P = 0.003, 95% Confidence interval (CI) [0.10, 0.48]; heterogeneity: I 2 = 46%, χ2 (8) = 14.89, P = 0.06; and for SDNN: SMD = 0.83, P = 0.02, 95% CI [0.16, 1.51]; heterogeneity: I 2 = 90%, χ2 (7) = 71.62, P < 0.001. Other HRV parameters did not demonstrate significant changes upon meta-analyses, but overall effect sizes showed a trend toward the expected direction.

Conclusion:

Based on the strength of the evidence, we conclude TC/QG interventions may shift HRV parameters toward improved health status and resilience. In addition, we offer suggestions to improve the design and measurement of future TC/QG research interventions exploring HRV.

Enhancing career adaptability in college students: a Tai Chi-based sports intervention study

Introduction

This research explores the impact of Tai Chi, a traditional Chinese martial art, on the career adaptability of college students, utilizing a quasi-experimental design. With the increasing complexities in the transition from school to work, effective interventions that address both psychological and vocational needs are essential.

Methods

The study involved 70 senior college students, randomly assigned to either an intervention group that participated in an organized 8-week Tai Chi program based on positive youth development (PYD) or a control group with no intervention.

Results

Results indicated significant improvements in the intervention group in terms of both career adaptability and satisfaction of basic psychological needs, compared to the control group. Mediation analysis revealed that the increase in career adaptability induced by intervention was mediated by the satisfaction of basic psychological needs, underscoring the effectiveness of Tai Chi as a holistic intervention tool.

Discussion

This study contributes to the field by demonstrating that physical activity, particularly one embedded with deep cultural and philosophical significance like Tai Chi, can effectively enhance the career adaptability of college students. It advocates for the inclusion of PYD-based physical practices in developmental interventions aimed at preparing youth for the challenges of the modern workforce.

Tai Chi Practice Buffers Aging Effects in Functional Brain Connectivity

Tai Chi (TC) practice has been shown to improve both cognitive and physical function in older adults. However, the neural mechanisms underlying the benefits of TC remain unclear. Our primary aims are to explore whether distinct age-related and TC-practice-related relationships can be identified with respect to either temporal or spatial (within/between-network connectivity) differences. This cross-sectional study examined recurrent neural network dynamics, employing an adaptive, data-driven thresholding approach to source-localized resting-state EEG data in order to identify meaningful connections across time-varying graphs, using both temporal and spatial features derived from a hidden Markov model (HMM). Mann-Whitney U tests assessed between-group differences in temporal and spatial features by age and TC practice using either healthy younger adult controls (YACs, n = 15), healthy older adult controls (OACs, n = 15), or Tai Chi older adult practitioners (TCOAs, n = 15). Our results showed that aging is associated with decreased within-network and between-network functional connectivity (FC) across most brain networks. Conversely, TC practice appears to mitigate these age-related declines, showing increased FC within and between networks in older adults who practice TC compared to non-practicing older adults. These findings suggest that TC practice may abate age-related declines in neural network efficiency and stability, highlighting its potential as a non-pharmacological intervention for promoting healthy brain aging. This study furthers the triple-network model, showing that a balancing and reorientation of attention might be engaged not only through higher-order and top-down mechanisms (i.e., FPN/DAN) but also via the coupling of bottom-up, sensory-motor (i.e., SMN/VIN) networks.

Mind-body therapy for treating fibromyalgia: a systematic review

OBJECTIVE

Fibromyalgia is a chronic and disabling condition that presents management challenges for both patients and healthcare providers. The objective of this systematic review was to summarize current evidence on the effectiveness and safety of mind-body therapies in the treatment and/or management of fibromyalgia.

METHODS

We searched MEDLINE, EMBASE, PsycINFO, AMED, and CINAHL databases from their inception to December 2023. Eligible articles included adults diagnosed with fibromyalgia participating in a mind-body therapy intervention and were published from the beginning of 2012 onwards. We assessed the quality of the studies using the Joanna Briggs Institute Critical Appraisal Checklists.

RESULTS

Of 3866 records screened, 27 studies (30 articles) met our inclusion criteria, in which 22 were randomized controlled trials and 5 were quasi-experimental studies. Mind-body therapies included guided imagery (n = 5), mindfulness-based stress reduction (n = 5), qi gong (n = 5), tai chi (n = 5), biofeedback (n = 3), yoga (n = 2), mindfulness awareness training (n = 1), and progressive muscle relaxation (n = 1). With the exception of mindfulness-based stress reduction, all therapies had at least one study showing significant improvements in pain at the end of treatment. Multiple studies on guided imagery, qi gong, and tai chi observed significant improvements in pain, fatigue, multidimensional function, and sleep. Approximately one-third of the studies reported on adverse events.

CONCLUSIONS

This review suggests that mind-body therapies are potentially beneficial for adults with fibromyalgia. Further research is necessary to determine if the positive effects observed post-intervention are sustained.

STUDY REGISTRATION

Open Science Framework (https://osf.io) (September 12, 2023; https://doi.org/10.17605/osf.io/6w7ac).

The Effect of Walking on Depressive and Anxiety Symptoms: Systematic Review and Meta-Analysis

Background

Previous literature lacks summative information on the mental health benefits achieved from different forms of walking.

Objective

The aim of this study was to assess the effectiveness of different forms of walking in reducing symptoms of depression and anxiety.

Methods

This was a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effects of walking on depressive and anxiety symptoms. MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, Allied and Complementary Medicine Database (AMED), CINAHL, and Web of Science were searched on April 5, 2022. Two authors independently screened the studies and extracted the data. Random-effects meta-analysis was used to synthesize the data. Results were summarized as standardized mean differences (SMDs) with 95% CIs in forest plots. The risk of bias was assessed by using the Cochrane Risk of Bias tool.

Results

This review included 75 RCTs with 8636 participants; 68 studies reported depressive symptoms, 39 reported anxiety symptoms, and 32 reported both as the outcomes. One study reported the results for adolescents and was not included in the meta-analysis. The pooled results for adults indicated that walking could significantly reduce depressive symptoms (RCTs: n=44; SMD -0.591, 95% CI -0.778 to -0.403; I2=84.8%; τ2=0.3008; P<.001) and anxiety symptoms (RCTs: n=26; SMD -0.446, 95% CI -0.628 to -0.265; I2=81.1%; τ2=0.1530; P<.001) when compared with the inactive controls. Walking could significantly reduce depressive or anxiety symptoms in most subgroups, including different walking frequency, duration, location (indoor or outdoor), and format (group or individual) subgroups (all P values were <.05). Adult participants who were depressed (RCTs: n=5; SMD -1.863, 95% CI -2.764 to -0.962; I2=86.4%; τ2=0.8929) and those who were not depressed (RCTs: n=39; SMD -0.442, 95% CI -0.604 to -0.280; I2=77.5%; τ2=0.1742) could benefit from walking effects on their depressive symptoms, and participants who were depressed could benefit more (P=.002). In addition, there was no significant difference between walking and active controls in reducing depressive symptoms (RCTs: n=17; SMD -0.126, 95% CI -0.343 to 0.092; I2=58%; τ2=0.1058; P=.26) and anxiety symptoms (14 RCTs, SMD -0.053, 95% CI -0.311 to 0.206, I2=67.7%, τ2=0.1421; P=.69).

Conclusions

Various forms of walking can be effective in reducing symptoms of depression and anxiety, and the effects of walking are comparable to active controls. Walking can be adopted as an evidence-based intervention for reducing depression and anxiety. More evidence on the effect of low-intensity walking is needed in the future.

Evaluation of traditional Chinese exercise for knee osteoarthritis (KOA): an overview of systematic reviews

BACKGROUND

Knee osteoarthritis (KOA) has become a public health issue. Several systematic reviews (SRs) and meta-analyses (MAs) indicate that traditional Chinese exercise (TCE) may be an effective treatment for reducing pain and stiffness and improving physical function in people with knee osteoarthritis (KOA).

OBJECTIVES

To evaluate the literature quality and evidence for the systematic reviews of TCE for KOA and provide evidence to support the clinical application of TCE for KOA.

METHODS

Eight databases were searched from their inception to January 3, 2023, to retrieve relevant literature, including China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Scientific Journal Database (VIP), China Biology Medical literature database (CBM), PubMed, Embase, Web of Science and Cochrane Library, without restrictions on publication date or language. AMSTAR-2 and PRISMA 2020 assessed the methodological and reporting quality of included SRs/MAs. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was utilized to evaluate the quality of evidence.

RESULTS

A total of 18 SRs/MAs were included. The methodological quality was "very low" based on AMSTAR-2. The overall reporting quality was deficient based on PRISMA 2020. The quality of Chinese and English literature differed, with English literature being superior in methodological and reporting quality. Among 93 pieces of evidence obtained, 46 (49.46%) were of very low quality, 34 (36.56%) were of low quality, 13 (13.98%) were of moderate quality, and none were of high quality. TCE was supported by 76 pieces of evidence (81.72%).

CONCLUSION

TCE appears beneficial and safe for managing KOA. However, due to the relatively low methodological and evidentiary quality of included SRs/MAs, clinicians should interpret these findings cautiously.

Tai Chi as a Complementary Therapy for Depression and Anxiety Among U.S. Veterans in a Mental Health Inpatient Setting

BACKGROUND

Depression and anxiety are two of the top five mental illnesses veterans report. Treatment for depression and anxiety includes medications and psychiatric treatment in inpatient, outpatient, and residential treatment programs; the use of complementary and alternative medicine (CAM) can have beneficial results by decreasing symptoms, recognize patients' preference for CAM, and be cost-effective.

AIM

This study aimed to evaluate the effects of Tai Chi on depression and anxiety symptoms on inpatient psychosocial or substance use disorder (SUD) rehabilitation treatment program residents since little evidence exists regarding the effectiveness of Tai Chi on participants in residential mental health treatment programs. METHOD: A mixed-method, cohort design with 88 participants (41 usual treatment without Tai Chi, 47 intervention) used a demographic survey, Hamilton Anxiety Scale, Quick Inventory of Depressive Symptomatology, self-report, and the Patient Health Questionnaire-9 at Weeks 1 and 4 of the treatment program. After Week 4, the intervention group responded to six open-ended questions about Tai Chi's effects on their overall depression and anxiety.

RESULTS

The anxiety level of the intervention group was significantly decreased, as evidenced by the Hamilton Anxiety Scale scores (p = .02). However, the measures of depression did not differ between the groups. Two themes, mindfulness and satisfaction, were identified from the written responses regarding the Tai Chi intervention.

CONCLUSION

Tai Chi effectively reduced symptoms of anxiety that varied by age and ethnicity. This study increased the insight regarding the benefit of including Tai Chi as a complementary therapy for those participating in residential treatment programs.

The Impact of Nonpharmacological Interventions on Opioid Use for Chronic Noncancer Pain: A Scoping Review

Despite the lack of evidence, opioids are still routinely used as a solution to long-term management for chronic noncancer pain (CNCP). Given the significant risks associated with long-term opioid use, including the increased number of unregulated opioid pills at large in the opioid ecosystem, opioid cessation or reduction may be the desired goal of the patient and clinician. Viable nonpharmacological interventions (NPIs) to complement and/or replace opioids for CNCP are needed. Comprehensive reviews that address the impact of NPIs to help adults with CNCP reduce opioid use safely are lacking. We conducted a literature search in PubMed, CINAHL, Embase, PsycINFO, and Scopus for studies published in English. The initial search was conducted in April 2021, and updated in January 2024. The literature search yielded 19,190 relevant articles. Thirty-nine studies met the eligibility criteria and underwent data extraction. Of these, nineteen (49%) were randomized controlled trials, eighteen (46%) were observational studies, and two (5%) were secondary analyses. Among adults with CNCP who use opioids for pain management, studies on mindfulness, yoga, educational programs, certain devices or digital technology, chiropractic, and combination NPIs suggest that they might be an effective approach for reducing both pain intensity and opioid use, but other NPIs did not show a significant effect (e.g., hypnosis, virtual reality). This review revealed there is a small to moderate body of literature demonstrating that some NPIs might be an effective and safe approach for reducing pain and opioid use, concurrently.

The Effect of Stress-Reducing Interventions on Heart Rate Variability in Cardiovascular Disease: A Systematic Review and Meta-Analysis

Stress is recognized as a significant trigger and exacerbator of various medical conditions, particularly in the field of cardiovascular disease (CVD). Given that heart rate variability (HRV) offers insight into the functioning of the autonomic nervous system and has been identified as a predictive factor for increased cardiovascular mortality, exploring the correlation between stress and HRV is pertinent. We systematically reviewed trials where researchers investigated the effects of stress-reducing interventions on biomarkers and time-domain/frequency-domain parameters of HRV in CVD. Eligible studies underwent meta-analysis utilizing a random-effects model. The meta-analysis showed overall beneficial effects of stress-reducing interventions on HRV for the standard deviation of Normal-to-Normal intervals (SDNN) in short-term and 24 h assessments, as well as for the low-frequency power (LF) in short-term assessment. Overall effect sizes were notably high and showed significant p-values (short-term SDNN: MD = 6.43, p = 0.01; 24 h SDNN: MD = 10.92, p = 0.004; short-term LF: MD = 160.11, p < 0.001). Our findings highlight the significant impact of stress-reducing interventions in modulating HRV by influencing short-term SDNN and LF parameters, as well as the 24 h assessment of SDNN. These results emphasize the importance of stress-reducing measures in lowering the risk of further progression in CVD and improving patient outcomes.

The role of a mindful movement-based program (Movimento Biologico) in health promotion: results of a pre-post intervention study

Introduction

Mindful movement is a comprehensive approach that integrates various bodily, emotional and cognitive aspects into physical activity, promoting overall well-being. This study assessed the impact of a mindful movement program, known as Movimento Biologico (MB), on participants psychological well-being (PWB), positive mental health (PMH), sense of coherence (SOC), and interoceptive awareness.

Methods

MB program was conducted for students attending the bachelor's degree in Kinesiology and Sport Sciences of University of Perugia over 8 weeks (from October 16 to November 27, 2022). Participants were requested to fill in four questionnaires before and after the MB program: (1) 18-item PWB scale; (2) 9-item PMH scale; (3) 13-item SOC scale; (4) 32-item scale for Multidimensional Assessment of Interoceptive Awareness (MAIA). Wilcoxon signed-rank tests were used to assess changes, with significance set at p < 0.05.

Results

Thirty-eight students (mean age 21.2, 60.5% male) participated. Several MAIA subscales, including noticing (p = 0.003), attention management (p = 0.002), emotional awareness (p = 0.007), self-regulation (p < 0.001), body listening (p = 0.001), and trusting (p = 0.001), showed significant improvements. PMH increased significantly (p = 0.015), and there was a significant enhancement in the autonomy subscale of PWB (p = 0.036). SOC and overall PWB also improved, though not significantly.

Conclusion

The MB program significantly improved participants' positive mental health and interoceptive awareness. This likely resulted from better recognition and management of positive physiological sensations, a stronger link between physical sensations and emotions, enhanced confidence in one's body, and increased autonomy.

Stress reduction through taiji: a systematic review and meta-analysis

PURPOSE

In light of the mounting prevalence of stress in contemporary society and the growing interest in stress reduction methods, this review investigates the potential of taiji as a viable strategy for alleviating stress.

METHODS

MEDLINE, EMBASE, the Cochrane Controlled Trials Register (CENTRAL), PsycINFO, and Web of Science were searched up to April 2023 to identify randomized controlled trials of taiji. Studies in both patients and healthy populations were considered. They had to provide a measure of perceived stress and include a no treatment or placebo control group. Data were extracted by two reviewers. Pooled standardized mean differences (SMD) were calculated for perceived stress, biological stress markers, anxiety, depression, and quality of life (QoL). Meta-regression analyses were performed to identify sources of heterogeneity.

RESULTS

Eleven trials with a total of 1323 patients comparing taiji to no intervention met the inclusion criteria. The included studies varied strongly with regard to patient characteristics, taiji intervention, and methodological quality. The overall SMD for perceived stress was significant at -0.41 (95% confidence interval, CI, -0.63 to -0.19; I2 = 63%). Exclusion of studies with less than 100 participants yielded a diminished SMD at -0.26 (95% CI, -0.45 to -0.06). The SMD for perceived stress at follow-up was significant (-0.25, 95% CI -0.46 to -0.05). Secondary outcomes highlighted improvements in anxiety and physical QoL, while depression, mental QoL, and biological stress markers remained unchanged.

CONCLUSIONS

Results underscore taiji's potential in mitigating perceived stress in both patients and healthy populations, paralleled by enhancements in depressive symptoms, anxiety levels, and physical QoL.

Effectiveness of mind-body exercises in chronic respiratory diseases: an overview of systematic reviews with meta-analyses

PURPOSE

To gather evidence on the effectiveness and safety of qigong, tai chi, and yoga to modulate symptoms associated with chronic respiratory diseases.

METHODS

A search of systematic reviews was conducted in CINHAL, Embase, PubMed, PsycINFO, SPORTDiscus, and the Cochrane Library from inception to November 2022. Systematic reviews with meta-analyses investigating physical and psychological measures were eligible. The methodological quality of systematic reviews (AMSTAR-2), the spin of information in abstracts, and the overlap of primary studies were explored.

RESULTS

Twenty-seven systematic reviews involving 37 000 participants, 146 studies, and 150 meta-analyses were included. Reviews investigated asthma (n = 4) and chronic obstructive pulmonary disease (COPD) (n = 23). Most reviews discussed their findings without considering the risk of bias of primary studies. The overlap ranged between slight (5%) and very high (35%). Yoga was better than control interventions to improve symptoms related with asthma. In adults with COPD, qigong improved dyspnoea, exercise endurance, lung function, and quality of life, while tai chi and yoga increased exercise endurance.

CONCLUSIONS

The impact of yoga on symptoms associated with asthma varied depending on the lung function parameter and the control group. Qigong, tai chi, and yoga could be effective to improve COPD-related symptoms, especially exercise endurance.

Motivational drivers and Sense of Belonging: unpacking the persistence in Chinese Martial Arts practice among international practitioners

Background

Chinese Martial Arts (CMAs) have garnered a global following, with their rich historical and cultural heritage transcending geographical and cultural differences, sparking profound interest among an international community. As an increasing number of non-Chinese individuals persist in practicing CMAs, investigating the motivations behind their continued participation has emerged as a compelling question. This study aims to delve deeper into the factors driving international practitioners to sustain their practice of CMAs, thereby broadening our understanding of the global resonance of CMAs.

Methods

Employing Self-Determination Theory, 226 international CMAs practitioners completed the Physical Activity and Leisure Motivation Scale, Perceived Belonging Scale, and Persistence in Practicing CMAs Scale. SPSS 20.0 was utilized for conducting descriptive statistics, common method bias tests, and correlation analyses. Structural equation modeling was performed using AMOS 26.0.

Results

Motivation for Practicing CMAs, comprised of enjoyment, mastery, physical condition, psychological condition, and appearance, has a positive impact on Persistence in Practicing CMAs (β = 0.297, p < 0.01). Sense of Belonging also positively affects Persistence in Practicing CMAs (β = 0.268, p < 0.01). The aforementioned variables account for 22.1% of the variance in Persistence in Practicing CMAs. Furthermore, Affiliation, Competition/Ego, and Others' Expectations were found to have no significant correlation with Persistence in Practicing CMAs.

Conclusion

The formation of persistence in the practice of CMAs among international practitioners is propelled by their ongoing desire for skill mastery, enjoyment, enhanced physical and mental health, body shape improvement, and a Sense of Belonging. The study reveals that a stronger motivation and Sense of Belonging significantly enhance their commitment to CMAs. Recommendations include that international instructors should center their teaching strategies around the practitioners, helping them to find joy in their practice, achieve skill mastery, and foster the development of physical, mental, and aesthetic qualities, alongside virtues and etiquette. Additionally, building a supportive CMAs community and cultivating a sense of ritual are essential. Such strategies are intended to reinforce practitioners' self-affirmation and group identity, thus boosting their Sense of Belonging and encouraging their continued engagement in CMAs.

Quercetin increases the antidepressant-like effects of sclareol and antagonizes diazepam in thiopental sodium-induced sleeping mice: A possible GABAergic transmission intervention

Quercetin is the most common polyphenolic flavonoid present in fruits and vegetables demonstrating versatile health-promoting effects. This study aimed to examine the effects of quercetin (QR) and sclareol (SCL) on the thiopental sodium (TS)-induced sleeping and forced swimming test (FST) mouse models. SCL (1, 5, and 10 mg/kg, p.o.) or QR (50 mg/kg, p.o.) and/or diazepam (DZP) (3 mg/kg, i.p.) were employed. After 30 min of TS induction, individual or combined effects on the animals were checked. In the FST test, the animals were subjected to forced swimming after 30 min of administration of the test and/or controls for 5 min. In this case, immobility time was measured. In silico studies were conducted to evaluate the involvement of GABA receptors. SCL (5 and 10 mg/kg) significantly increased the latency and decreased sleeping time compared to the control in the TS-induced sleeping time study. DZP (3 mg/kg) showed a sedative-like effect in animals in both sleeping and FST studies. QR (50 mg/kg) exhibited a similar pattern of activity as SCL. However, its effects were more prominent than those of SCL groups. SCL (10 mg/kg) altered the DZP-3-mediated effects. SCL-10 co-treated with QR-50 significantly (p < 0.05) increased the latency and decreased sleep time and immobility time, suggesting possible synergistic antidepressant-like effects. In silico studies revealed that SCL and QR demonstrated better binding affinities with GABAA receptor, especially α2, α3, and α5 subunits. Both compounds also exhibited good ADMET and drug-like properties. In animal studies, the both compounds worked synergistically to provide antidepressant-like effects in a slightly different fashion. As a conclusion, the combined administration of SCL and QR may be used in upcoming neurological clinical trials, according to in vivo and in silico findings. However, additional investigation is necessary to verify this behavior and clarify the potential mechanism of action.

The effect of Tai Chi exercise intervention on sleep quality in community residing older adults: a systematic review and meta-analysis

PURPOSE

While clinical research has shown that Tai Chi exercise may improve the sleep quality of older adults, there is a lack of robust evidence-based verification. Therefore, this study conducted a systematic review of published research on the effect of Tai Chi exercise on the sleep quality of community-dwelling older adults, aiming to provide solid evidence-based medicine to enhance their sleep quality.

METHODS

A systematic search was conducted on PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, VIP, and SinoMed databases from their inception to December 9, 2022. The Cochrane risk of bias assessment tool 2.0 was used to assess the risk of bias in the included studies.

RESULTS

This systematic review included 12 original articles, involving a total of 1,058 community-dwelling older adults, with 553 in the Tai Chi group and 505 in the control group. The meta-analysis results revealed a significant improvement in the sleep quality of community-dwelling older adults who practiced Tai Chi compared to the control group [WMD =  - 1.96 (95% CI: - 3.02 to - 0.90, z = 3.62, P < 0.001)]. Subgroup analysis showed that Tai Chi had significantly beneficial effects regardless of age, country/region, intervention time, and Tai Chi type.

CONCLUSIONS

Tai Chi exercise can serve as an effective non-medication approach for addressing sleep problems in this demographic. Among the various types of Tai Chi exercises, the 24-form Tai Chi exercise emerges as a preferred option. Moreover, Tai Chi exercise proves to be an excellent choice for older people in their later years, promoting their overall well-being and health.

Effect of a Home-Based Simplified Tai Chi Exercise Program on Sleep Quality, Daytime Sleepiness, Quality of Life, and Psychological Well-Being in Egyptian Older Adults: A Quasi-Experimental Study

Introduction: Sleep disturbances are common among older adults and can have detrimental effects on their overall well-being. Tai Chi exercise has shown promise in improving sleep quality, quality of life (QoL), and psychological well-being in various populations. Objective: To investigate the effect of a home-based simplified Tai Chi exercise program on sleep quality, daytime sleepiness, QoL, and psychological well-being in Egyptian older adults. Methods: A quasi-experimental design was employed, with 152 participants aged 60 years and above assigned to either an experimental group (n = 87) or a control group (n = 65). Thecontrol group received a health education program to improve their sleeping quality and life-style, while the experimental group received a similar health education program and Tai Chi exercise training program. The participants in the experimental group were instructed to perform 3 months Tai Chi exercise. Data on sleep quality, daytime sleepiness, QoL, generalized anxiety disorder (GAD), and depression symptoms were collected at baseline, and one month, and 3 months post-intervention using validated questionnaires. Repeated measures ANOVA was done to investigate the effectiveness of the intervention programsover 3 time periods. Results: The results showed significant improvements in sleep quality (p < .001), QoL (p < .005), GAD (p < .005), and depression symptoms (p < .005) post-interventions. Also, there were significant difference in the effectiveness of the intervention programs between both the experimental and control groups. The experimental group exhibited greater improvements compared to the control group. Conclusion: The findings support the beneficial effects of a home-based simplified Tai Chi exercise program on sleep quality, QoL, and psychological well-being in Egyptian older adults. These results have important implications for promoting healthy aging and improving overall well-being in this population. Further research is recommended to validate these findings and explore the underlying mechanisms of Tai Chi exercise on the outcomes of interest.

Health benefits of short Taichi Qigong exercise (STQE) to University Students' core strength, lower limb explosive force, cardiopulmonary endurance, and anxiety: A Quasi experiment research

BACKGROUND

College students' physical fitness has declined over the past decades. Taichi Qigong exercise offers numerous health benefits and could serve as a suitable option for them. Traditional programs, however, are time-consuming and necessitate long-term commitments. Therefore, a more cost-effective intervention is needed.

METHODS

The study enrolled a total of 31 students who actively participated in a 5-week STQE program, consisting of three 60-minute sessions per week. Physical and mental health assessments included the Plank test, vital capacity measurement, 1000/800 m run test, standing jump, and the Zung Self-Rating Scale. Data analysis was performed using SPSS.

RESULTS

Following the STQE intervention, participants showed improvement in core strength (28.1 seconds in the Plank test, P = .025) and lower limb explosive force (6.52 cm in the standing jump test, P = .011), accompanied by a decrease in anxiety levels (a reduction of 3.41 in the Zung Self-Rating Scale, P = .039). However, no significant improvements were observed in cardiopulmonary endurance, as evidenced by a non-significant increase of 237.84 mL in vital capacity (P = .134) and a non-significant reduction of 1.6 seconds in the 1000/800 m run test (P = .764).

CONCLUSION

The study suggests that the STQE program effectively improves core strength, lower limb explosive force, and reduces anxiety levels among university students.

Effects of tai chi, ba duan jin, and walking on the mental health status of urban older people living alone: the mediating role of social participation and the moderating role of the exercise environment

With the global trend of aging, lacking of interpersonal communication and spiritual support and companionship have had a great impact on the mental health of older people living alone. This study examines the multifaceted impacts of engaging in tai chi, ba duan jin, and walking on the mental wellbeing of older people residing alone in urban areas. Additionally, this research aims to explore the association between tai chi, ba duan jin, and walking, and the mental health status of urban older people living alone, by considering the mediating influence of social participation and the moderating influence of the exercise environment. To do so, 1,027 older people living alone in six Chinese cities were investigated using the Physical Activity Rating Scale (PARS-3), the Geriatric Health Questionnaire (GHQ-12), the Social Participation Indicator System Scale, and the Exercise Environment Scale. SPSS 25.0 was utilized for conducting mathematical statistical analysis, specifically for doing linear regression analysis. Additionally, AMOS was employed to develop the study model. We found that a significant negative correlation between tai chi, ba duan jin, and walking and mental health status; among these, tai chi had the greatest impact on the mental health status of urban older people living alone. Social participation mediated the relationship between tai chi, ba duan jin, walking, and mental health status, and the exercise environment had a moderating effect on this relationship. The findings of this study indicate that tai chi, ba duan jin, and walking have a positive impact on the mental health of urban older people living alone, which can be influenced by the mediating efficacy of social participation and the moderating effect of the exercise environment.

Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review

BACKGROUND

Traumatic brain injury (TBI) adversely affects both young and old and is a growing public health concern. The common functional, psychological, and cognitive changes associated with TBI and recent trends in its management, such as recommending sub-threshold aerobic activity, and multi-modal treatment strategies including vestibular rehabilitation, suggest that Tai Chi/Qigong could be beneficial for TBI. Tai Chi and Qigong are aerobic mind-body practices with known benefits for maintaining health and mitigating chronic disease. To date, no systematic review has been published assessing the safety and effectiveness of Tai Chi/Qigong for traumatic injury.

METHODS

The following databases were searched: MEDLINE, CINAHL Cochrane Library, Embase, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. All people with mild, moderate, or severe TBI who were inpatients or outpatients were included. All Types of Tai Chi and Qigong, and all comparators, were included. All measured outcomes were included. A priori, we chose "return to usual activities" as the primary outcome measure as it was patient-oriented. Cochrane-based risk of bias assessments were conducted on all included trials. Quality of evidence was assessed using the grading of recommendation, assessment, development, and evaluation (GRADE) system.

RESULTS

Five trials were assessed; three randomized controlled trials (RCTs) and two non-RCTs; only two trials were conducted in the last 5 years. No trial measured "return to normal activities" or vestibular status as an outcome. Four trials - two RCTs and two non-RCTS - all found Tai Chi improved functional, psychological and/or cognitive outcomes. One RCT had a low risk of bias and a high level of certainty; one had some concerns. One non-RCTs had a moderate risk of bias and the other a serious risk of bias. The one Qigong RCT found improved psychological outcomes. It had a low risk of bias and a moderate level of certainty. Only one trial reported on adverse events and found that none were experienced by either the exercise or control group.

CONCLUSION

Based on the consistent finding of benefit in the four Tai Chi trials, including one RCT that had a high level of certainty, there is a sufficient signal to merit conducting a large, high quality multi-centre trial on Tai Chi for TBI and test it against current trends in TBI management. Based on the one RCT on TBI and Qigong, an additional confirmatory RCT is indicated. Further research is indicated that reflects current management strategies and includes adverse event documentation in both the intervention and control groups. However, these findings suggest that, in addition to Tai Chi's known health promotion and chronic disease mitigation benefits, its use for the treatment of injury, such as TBI, is potentially a new frontier.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO [ CRD42022364385 ].

Tai Chi Effects on Heart Rate Variability: A Systematic Review and Meta-Analysis

Background: Tai Chi, originating in China, is a mind-body exercise that integrates mind training, Qi training, and body training. While Tai Chi practice has demonstrated beneficial physical and psychological health benefits, how it achieves effects has been less studied. In recent years, some researchers have begun to explore the potential of heart rate variability (HRV) changes as balancing the autonomic nervous system (ANS) to achieve results, but only a few studies have directly tested how Tai Chi impacts HRV, and results have been mixed. Objective: This study systematically evaluates the effects of Tai Chi on HRV. Methods: Electronic databases including Web of Science, PubMed, Scopus, Cochrane Library, and EBSCOhost direct from inception until December 2020 were searched to obtain eligible studies. The primary outcomes examined were HRV parameters (time domain and frequency domain), and secondary analysis was whether breathing was emphasized during Tai Chi interventions. Results: Based on the 11 randomized controlled trials included comparing Tai Chi with non-active control condition, meta-analyses showed significantly beneficial effects on HRV parameters (low-frequency power [LF], mean difference [MD] = -200.40, 95% confidence interval [CI]: 365.31 to -35.49, p = 0.02; normalized low-frequency power [nLF], MD = -7.39, 95% CI: -12.48 to -2.29, p = 0.004; total power [TP], MD = -649.82, 95% CI: -1180.54 to -119.11, p = 0.02; very low-frequency power [VLF], MD = -200.55, 95% CI: -349.63 to -51.46, p = 0.008; root mean square of the square sum of the difference between adjacent normal heartbeat intervals [RMSSD], MD = 2.59, 95% CI: -7.23 to 12.41, p < 0.0001; standard deviation of the heartbeat interval [SDNN], MD = 8.33, 95% CI: 0.69 to 15.98, p = 0.03). The effect of Tai Chi on certain HRV parameters compared with active control conditions was less favorable (nLF, MD = 6.42, 95% CI: 3.74 to 9.09, p < 0.00001; normalized high-frequency power [nHF], MD: -6.13, 95% CI: -8.76 to -3.50, p < 0.00001; low-frequency/high-frequency power ratio [LF/HF], MD = 1.00, 95% CI: 0.68 to 1.33, p < 0.00001). In addition, studies describing an emphasis on breathing in the Tai Chi intervention showed positive impact on HRV (nLF, MD = -3.22, 95% CI: -5.32 to -1.12, p = 0.003; nHF, MD = 3.80, 95% CI: 0.80 to 6.81, p = 0.01; SDNN, MD = 5.55, 95% CI: 4.85 to 6.25, p < 0.00001). Conclusions: Meta-analysis results showed that Tai Chi compared with non-active control conditions has a positive impact on key HRV parameters associated with the ANS balance. However, active control condition comparisons showed greater HRV improvements than for Tai Chi. Considering the limited number of studies and their heterogeneity, further robust studies are necessary to verify findings and investigate differential effects of Tai Chi on HRV.

The effects of different types of Tai Chi exercise on anxiety and depression in older adults: a systematic review and network meta-analysis

Background

The body of evidence supporting the beneficial effects of Tai Chi in reducing anxiety and depressive symptoms in older adults is steadily increasing. Nonetheless, there remains a scarcity of studies directly comparing the clinical effectiveness of various Tai Chi exercises in addressing anxiety and depressive symptoms in older adults. Thus, this study aimed to systematically review and analyze the therapeutic efficacy of four types of Tai Chi interventions in enhancing anxiety and depressive symptoms in older adults.

Methods

During the period up to July 26, 2023, searches were conducted in the Web of Science, PubMed, the Cochrane Library, CNKI, and the Chinese Scientific Journal Database (VIP). The language scope encompassed both English and Chinese. Two independent reviewers conducted the literature review and data extraction. Review Manager 5.4 was employed for traditional meta-analysis and risk assessment, while version 15 of STATA software was used for generating evidence and funnel plots for network meta-analysis. This study was registered in PROSPERO number CRD 42023442270.

Result

In this analysis, a total of 20 studies were included, involving 1798 participants. The findings of the pairwise meta-analysis revealed that Tai Chi intervention was more effective than the control group in reducing anxiety (SMD: -1.19, 95% CI: -2.04, -0.34, p < 0.05) and depression (SMD: -0.65, 95% CI: -0.95, -0.65, p < 0.05) symptoms among older adults. The network meta-analysis specifically focused on anxiety symptoms and found that Yang-style Tai Chi (69.9%) had the most favorable outcome, followed by the 24-form Simplified Tai Chi (66.8%). In terms of depression symptoms, the Tai Chi Exercise Program (92.6%) had the highest performance, followed by Yang-style Tai Chi (77.9%).

Conclusion

The findings of this study imply that Tai Chi can have beneficial outcomes in the reduction of anxiety and depressive symptoms among older individuals. Specifically, when examining various forms of Tai Chi interventions, it was observed that Yang-style Tai Chi exhibited a greater efficacy in alleviating anxiety symptoms, whereas Tai Chi exercise programs demonstrated a higher effectiveness in improving depressive symptoms. Nonetheless, it is strongly advised that older adults select an exercise program that aligns with their interests and preferences, as this can enhance social integration and overall well-being.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023442270, identifier [CRD42023442270].

The influence of tai chi on the death anxiety of elderly people living alone: the chain mediating effect of social support and psychological capital

Background

Population aging is a global trend, and the number of older adults living alone is increasing. Tai chi, a traditional Chinese exercise, has been shown to improve the physical and mental health of older adults.

Aim

To investigate the effects of tai chi on death anxiety in older adults living alone and the role of social support and psychological capital in this relationship.

Method

A cross-sectional study of 493 older adults living alone in four cities in southwestern China. Participants were assessed using questionnaires on tai chi practice, social support, psychological capital, and death anxiety.

Results

Tai chi practice significantly reduced death anxiety in older adults living alone. It also positively correlated with social support and psychological capital, both of which negatively correlated with death anxiety. Social support and psychological capital mediated the relationship between tai chi practice and death anxiety, suggesting that tai chi may reduce death anxiety through these factors. These findings encourage older adults living alone to practice tai chi, as it may improve their mental and physical health and reduce their risk of death anxiety.

Conclusion

Tai chi practice may reduce death anxiety in older adults living alone through the chain-mediated effects of social support and psychological capital. This suggests that tai chi may be a beneficial intervention for older adults living alone.

Large-scale data reveal disparate associations between leisure time physical activity patterns and mental health

BACKGROUND

Leisure time physical activity (LTPA) is known to be associated with a lower risk for mental health burden, while whether the underlying mechanisms vary across populations is unknown. We aimed to explore the disparate associations between LTPA and mental health based on large-scale data.

METHODS

In this study, we analyzed data including 711,759 individuals aged 15 years or above from the latest four rounds (2003, 2008, 2013, and 2018) of the National Health Service Survey (NHSS) in China. We used multiple logistic regression models adjusted for potential confounders to investigate associations between LTPA and mental health in the total population and subgroups by measuring a diverse set of activity frequencies, intensities, and types. To examine the dose-response associations between total activity volume and mental health, we conducted restricted cubic splines to investigate possible nonlinearity.

RESULTS

LTPA was associated with remarkably lower self-reported mental health burden (OR 0.56, 95% CI 0.54-0.58). The dose-response relationship between total activity volume and mental health was highly nonlinear (p < 0.001), presenting L-shaped with first 1200 metabolic equivalents of task (METs)-min/week for significant risk reduction (OR 0.58, 95% CI 0.56-0.60). Notably, merely exercising 3-5 times per week with moderate swimming was significantly associated with lower mental health burden among younger people, while the association was strongly large in older adults aged 60 years or above doing 55-min moderate apparatus exercise at least six times a week.

CONCLUSIONS

In a large Chinese sample, LTPA was meaningfully and disparately associated with mental health burden across different people. Policy targeted at prompting activity may be effective for reducing mental health burden, but importantly, tailored strategies are needed based on population contexts.

Tai Chi as a Body-Mind Exercise for Promotion of Healthy Aging in Nursing Home Residents: Appropriateness, Feasibility, and Effectiveness

The lack of activity, opportunity for providing input and participation in activities, and interaction with other people are the features of institutional living which reinforces dependency among nursing home residents. Residents are usually frustrated with paternalistic-type care. Arranging health-oriented meaningful activities for residents contributes to health promotion and enhancement of healthy aging. Moreover, it contributes to the cultivation of a positive meaning of life which is particularly important as residents reach the late geriatric stages of their lives. With exercise being seen as generally beneficial for health, Tai Chi as a Chinese-based exercise with a body-mind emphasis and unique characteristics becomes a particularly suitable exercise in aiding the residents in this major shift of lifestyle. This paper analyzes the appropriateness, feasibility, and effectiveness of Tai Chi in promoting healthy aging for residents. Theoretical considerations and scientific evaluations lend it appropriate, feasible, and effective in providing physiological and psychosocial health benefits to the residents. This paper recommends the use of Tai Chi to promote healthy aging in nursing home residents. With a rapidly aging population and mounting demand for residential geriatric care worldwide, this paper's timely findings should provide important implications for adopting Tai Chi to advance the quality of care delivered by nursing homes worldwide.

Acceptability, feasibility, and user satisfaction of a virtual reality relaxation intervention in a psychiatric outpatient setting during the COVID-19 pandemic

Background

The COVID-19 pandemic was particularly difficult for individuals with mental disorders. Due to governmental restrictions, face-to-face offers for psychiatric outpatients like therapies, psychoeducational groups or relaxation courses were limited. Virtual reality (VR) might be a new possibility to support these patients by providing them with a home-based relaxation tool.

Objective

The aim of this study was to evaluate the acceptability, feasibility, and user satisfaction of a supportive therapy-accompanying, relaxation VR intervention in psychiatric outpatients during the COVID-19 pandemic in Germany.

Methods

The four-weeks VR intervention consisted of regular watching of relaxing videos in the participants' home environment. Sociodemographics, feasibility (frequency of use, user-friendliness), satisfaction (Client Satisfaction Questionnaire-8), depressive symptoms (Patient Health Questionnaire-9), quality of life (abbreviated World Health Organization Quality of Life assessment), and credibility and expectancy (Credibility Expectancy Questionnaire-8) were measured in an intention-to-treat (ITT) analysis and a per-protocol (PP) analysis of completers.

Results

In total, N = 40 patients participated in the study. Most of the participants in the ITT analysis (n = 30, 75.0%) used the VR device three or 4 weeks. A majority of the N = 29 completers (PP: n = 18, 62.1%) used it all 4 weeks. Most participants used the device two or more times a week (ITT: n = 30, 83.3%; PP: n = 26, 89.7%) and described the user-friendliness as rather or very easy (ITT: n = 33, 91.7%; PP: n = 26, 89.7%). User satisfaction was high (ITT: 19.42, SD = 4.08; PP: M = 20.00, SD = 4.19) and did not correlate with participants' sex or age (all p < 0.05). Depressive symptoms and psychological quality of life improved significantly from pre-to post-intervention (ITT and PP, all p < 0.05). Higher pre-intervention credibility significantly correlated with a better outcome of satisfaction (ITT and PP), depressive symptoms, physical, psychological, and social quality of life (PP; all p < 0.05).

Conclusion

A supportive therapy-accompanying VR relaxation intervention is feasible and acceptable in a psychiatric outpatient setting. Due to the high satisfaction and user-friendliness, VR can be an easy to implement relaxation tool to support psychiatric outpatients.

Clinical trial registration

https://clinicaltrials.gov/, DRKS00027911.

Stress reduction for paid home care aides: A feasibility study of mindfulness meditation and Tai Chi interventions

Evidence of effective self-care strategies to support Home Care Aides' (HCAs) mental health is limited. This study compares the feasibility of implementing one of two non-clinical, evidence-based stress-reduction treatments: mindful awareness practices (MAPs) meditation versus Korean-style Tai Chi. Program effectiveness was assessed on a range of self-reported health and mental health quantitative outcomes at three time-points. Both groups showed statistically significant improvements in depression, insomnia, and negative affect during the six weeks (all p. <0.05), but only the MAPs group demonstrated a sustained improvement in negative affect at three-month follow-up (p. <0.05). At three-month follow-up, 55% of Tai Chi participants continued practicing learned techniques, compared to 75% of MAPs participants. MAPs were found to be more practical and amenable to integration in daily life compared to Tai Chi. Showing positive results on both feasibility and effectiveness assessment, MAPs were chosen over Tai Chi to be scaled as a benefit to HCAs.

Effects of Tai Chi on Lung Function, Exercise Capacity and Psychosocial Outcomes in Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-analysis of Randomized Controlled Trials

Objectives: To explore whether tai chi can improve lung function, exercise capacity, and health-related outcomes in patients with chronic obstructive pulmonary disease (COPD). Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure (CNKI), Wanfang, and China Science and Technology Journal Database (VIP) databases were searched from inception to January 5, 2023. The methodological quality of the included studies was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions criteria. Results: A total of 1430 participants from 20 randomized controlled trials were included in this review. The results indicated significant effects of tai chi on FEV1, 6WMD, anxiety, and quality of life (p < 0.01), but not on FEV1%, FEVI/FVC, depression, and social support. Conclusions: Tai chi might be a potential alternative therapy to improve FEV1, 6WMD, anxiety, and quality of life for patients with COPD.

Multimodal Physical Exercise Affects Visuo-Spatial Working Memory: Preliminary Evidence from a Descriptive Study on Tai-Chi Practitioners and Runners

Recent evidence has shown a relationship between physical exercise (PE) and cognitive functioning. However, it is unknown if unimodal and multimodal modalities of PE affect cognitive abilities in different ways. To fill this gap, we analyzed the effects of unimodal PE (running) and multimodal PE (Tai Chi) on specific cognitive abilities. A sample of 33 participants (mean age = 52.6 ± 7.2) divided into eleven runners, eleven Tai Chi practitioners, and eleven age-matched sedentary individuals were subjected to a neuropsychological tests battery to assess shifting and problem solving abilities (Rule Shift Cards, BADS-RS, and Key Search tasks), verbal fluency (semantic and phonemic verbal fluency tasks), verbal memory (Rey's 15 words test), visuo-spatial working memory (Corsi test), and global cognitive functioning (clock-drawing test). The results showed significantly higher BADS-RS scores in runners and Tai Chi practitioners in comparison to the sedentary participants, thus evidencing improved shifting abilities for active individuals. Interestingly, post hoc analysis showed significantly higher span scores of Corsi test only in Tai Chi practitioners as compared to sedentary participants, suggesting how multimodal PE facilitates the visuo-spatial working memory processes. Although preliminary, our descriptive study indicates that the type of PE could modulate specific cognitive domains, even if the practice of motor activity favors a global cognitive improvement.

The neurobiological effects of mind-body exercise: a systematic review and meta-analysis of neuroimaging studies

The neurobiological effects of mind-body exercise on brain activation, functional neural connections and structural changes in the brain remain elusive. This systematic review and coordinate-based meta-analysis investigated the changes in resting-state and task-based brain activation, as well as structural brain changes before and after mind-body exercise compared to waitlist or active controls based on published structural or functional magnetic resonance imaging randomized controlled trials or cross-sectional studies. Electronic database search and manual search in relevant publications yielded 34 empirical studies with low-to-moderate risk of bias (assessed by Cochrane risk-of-bias tool for randomized trials or Joanna Briggs Institute's critical appraisal checklist for analytical cross-sectional studies) that fulfilled the inclusion criteria, with 26 studies included in the narrative synthesis and 8 studies included in the meta-analysis. Coordinate-based meta-analysis showed that, while mind-body exercise enhanced the activation of the left anterior cingulate cortex within the default mode network (DMN), it induced more deactivation in the left supramarginal gyrus within the ventral attention network (uncorrected ps < 0.05). Meta-regression with duration of mind-body practice as a factor showed that, the activation of right inferior parietal gyrus within the DMN showed a positive association with increasing years of practice (voxel-corrected p < 0.005). Although mind-body exercise is shown to selectively modulate brain functional networks supporting attentional control and self-awareness, the overall certainty of evidence is limited by small number of studies. Further investigations are needed to understand the effects of both short-term and long-term mind-body exercise on structural changes in the brain.PROSPERO registration number: CRD42021248984.

Boxing as an Intervention in Mental Health: A Scoping Review

Introduction: Physical activity has been shown to have a multitude of mental health benefits. However, there is limited evidence on the specific mental health benefits of boxing. We conducted a scoping review of academic and grey literature to map research of boxing exercises as an intervention in mental health and to identify gaps in knowledge. Methods: The authors utilized the PRISMA-ScR methodological approach and guidelines from the Joanna Briggs Institute and a structured search was completed from inception until August 08, 2022. Results: We identified 16 documents that used non-contact boxing as an exercise intervention that improved various mental health difficulties. Non-contact boxing exercises, usually in a high-intensity-interval training group setting, provided significant reduction in symptoms of anxiety, depression, PTSD and negative symptoms of schizophrenia. Non-contact boxing provided a cathartic release of anger and stress, with evidence of improved mood, self-esteem, confidence, concentration, metabolic burden, strength and coordination. Conclusions: Preliminary evidence indicates that non-contact boxing exercises are a promising intervention to improve mental health burden. Further well designed randomized controlled trials using group, non-contact boxing exercises as an intervention for common mental disorders are warranted to confirm its benefits for mental health.

Enhanced Integrity of White Matter Microstructure in Mind-Body Practitioners: A Whole-Brain Diffusion Tensor Imaging Study

Tai Chi Chuan (TCC) is an increasingly popular multimodal mind-body practice with potential cognitive benefits, yet the neurobiological mechanisms underlying these effects, particularly in relation to brain white matter (WM) microstructure, remain largely unknown. In this study, we used diffusion tensor imaging (DTI) and the attention network test (ANT) to compare 22 TCC practitioners and 18 healthy controls. We found extensive differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) between the two groups. Specifically, TCC practitioners had significantly different diffusion metrics in the corticospinal tract (CST), fornix (FX)/stria terminalis (ST), and cerebral peduncle (CP). We also observed a significant correlation between increased FA values in the right CP and ANT performance in TCC practitioners. Our findings suggest that optimized regional WM microstructure may contribute to the complex information processing associated with TCC practice, providing insights for preventing cognitive decline and treating neurological disorders with cognitive impairment in clinical rehabilitation.

Are tai chi and qigong effective in the treatment of TBI? A systematic review protocol

Background

Traumatic brain injury (TBI) adversely affects both young and old and is a growing public health issue. A number of recent trends in managing TBI, such as recommending sub-threshold aerobic activity, tailoring multi-modal treatment strategies, and studying the possible role of low-grade inflammation in those with persistent symptoms, all suggest that the physical and cognitive exercise of tai chi/qigong could have benefit.

Method

Designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the following databases will be searched: MEDLINE, CINAHL, Cochrane Library, Embase, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. All clinical trials on mild, moderate and/or severe TBI with tai chi and/or qigong as the treatment group and any comparison group, in any setting will be included. Four reviewers will independently select studies; two reviewers for the English and two for the Chinese databases. Cochrane-based risk of bias assessments will be conducted on all included studies. An analysis will then be conducted with the grading of recommendation, assessment, development, and evaluation (GRADE) instrument.

Results

This review will summarize the clinical trial evidence on tai chi/qigong for TBI including type of TBI, age/sex of participants, type and length of intervention and comparator, outcome measures, and any adverse events. The risk of bias will be considered, and the strengths and weaknesses of each trial will be analyzed.

Discussion

The results of this review will be considered with respect to whether there is enough evidence of benefit to merit a more definitive randomized controlled trial.Systematic Review Registration: PROSPERO [CRD42022364385].

Are movement-based mindful exercises (QIGONG, TAI CHI, AND YOGA) beneficial for stroke and Parkinson's disease? A scoping review

OBJECTIVE

To synthesize evidence from systematic reviews on the effects of qigong, tai chi, and yoga in people with neurological diseases.

METHODS

A systematic search was conducted in PubMed, PsycINFO, Embase, CINAHL and Cochrane Library until September 2022. Methodological quality was assessed using the AMSTAR 2 tool. A qualitative synthesis of included reviews and meta-analyses was performed. Citation matrices and the corrected covered area were used to explore the overlap of randomized controlled trials among reviews.

RESULTS

Nineteen systematic reviews (containing 74 trials and 80 meta-analyses) in people with Parkinson's disease (PD) or stroke were included. The critical domains of the AMSTAR 2 were not satisfied in more than half of the reviews, and only 4 evaluated the certainty of the evidence. The overlap was very high (21.7%) and high (11%) for tai chi studies in PD and stroke, respectively. In people with PD, qigong, yoga, and tai chi can improve balance, with tai chi being beneficial to increase functional mobility. For stroke patients, tai chi was better than controls to enhance motor function and independence, but not for health-related quality of life and quality of sleep. Findings on balance, walking ability and depression were inconclusive in stroke population.

CONCLUSIONS

Qigong, tai chi, and yoga appear to be effective to improve balance performance in people with PD. Tai chi practice enhances motor function and independency in stroke patients.

Pilot study of Qigong/Tai Chi Easy acute effects of meditative movement, breath focus and "flow" on blood pressure, mood and oxytocin in older adults

BACKGROUND

Older adults are increasingly lonely and at risk for hypertension. Endogenous oxytocin levels are associated with lowering blood pressure (BP), suggesting value in increasing oxytocin. Regular practice of Tai Chi improves BP and mood; we explored a single session of Tai Chi Easy (TCE) with older adults and feasibility of measuring oxytocin as a key biomarker.

METHOD

In a single-arm pre-post design pilot study, 21 older adults (age 55-80) with mild-moderate hypertension practiced a single session (50-min) TCE. BP, psychosocial measures, and saliva samples were collected pre/post to examine feasibility of acute measures of oxytocin and explore effect sizes of outcomes. Participants (N = 21; 19 % Latinx, 76.2 % female, mean age 66.76).

RESULTS

BP systolic: 138.43-134.86; diastolic 78.48-78.00 (p > .05; Cohen's d -0.23; -0.08 respectively). Total Mood Disturbance (TMD) and Connection (CN) improved [TMD mean pre 41.891 (SD=19.60) to post 35.00 (SD=10.21), p = .01; Cohen's d - 0.67); CN mean 7.85 (SD=2.01) to post 9.05 (SD=1.00), p = .01; Cohen's d 0.70]. Baseline oxytocin was positively correlated with baseline loneliness (N = 14, r = .599); pre/post oxytocin changes were negatively correlated with baseline loneliness (N = 14, r = -.585). BP decrease was associated with characteristics of the intervention: "flow" (coef=.=0.58N = 17) and meditative/breath focus (coef=-1.78; N = 17).

DISCUSSION/CONCLUSION

Medium to large effect sizes indicating change in mood and connection were found for this single session intervention. Knowing that Tai Chi improves BP when practiced over time, this TCE intervention shows promise for planning a fully powered, randomized controlled study of BP, mood and perceptions of connection in hypertensive older adults. Feasibility of assessing acute salivary oxytocin is less promising. Increase in oxytocin levels occurred for those less lonely, but declined for lonelier participants. With different responses based on baseline loneliness scores, no mean change in oxytocin levels was found. Seemingly unstable levels (possibly related to interaction with study staff) suggests the need for further testing in more controlled study designs. Finally, BP associations with meditative/breath focus and flow could be further explored in future study designs addressing mediation.

Effects of a structured Tai Chi program on improving physical activity levels, exercise self-efficacy and health outcomes among pregnant women: study protocol for a randomised controlled trial

INTRODUCTION

Tai Chi is a traditional Chinese martial art developed over 300 years ago. Although studies report that Tai Chi benefits practitioners' cardiovascular health, respiratory system and psychological outcomes, only limited studies have evaluated the effects of Tai Chi on pregnant women. More evidence is needed to examine the effects of a Tai Chi exercise programme among pregnant women.

METHODS AND ANALYSIS

This is a randomised controlled trial to investigate the effects of a 12-week theory-based Tai Chi programme on improving physical activity levels, exercise self-efficacy and health outcomes among pregnant women. A total of 136 low-risk pregnant women (68 per group) were recruited and randomly assigned to receive usual care or usual care with the Tai Chi programme consisting of two group-based educational sessions and three Tai Chi sessions over 3 months. A Tai Chi video was provided to the participants to facilitate self-practice at home. Outcomes including physical activity levels, exercise self-efficacy, weight gain, prenatal depressive symptoms and prenatal anxiety symptoms were evaluated at baseline (T0), 6th week after intervention commencement (T1) and 1 week after intervention completion (ie, post-intervention) (T2). Intention-to-treat analysis and generalised estimating equations model will be used to analyse repeated outcome measures.

ETHICS AND DISSEMINATION

The study has been approved by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (Ref. 2022.043-T). Written consent was obtained from each participant. The findings will be disseminated in peer-reviewed journals and conference presentations.

TRIAL REGISTRATION NUMBER

ChiCTR2200059920.

Is physical activity effective against cancer-related fatigue in lung cancer patients? An umbrella review of systematic reviews and meta-analyses

OBJECTIVES

To discuss the effects of physical activity on cancer-related fatigue (CRF) in lung cancer patients, summarize the types of physical activity in the published reviews, assess the quality of the evidence, and provide suggestions for the clinical selection of exercise intervention.

METHODS

PubMed, EMBASE, Web of Science, and the Cochrane Database of Systematic Reviews were searched through 8 November 2021 to identify relevant systematic reviews and meta-analyses. We also performed a manual search of the reference lists of included articles as supplements. Two researchers independently performed literature screening, data extraction, and quality assessment. The umbrella review has been registered in the International Prospective Register of Systematic Review (PROSPERO) registry (CRD42021292548).

RESULTS

From the 13 systematic reviews or meta-analyses identified, 10 physical activity interventions were included. The most mentioned intervention was aerobic combined with resistance exercise; however, no reduction of the symptoms of CRF was observed in lung cancer patients by this exercise intervention. Most of the patients who performed aerobic exercises alone showed improvement in CRF after the intervention. In addition, Tai Chi and breathing exercises have been shown to improve fatigue, but more high-quality research is still needed to support its effectiveness.

CONCLUSIONS

Aerobic exercise, respiratory muscle training, aerobic combined with balance training, and other exercise interventions have been shown to improve CRF in lung cancer patients. But it should be noted that according to the different treatment methods and disease stages of patients, individualized rehabilitation programs should be developed for patients. Due to the low methodological quality and evidence quality of some systematic reviews and meta-analyses included in this study, more high-quality clinical studies and systematic reviews are still needed for validation in the future. This umbrella review helps to identify effective ways of exercise to improve fatigue in lung cancer patients before dedicated evidence-based medical guidelines are established.

Tai Chi Exercise for Mental and Physical Well-Being in Patients with Depressive Symptoms: A Systematic Review and Meta-Analysis

Tai Chi is a mindfulness-body practice that has physiological and psychosocial benefits and can be integrated into the prevention and rehabilitation of various medical conditions; however, the effectiveness of Tai Chi in the treatment of depression remains unclear. This review aimed to determine the effects of Tai Chi exercise on mental and physical well-being in patients with depressive symptoms. We searched databases for English language publications that appeared during January 2000-2022. The included trials were RCTs that involved people with depression with no other medical conditions, and included both adolescent and adult samples. A meta-analysis was performed using a random effects model and the heterogeneity was estimated using I2 statistics. The quality of each trial was assessed according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology. The eight trials were divided into two comparisons: (1) a combination of Tai Chi and antidepressants versus standard antidepressants; (2) Tai Chi versus no intervention. The Tai Chi intervention showed improvements in mental and physical well-being as evidenced by the reductions in depression and anxiety and improved quality of life (QOL) of the patients with depressive symptoms. Further well-controlled RCTs are recommended with a precision trial design and larger sample sizes.

Inflammatory Markers of Geriatric Depression Response to Tai Chi or Health Education Adjunct Interventions

BACKGROUND

Underlying inflammation is associated with an increased risk of depression in older adults. In this study, we examined the role of inflammatory biomarkers in antidepressant response in depressed older adults undergoing adjunct Tai Chi Chih (TCC) or Health education interventions.

METHODS

Older adults aged 60 years and above with a diagnosis of major depression were randomized to 12 weeks of TCC versus Health and Wellness Education (HEW) as an adjunct therapy to their stable antidepressant treatment regimen. A panel of 19 cytokine/chemokines was measured at baseline and 12 weeks. Five factors were derived using factor analysis. General linear models were estimated to examine the change in factor scores and the association of these changes on depression remission rates, controlling for age, sex, and body mass index.

RESULTS

Of the 170 randomized participants (TCC: n = 85 and HEW: n = 85), 55 TCC and 58 HEW completed the 3-month assessment. The groups did not differ at baseline in any measure. At follow-up, neither the changes in cytokine/chemokines scores nor the depression remission rate differed significantly between TCC and HEW. However, remitters and non-remitters differed significantly in changes in a factor composed of growth-regulated oncogene protein-alpha (GRO-alpha), epidermal growth factor (EGF), and soluble CD40 ligand (sCD40L). GRO-alpha and EGF levels (in both groups) were significantly increased in remitters compared to non-remitters.

CONCLUSION

Changes in certain cytokines/chemokines may accompany improvement in depressive symptoms in older adults. Future studies will need to explore the role of these molecules in remission of late-life depression.

Tai Chi exercise improves working memory capacity and emotion regulation ability

Purpose

The study aimed to research the promoting effects of Tai Chi exercise on working memory capacity and emotional regulation ability among college students.

Methods

Fifty-five participants were recruited and randomly divided into the Tai Chi group and control group. The Tai Chi group had a 12-week Tai Chi training to implement intervention, while the control group performed non-cognitive traditional sports with the same exercise intensity as the Tai Chi group. The visual 2-back test of action pictures and the Geneva emotional picture system test were performed before and after the trial, which aimed to examine whether the action memory of Tai Chi training can improve individuals' working memory capacity and emotion regulation ability.

Results

After 12 weeks, a significant difference was observed in Accuracy Rate (AR) (F = 54.89, p ≤ 0.001) and Response Time (RT) (F = 99.45, p ≤ 0.001) of individuals' Visual Memory Capacity between the Tai Chi group and the control group. Significant effects in Time (F = 98.62, p ≤ 0.001), Group (F = 21.43, p ≤ 0.001), and Interaction (Groups × time; F = 50.81, p ≤ 0.001) on Accuracy Rate (AR) of the Visual Memory Capacity were observed. The same effect was observed again on the Response Time (RT) of the Visual Memory Capacity, Time (F = 67.21, p ≤ 0.001), Group (F = 45.68, p ≤ 0.001), Interaction (groups × time; F = 79.52, p ≤ 0.001). Post-hoc analysis showed that at the end of 12 weeks, the participants in the Tai Chi group had significantly higher Visual Memory Capacity than those in the control group (p < 0.05).After 12 weeks, valence difference (F = 11.49, p ≤ 0.001), arousal difference (F = 10.17, p ≤ 0.01), and dominance difference (F = 13.30, p ≤ 0.001) in the emotion response were significantly different between the control group and the Tai Chi group. The effect of valence differences in Time (F = 7.28, p < 0.01), Group (F = 4.16, p < 0.05), and Time*Group (F = 10.16, p < 0.01), respectively, was significant in the Tai Chi group after 12-week intervention. Post hoc analysis showed valence swings in the Tai Chi group were significantly lower than that in the control group (p < 0.05); The effect of arousal difference in Time (F = 5.18, p < 0.05), Group (F = 7.26, p < 0.01), Time*Group (F = 4.23, p < 0.05), respectively, was significant in the Tai Chi group after 12-week intervention. Post hoc analysis showed arousal fluctuations in the Tai Chi group was significantly lower than that in the control group too (p < 0.01); As the same, the effect of dominance differences in Time (F = 7.92, p < 0.01), Group (F = 5.82 p < 0.05) and Time*Group (F = 10.26, p < 0.01), respectively was significant in the Tai Chi group. Dominance swings in the Tai Chi group were significantly lower than that in the control group (p < 0.001).

Conclusion

The data support our speculation that action memory training in Tai Chi exercise may improve individuals' working memory capacity, and then improve their emotion regulation ability, which has provided insightful information for customized exercise programs for emotion regulation in adolescents. Thus, we suggest those adolescents who are experiencing volatile moods and poor emotion regulation attend regular Tai Chi classes, which could contribute to their emotional health.

Complementary and alternative therapies for generalized anxiety disorder: A protocol for systematic review and network meta-analysis

BACKGROUND

Generalized anxiety disorder (GAD) is a prevalent and impairing psychiatric disorder, which is a great threat to people's mental health, and imposes a major burden on individuals, families and society. Complementary and alternative medicine (CAM) therapies is a potential treatment for GAD, however, the selection strategies of different CAM therapies in clinical practice is still unclear, and the purpose of this study is to evaluate the efficacy and acceptability of different CAM interventions using systematic review and network meta-analysis (NMA).

METHODS

Based on the strategy, the authors will retrieve a total of 9 electronic databases by January 2023. After a series of screening, the 2 researchers will use Aggregate Data Drug Information System (ADDIS) and Stata software to analyze the data extracted from randomized controlled trials (RCTs) of CAM therapies for the GAD. Finally, the evidence grade of the results will be evaluated.

RESULTS

This study will provide a reliable evidence for the selection of CAM therapies for GAD.

CONCLUSION

The results of this study will provide references for evaluating the influence of different CAM therapies for GAD, and provide a choice basis for clinical decision-making.

Efficacy of cognitive behavioral therapy after the surgical treatment of women with endometriosis: A preliminary case-control study

BACKGROUND

Regardless of unique status or symptoms, any woman with endometriosis is at risk of developing mental health issues such as anxiety and depression. Cognitive behavioral therapy (CBT) is an effective psychological treatment for depression, anxiety, and stress. The objectives of the study were to see whether usual care combined with CBT improves depression, anxiety, and stress in patients after surgery for endometriosis as compared to usual care alone.

METHODS

Patients aged 18 to 50 years old with endometriosis who were scheduled for surgery were received usual care (Chinese martial arts) with CBT (1 pre-surgery and 6 post-surgery CBT sessions; Case or Intervention group, n = 48) or usual care only (Control group, n = 48). The demographic characteristics questionnaire was given to all individuals. Depression, anxiety, and stress were evaluated at baseline (within 24 hours after admission to the hospital) and postintervention (immediately before discharged) in both groups using the Chinese short version of Depression Anxiety and Stress scale (DASS-21).

RESULTS

At postintervention DASS-21 scores for depression, anxiety, and stress of the case group and the control group were decreased as compared to baseline (P < .0001 for all). At postintervention DASS-21 score for anxiety of the case group was decreased compared to the control group (P = .0091). Usual care plus CBT significantly increased the number of females with no symptoms of depression as compared to baseline at postintervention(s) (P = .0356). At postintervention(s), there was no female with extremely severe depression in both groups. Usual care plus CBT significantly decreased the number of females with symptoms of extremely severe anxiety as compared to baseline at postintervention(s) (P = .035). Unlike the control group, in the case group, there were no females with extremely severe stress at postintervention.

CONCLUSIONS

females with endometriosis who had surgery reported high levels of depression, anxiety, and stress at the time of hospital admission. Patients with endometriosis can benefit from CBT.

Virtual Tai Chi program for patients with irritable bowel syndrome with constipation: Proof-of-concept feasibility trial

BACKGROUND

Satisfaction with current treatment options for irritable bowel syndrome with constipation (IBS-C) is low, with many patients turning to complementary treatments. Tai Chi is a mind-body medicine practice with proven efficacy in other functional disorders. As a proof-of-concept, we tested the feasibility and preliminary clinical outcomes associated with a Tai Chi program designed for IBS-C.

METHODS

A total of 27 IBS-C patients participated in a single-arm trial of 8 sessions of Tai Chi delivered weekly over 7 weeks via live videoconferencing in group format. Clinical improvement was assessed via change in IBS Symptom Severity Score (IBS-SSS) from baseline to 4 weeks posttreatment (week 11) with secondary outcomes exploring symptom ratings, IBS-related quality of life (IBS-QOL), GI-specific anxiety, abdominal distention, and psychological factors.

KEY RESULTS

Despite substantial dropout (n = 7; 26%), the treatment protocol had moderate to excellent feasibility for other criteria. Treatment satisfaction was excellent. Exit interviews confirmed high satisfaction with the program among completers, but a high burden of data collection was noted. One participant experienced an adverse event (mild, exacerbation of sciatica). There was a significant improvement in intra-individual IBS-SSS between baseline and posttreatment (average change -66.5, 95% CI -118.6 to -14.3, p = 0.01). Secondary outcomes were notable for improvements in other IBS symptom scoring measures, IBS-QOL, measured abdominal diameter, and leg strength.

CONCLUSIONS AND INFERENCES

Our data provide preliminary evidence of the feasibility of a Tai Chi intervention for IBS-C, show promise for improving outcomes, and identify more streamlined data collection as an area for further program improvement.

Impact of Tai Chi as an adjunct treatment on brain connectivity in geriatric depression

BACKGROUND

As an adjunct to antidepressant treatment, Tai Chi Chih (TCC) is superior to health education and wellness (HEW) training in improving the general health of patients with geriatric depression (GD). This study investigated the brain connectivity changes associated with TCC and HEW in combination with antidepressant treatment in patients with GD.

METHODS

Forty patients with GD under stable antidepressant treatment underwent TCC training (n = 21) or HEW training (n = 19) for 12 weeks, and completed baseline and 3-month follow-up resting state magnetic resonance imaging scans. Within-group and between-group differences in parcel-to-parcel connectivity changes with intervention were evaluated by general linear modeling. Relationships between significant connectivity changes and symptom/resilience improvement were evaluated by partial least squares correlation analysis.

RESULTS

Significantly greater increases in connectivity with TCC than with HEW (FDR-corrected p < .05) were observed for 167 pairwise connections, most frequently involving the default mode network (DMN). In both groups, increased connectivity involving largely DMN regions was significantly and positively correlated with improvement in symptoms/resilience.

LIMITATIONS

The sample size was relatively small, mainly due to neuroimaging contraindications (e.g., implants). Additionally, the standard antidepressant treatment varied greatly among patients, adding heterogeneity.

CONCLUSIONS

Non-pharmacological adjuncts, such as TCC, may enhance DMN connectivity changes associated with improved depressive symptoms and psychological resilience in the treatment of GD.

Physical activity and subjective well-being of older adults during COVID-19 prevention and control normalization: Mediating role of outdoor exercise environment and regulating role of exercise form

Since the outbreak of the COVID-19 pandemic, the physical and mental health of older adults has been threatened. Promoting physical and mental health through physical activity has therefore become a strategy for healthy aging. In order to better understand the impact of the participation of older adults in physical activity, this paper selects different types of physical activity, and examines the relationship between them and subjective well-being through the analysis of the mediation effect of outdoor exercise environment and the regulating effect of exercise form. In this cross-sectional study, a questionnaire survey was conducted in mainland China. The main data come from 903 older adults in five urban areas in Chengdu, Sichuan Province. The surveys were carried out using the Physical Activity Rating Scale, Newfoundland Subjective Well-Being Scale, Exercise Environment Scale, and Exercise Form Scale. SPSS was used for statistical analysis, linear regression analysis was adopted for processing data, and AMOS was used to establish a mediation model. The mediating variable is the outdoor exercise environment, and the moderating variable is exercise form; gender, age, education level, and monthly income were used as control variables. The study results showed that different physical activities (tai chi; health qigong; walking and jogging) were significantly, positively correlated with the subjective well-being of older adults (tai chi: R = 0.351, p < 0.01; health qigong: R = 0.340, p < 0.01; walking and jogging: R = 0.245, p < 0.01); among the activities, tai chi had the strongest effect on the subjective well-being of older adults (R = 0.351, p < 0.01). Outdoor exercise environment played a mediating role between different physical activity types and subjective well-being of older adults [tai chi: β = 0.030, 95% CI (0.005, 0.031); health qigong: β = 0.018, 95% CI (0.000, 0.021); walking and jogging: β = 0.034, 95% CI (0.008, 0.035)]. Exercise form moderated the subjective well-being of older adults in different physical activities (tai chi: 0.006, p < 0.05; health qigong: 0.006, p < 0.05; walking and jogging: 0.009, p < 0.001). The results of this study demonstrate that the outdoor exercise environment plays a mediating role between different physical activities and the subjective well-being of older adults, and the form of exercise can also moderate the impact of different physical activities on the subjective well-being of older adults. This study has enlightening significance for psychological intervention with older adults facing stress, anxiety and depression.

Activity, Activity Personalization, and Well-Being in Nursing Home Residents With and Without Cognitive Impairment: An Integrative Review

OBJECTIVES

Engagement in personally relevant and pleasant activity is a facet of many theories of well-being. This integrated review and narrative synthesis explored the hypothesis that activity participation improves well-being for nursing home residents.

METHODS

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE, PsycINFO, Academic Search Complete, Psychology and Behavioral Sciences Collection, Embase, and CINAHL for research published between 2006 and 2018. We included peer-reviewed, English-language studies of nursing-home residents, with interventions focused on activities and on well-being or affect outcomes.

RESULTS

After screening, the search yielded 45 studies: 15 reviews of specific activities and 30 empirical articles. We found consistent support for tailored activity interventions and less consistent support for specific or generic activity interventions with the possible exception of music therapy. Research focused on specific activity types had methodological limitations and confounds with activity preferences.

CONCLUSIONS

Participation in activities may improve well-being in residents of nursing homes. Tailored activities are likely to be superior to those provided indiscriminately to all residents.

CLINICAL IMPLICATIONS

Improving quality of life in long-term care should include opportunities to engage in activities; those most effective will be tailored to individuals and no single activity will be effective for everyone.

Effects of taichi on physical and psychological health of college students: A systematic review

Background: Increasing studies have documented taichi’s usefulness in physical and psychological health in various participants, especially patients or the elderly. However, there is a need for a systematic review to evaluate its effects and health benefits among college students.

Objective:The present study aims to evaluate the current literature surrounding the effects of taichi on physical and psychological health among college students and identify the experimental areas for future research to establish guidelines for learning and teaching taichi in university.

Methods: The literature search involved several databases (PubMed, EBSCOhost, Web of Science, Scopus, and China National Knowledge Infrastructure). Subsequent research utilised the Preferred Reporting Items for Systematic Reviews and PRISMA checklist. In addition, the “QualSyst” tool assessed the quality of full-text articles.

Results: A total of 22 articles were analysed, out of which eight were strong, and 14 were of moderate quality. It is challenging to conduct a meta-analysis since the research contents were distributed differently. The general finding demonstrated that Taichi interventions have beneficial effects on college students. For example, the physical and psychological health benefits compared to other control groups include balance, leg strength, flexibility, cardiopulmonary functions, reducing stress, anxiety, and depression, and improving attention. However, there are some uncertain parameters in a state of poor or no evidence, such as upper strength, mood, and psychoticism.

Conclusion: Overall, this study shows that Taichi exercise is beneficial for college students compared to the control group. Evidence of health benefits for females is more than males. In addition, the current evidence showed that the effectiveness of taichi does not match some other sports such as Pilates, Yoga, Mindfulness courses, and even bodybuilding exercise. This research analyzed the mind-body mechanism of included studies. It revealed that it is difficult for college students, as a beginner of Taichi, to regulate an even breathing and quiet mind while maintaining low posture movements. Therefore, this study assumes that relaxation theories and approaches of Taichi that are easier to understand and closer to Chinese traditional Taichi theory are more appropriate in the research trials compared with coordination theory.

Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021278032.