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Yang F, Gelfond J, McGeary D, Perkins A, Moore AA, Song L, Escalante A, Liu W. Optimal Tai Chi forms in knee osteoarthritis: An exploration from biomechanical rationale to pain reduction. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100480. [PMID: 38800823 PMCID: PMC11126833 DOI: 10.1016/j.ocarto.2024.100480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/05/2024] [Indexed: 05/29/2024] Open
Abstract
Objectives Tai Chi (TC) shows some beneficial effects in reducing pain in knee osteoarthritis (OA). However, the selection of criteria TC forms in previous studies were unclear and inconsistent, possibly accounting for the varying outcomes and rendering the training effects suboptimal. We have selected four optimal TC (OTC) forms based on the knee joint load and its association with pain. This pilot study sought to examine the effect of the OTC forms on reducing knee pain in individuals with knee OA. Methods Fifteen knee OA participants were recruited. Their knee joint pain level was rated by using the Visual Analogue Scale before and after two weeks of OTC training and compared between these two assessments. Results The two-week OTC training course was well accepted by our participants. The knee OA pain showed a significant reduction (median pain score: 5 cm before training and 1 cm post-training, Wilcoxon p < 0.001) after the two-week training program. Conclusions Our pilot results revealed that the 2-week four-form-based OTC program could significantly reduce the knee pain level in people with knee OA. Additionally, our OTC program appears to be about 50% more effective in reducing knee pain than the existing TC-based program, which uses 10 TC forms over 12 weeks (1.59 vs. 1.06 in Hedge's g). The findings in this study may inform the development of OTC-based knee pain reduction programs and the design of relevant clinical trials to establish OTC's effectiveness, safety, and dose-response relationship in easing knee OA pain.
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Affiliation(s)
- Feng Yang
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA, 30303, USA
| | - Jonathan Gelfond
- School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Donald McGeary
- School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Allen Perkins
- School of Medicine, University of South Alabama, AL, 36688, USA
| | - Alison A. Moore
- School of Medicine, University of California, San Diego, CA, 92093, USA
| | - Lixin Song
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Agustín Escalante
- School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Wei Liu
- School of Health Professions, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
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Tao T, Shi MP, Tan BY, Zhang XS, Sun FL, Liu BR, Li SJ, Li ZH. Evaluation of traditional Chinese exercise for knee osteoarthritis (KOA): an overview of systematic reviews. Syst Rev 2024; 13:187. [PMID: 39026375 PMCID: PMC11256411 DOI: 10.1186/s13643-024-02606-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 07/07/2024] [Indexed: 07/20/2024] Open
Abstract
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.
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Affiliation(s)
- Tao Tao
- College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Ming-Peng Shi
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Bo-Yang Tan
- College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Xian-Shuai Zhang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Feng-Ling Sun
- Affiliated Hospital of the Changchun University of Chinese Medicine, Changchun, 130021, China
| | - Bao-Ren Liu
- Taojiatun Town Health Center, Gongzhuling City, Changchun, 136104, China
| | - Shao-Jun Li
- Affiliated Hospital of the Changchun University of Chinese Medicine, Changchun, 130021, China
| | - Zhen-Hua Li
- Affiliated Hospital of the Changchun University of Chinese Medicine, Changchun, 130021, China.
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de-la-Casa-Almeida M, Villar-Alises O, Rodríguez Sánchez-Laulhé P, Martinez-Calderon J, Matias-Soto J. Mind-body exercises for osteoarthritis: an overview of systematic reviews including 32 meta-analyses. Disabil Rehabil 2024; 46:1699-1707. [PMID: 37115606 DOI: 10.1080/09638288.2023.2203951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 04/13/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE To develop an overview of systematic reviews (SRs) to summarize the current evidence on the effectiveness of mind-body exercises, specifically qigong, tai chi, and yoga, on osteoarthritis-related symptoms. METHODS CINAHL, Embase, PsycINFO, PubMed, SPORTDiscus, and the Cochrane Library were searched from inception up to 20 June 2022. Pain, physical function, psychological symptoms, and quality of life were analyzed. AMSTAR 2 was used to assess the methodological quality of SRs. The primary study overlap among SRs was calculated. RESULTS A total of 13 SRs were selected, including 32 meta-analyses of interest that comprised 33 distinct primary studies. Overall, qigong, tai chi, and yoga-based interventions may improve osteoarthritis-related symptoms, mainly physical function. However, no SRs were judged to have high methodological quality. Only three SRs judged certainty of evidence using a gold standard for it. The primary study overlap was very high for SRs covering tai chi or yoga trials. CONCLUSIONS There was a positive tendency in favor of these mind-body exercises for improving pain, arthritis self-efficacy, and mainly, physical function. Unfortunately, no clinical recommendations can be made due to the high number of methodological concerns that were described above. New high-quality SRs covering this topic are needed.
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Affiliation(s)
- Maria de-la-Casa-Almeida
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
| | - Olga Villar-Alises
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - Pablo Rodríguez Sánchez-Laulhé
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - Javier Matias-Soto
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
- Department of Physical Therapy, Faculty of Health Sciences, Universidad de Malaga, Malaga, Spain
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Alpay K, Sahin M. Effects of basic body awareness therapy on pain, balance, muscle strength and functionality in knee osteoarthritis: a randomised preliminary trial. Disabil Rehabil 2023; 45:4373-4380. [PMID: 36444879 DOI: 10.1080/09638288.2022.2151650] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 11/20/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aimed to investigate the effects of basic body awareness therapy (BBAT) on pain, balance, muscle strength, and functionality in knee OA. METHODS Forty patients (mean age: 55.20 ± 6.40 years) with knee OA were randomly assigned to experimental and control groups. Both groups participated in a home-based exercise programme. The home-based exercise programme was performed daily for 6 weeks. In addition to the home-based programme, patients in the experimental group participated in BBAT 3 days a week for 6 weeks. The visual analogue scale, fall risk assessment, single-leg stability test, knee extension muscle strength, five times sit-to-stand test, joint range of motion assessment, Western Ontario and McMaster Universities Osteoarthritis Index, 6-minute walk test, and stair climb test were performed at baseline and after 6 weeks. RESULTS All outcomes in the experimental group significantly improved after 6 weeks (p < 0.05). There were significant differences between the two groups in terms of the experimental group in muscle strength (p = 0.018, η2= 0.191), five times sit-to-stand test (p < 0.001, η2= 0.510), and the stair climbing test (p = 0.012, η2=0.212). CONCLUSION This study showed that BBAT, in addition to a home-based exercise programme, can improve muscle strength and functionality in patients with knee OA. CLINICAL TRIAL REGISTRATION NUMBER NCT04165187.
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Affiliation(s)
- Kubra Alpay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
- Health Sciences Institute, Istanbul Medipol University, Istanbul, Turkey
| | - Mustafa Sahin
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
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Irnich D, Bäumler P. [Concept for integrative pain treatment of osteoarthritis of the knee based on the evidence for conservative and complementary therapies]. Schmerz 2023; 37:413-425. [PMID: 37505229 DOI: 10.1007/s00482-023-00739-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/09/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Osteoarthritis of the knee (gonarthritis) represents a medical challenge. RESEARCH QUESTION What is the evidence with respect to approaches of complementary medicine and their integration into multimodal pain management concepts? MATERIAL AND METHODS Qualitative nonsystematic literature search on the epidemiology and pathophysiology as well as informative clinical trials, meta-analyses and clinical guidelines about conservative treatment including complementary therapy for gonarthritis. RESULTS Osteoarthritis of the knee is a frequent condition with biopsychosocial risks factors for chronification. The German S2k clinical guideline (k = consensus-based, not based on scientific systematic literature searches) published by the Association of the Scientific Medical Societies in Germany (AWMF) in 2017 has not yet been updated. The current guidelines of the American College of Rheumatology (ACR) date from 2020. Both guidelines recommend exercise therapy, weight reduction, short-term analgesics, topical therapy, intra-articular corticoid injections and acupuncture with variable strengths. Furthermore, transcutaneous electrical nerve stimulation (TENS), laser and other electrophysical therapies, shock waves, traction treatment, ergotherapy, comfrey poultices and mudpacks can also be used. Current research supports the benefits of tai chi/qigong and medicinal leaches. CONCLUSION Complementary treatment approaches, such as acupuncture, tai chi/qigong, topical naturopathic self-treatment and leeches (with limitations) can, in addition to behavioral changes, exercise therapy and short-term pharmacological treatment, be important evidence-based components of integrative pain management concepts, e.g. in terms of an interdisciplinary multimodal pain treatment (IMPT). Besides pain reduction and functional improvement they promote the internal control conviction through the possibility of self-treatment and self-exercise.
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Affiliation(s)
- Dominik Irnich
- Interdisziplinäre Schmerzambulanz, Klinik für Anaesthesiologie, Klinikum der Ludwig-Maximilians-Universität München, LMU München, Campus Innenstadt, Pettenkoferstr. 8a, 80336, München, Deutschland.
| | - Petra Bäumler
- Interdisziplinäre Schmerzambulanz, Klinik für Anaesthesiologie, Klinikum der Ludwig-Maximilians-Universität München, LMU München, Campus Innenstadt, Pettenkoferstr. 8a, 80336, München, Deutschland
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Ye Y, Liu A. The Effectiveness of Tai Chi for Knee Osteoarthritis: An Overview of Systematic Reviews. Int J Gen Med 2023; 16:4499-4514. [PMID: 37814642 PMCID: PMC10560483 DOI: 10.2147/ijgm.s434800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/22/2023] [Indexed: 10/11/2023] Open
Abstract
Background Knee Osteoarthritis (KOA) has become a serious health issue for elderly patients. Several systematic reviews (SRs) have reported Tai Chi has widely been used in the treatment of KOA. However, the methodology and conclusions of these SRs are controversial. This overview aims to summarize and evaluate the available evidence for the efficacy and safety of Tai Chi for KOA. Methods Two independent researchers searched eight databases from the inception to April 30, 2022. The included SRs were assessed respectively by A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, the Risk of Bias in Systematic Reviews (ROBIS) tool, and the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) statement. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to assess the quality of the included SRs in terms of outcome indicators. Results Six SRs were finally included in this overview. The results of methodological quality, reporting quality, and risk of bias of the included SRs were generally unsatisfactory. The limitations were a lack of explaining the reasons for selection, a list of excluded literature, reporting bias assessment, and reporting the potential sources of conflict of interest. In addition, only 1 item was assessed as moderate quality by using the GRADE tool. Limitations were the most common downgraded factors. Conclusion Tai Chi is effective as a non-pharmacological intervention in the integrative treatment of KOA. However, the quality of evidence and methodological quality of SRs is generally unsatisfactory, suggesting that these results must be interpreted with caution. Trial Registration/Protocol Registration PROSPERO registration number: CRD42022315146.
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Affiliation(s)
- Yuntian Ye
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, People’s Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, People’s Republic of China
| | - Aifeng Liu
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, People’s Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, People’s Republic of China
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Zhang N, Cui H, Li H, Yang Y, Gao Z, Zeng X, Sun X, Bu H, Wang H. Effects of Tai chi in knee osteoarthritis patients: An overview of systematic reviews and meta-analyses. Complement Ther Med 2023; 77:102978. [PMID: 37634763 DOI: 10.1016/j.ctim.2023.102978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/13/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE Tai Chi (TC) is a complementary therapy for knee osteoarthritis (KOA). Although systematic reviews (SRs) and meta-analyses (Mas) of efficacy studies have been published, the results remain uncertain, and their quality has not yet been fully evaluated. Here, we summarize the existing SRs/Mas, evaluate their quality and level of evidence, and provide a reference for the effectiveness of TC. METHODS SRs/Mas of TC therapy for KOA published before February 2023 were retrieved from eight databases in Chinese and English. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, and the Risk of Bias in Systematic (ROBIS) scale were used to assess methodological quality, reporting quality, and risk of bias. RESULTS Seven SRs/Mas were finally included. One was deemed high quality by AMASTAR-2, while the rest were of critically low quality. In the PRISMA2020 assessment, the response rate of "Yes" for Q7, Q15, Q22, Q24, and Q27 was less than 50%. In the ROBIS assessment, three reports in Phase 3 were high risk and four were low risk. In the efficacy assessment, TC has shown varying degrees of improvement in physical function, pain, stiffness, 6-minute walk test, mental quality of life, TUG, and balance in patients with KOA. CONCLUSION TC effectively treats KOA-associated pain, stiffness, body function, and mental quality of life. However, the low methodological quality of the studies and the high risk of migration reduced their reliability. Therefore, these conclusions should be taken with caution. High-quality, large-sample research is needed to provide stronger and more scientific evidence.
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Affiliation(s)
- Naijin Zhang
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Huaixing Cui
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongyu Li
- Department of Orthopedics, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Heilongjiang, China
| | - Yuhang Yang
- Department of Orthopedics, The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhuo Gao
- Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xianyue Zeng
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xuan Sun
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Huaien Bu
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongwu Wang
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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Yue H, Li Y, Ma J, Xie C, Xie F, Cai J, Fang M, Yao F. Effect of Tai Chi on knee pain and muscle strength in middle-aged and older adults with knee osteoarthritis: a randomized controlled trial protocol. BMC Complement Med Ther 2023; 23:256. [PMID: 37474949 PMCID: PMC10360298 DOI: 10.1186/s12906-023-04070-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a common public health problem and a leading cause of long-term pain, decreased muscle strength, and even disability. Tai Chi has been proved effective and highly recommended for KOA management worldwide. However, little is known about its benefits on quadriceps strength which is closely associated with relieving knee pain. This trial is designed to evaluate the efficacy and safety of Tai Chi on knee pain and muscle strength in middle-aged and older adults with KOA. METHODS A total of 100 participants will be randomly divided into a Tai Chi group (TC group) (1x/week for 12 weeks) and a control group with a health education and stretching program (1x/week for 12 weeks) with a follow-up period of 6 weeks. The primary outcome is the change of Western Ontario and McMaster Universities (WOMAC) pain subscale at week 12 compared with baseline. Secondary outcomes include WOMAC stiffness and function subscales, data from isokinetic dynamometry, gait analysis with electromyography (EMG), and a 36-item short form health survey (SF-36). The daily dose of pain-relieving medication will also be recorded. All adverse effects will be assessed by the Treatment Emergent Symptom Scale (TESS). DISCUSSION We expect this randomized trial to evaluate the effectiveness of Tai Chi on relieving pain and increasing quadriceps strength in KOA patients. This protocol, if proven effective, will contribute to providing a promising alternative intervention for middle-aged and older adults with KOA. TRIALS REGISTRATION NUMBER This trial has been registered in the China Clinical Trials Registry (registration number: ChiCTR2300069339).
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Affiliation(s)
- Hongyu Yue
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yang Li
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianwen Ma
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chaoqun Xie
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fangfang Xie
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Junhao Cai
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Fang
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Fei Yao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Wan R, Shi J, Hu K, Wang Y, Jiang X, Yan W, Cao M, Wang Y. Effect of different weekly frequencies of Chen-style Tai Chi in elders with chronic non-specific low back pain: study protocol for a randomised controlled trial. Trials 2022; 23:951. [PMID: 36414978 PMCID: PMC9682833 DOI: 10.1186/s13063-022-06909-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Tai Chi (TC), as one of mild to moderate exercise therapies specifically recommended by clinical practice guideline from the American College of Physician, is a viable option for chronic non-specific low back pain (CNLBP) treatment. Nevertheless, limited studies focused on the effect of different weekly frequencies of TC in elders with CNLBP. This superiority study aims to compare the differences of TC with different weekly frequencies in elders with CNLBP on the premise of proving its effectiveness, and identifying whether mindfulness mediates the effect of TC on treatment outcomes. METHODS In total, 284 senior citizens with CNLBP will be recruited in this single-centre, randomised, single-blinded (outcome assessors, data managers and the statistician), parallel controlled trial. Participants will be randomly divided into either one of three TC groups (1, 3, or 5 sessions/week, on the basis of weekly health educational lectures) or weekly health educational lectures, sustaining for 12 weeks, followed by 12 weeks of follow-up after the end of intervention. The primary outcome (the changes of LBP intensity at rest) will be measured at baseline before randomisation and immediately after the completion of weeks 4, 8 and 12 of the intervention, and the end of follow-up (week 24) using the visual analogue scale (VAS, 0-10 cm) to put a mark on the VAS scale to show how severities of their average low back pain have been over the past 24 h. Secondary outcomes, including Beck Depression Inventory-II, Pain Catastrophising Scale and Five Facet Mindfulness Questionnaire, Oswestry Disability Index and Short Form-36, will be measured at baseline and immediately after the completion of week 12 of the intervention and end of follow-up. The intention-to-treat and per-protocol principles will be used to analyse outcomes with a setting at α = 0.05 as statistical significance. DISCUSSION This comprehensive and detailed protocol will be the first trial to compare the effectiveness of different weekly frequencies of TC in elders with CNLBP. The outcomes may provide valuable data about the choice of the ideal number of sessions to further normalise the application of exercise for clinicians. TRIAL REGISTRATION Chinese clinical trial registry ChiCTR2200058190 . Registered on 1 April 2022.
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Affiliation(s)
- Ruihan Wan
- grid.411504.50000 0004 1790 1622College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China ,grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China
| | - Jian Shi
- grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China ,grid.443556.50000 0001 1822 1192College of Kinesiology, Shenyang Sport University, Shenyang, China
| | - Kun Hu
- grid.443556.50000 0001 1822 1192College of Kinesiology, Shenyang Sport University, Shenyang, China
| | - Yafei Wang
- grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China
| | - Xue Jiang
- grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China ,grid.412543.50000 0001 0033 4148Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Wangwang Yan
- grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China ,grid.412543.50000 0001 0033 4148Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Mali Cao
- Department of Rehabilitation, Changsha Social Work College, Changsha, China
| | - Yuling Wang
- grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China
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Wen YR, Shi J, Wang YF, Lin YY, Hu ZY, Lin YT, Wang XQ, Wang YL. Are Mind-Body Exercise Beneficial for Treating Pain, Function, and Quality of Life in Middle-Aged and Old People With Chronic Pain? A Systematic Review and Meta-Analysis. Front Aging Neurosci 2022; 14:921069. [PMID: 35800981 PMCID: PMC9255956 DOI: 10.3389/fnagi.2022.921069] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
Background Aging is a significant risk factor in chronic pain development with extensive disability and greater health care costs. Mind-body exercise (MBE) has been scientifically proven to affect the pain intensity and physical health. Objectives To assess the effects of MBE modes (Tai Chi, yoga, and qigong) for treating chronic pain among middle-aged and old people, compared with nonactive and active treatment, as well as function, quality of life, and adverse events. Methods We searched PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Scientific Journals Full-Text Database (VIP) till March 2022. No restrictions were chartered within the year and language of publication. We included randomized controlled trials of MBE treatment in middle-aged and elderly people with chronic pain. The overall certainty of evidence was evaluated by using the GRADE approach. Results A total of 17 studies (n = 1,332) were included in this review. There was low-certainty evidence indicating that MBE had a moderate effect on reducing pain compared with the nonactive and active control group (standard mean difference (SMD): −0.64, 95% confidence interval (CI): −0.86 to −0.42, P < 0.001). Very-low-certainty evidence showed that the pooled SMD for the functional improvement was −0.75 (95% CI: −1.13 to −0.37, P < 0.001). Low-certainty evidence presented that no influence was observed in physical component summary (SMD: 0.23, 95% CI: −0.16 to 0.62, P = 0.24) and mental component summary (SMD: −0.01, 95% CI −0.39 to 0.36, P = 0.95). Conclusion Our results indicated that MBE was an effective treatment for reducing symptoms of middle-aged and elderly people with chronic pain compared with nonactive and active control groups. TC and qigong had obvious benefits for knee osteoarthritis in self-reported function, but the efficacy of chronic low back pain was uncertain. No significant benefit of MBE on quality of life in older adults with chronic pain was found. More high-quality RCTs should be conducted to explore the efficacy and mechanism of MBE on chronic pain in middle-aged and elderly people from various dimensions, such as affective and cognitive dimensions. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=316591, identifier CRD42022316591.
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Affiliation(s)
- Yu-Rong Wen
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Shi
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ya-Fei Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yang-Yang Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zheng-Yu Hu
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - You-Tian Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
- *Correspondence: Xue-Qiang Wang
| | - Yu-Ling Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Yu-Ling Wang
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Song J, Wei L, Cheng K, Lin Q, Xia P, Wang X, Wang X, Yang T, Chen B, Ding A, Sun M, Chen A, Li X. The Effect of Modified Tai Chi Exercises on the Physical Function and Quality of Life in Elderly Women With Knee Osteoarthritis. Front Aging Neurosci 2022; 14:860762. [PMID: 35721018 PMCID: PMC9204295 DOI: 10.3389/fnagi.2022.860762] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022] Open
Abstract
Background Knee osteoarthritis (KOA) is the leading cause of pain and stiffness, affecting older adults’ physical function and quality of life. As a form of mind-body exercise, Tai Chi has been recommended as an exercise prescription for KOA patients. This study examined the effects and continuation of modified Tai Chi exercises on physical function and quality of life in elderly women with KOA. Methods We conducted a single-blind, randomized controlled trial (RCT) on 40 older women with KOA. The participants were randomized to a 12 weeks Tai Chi or control group. The Tai Chi group attended a kind of modified Tai Chi training sessions three times per week; the control group attended wellness education sessions once a week. The primary outcome was the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Secondary outcomes were the Berg Balance Scale (BBS), Timed Up and Go (TUG), Short-Form 36 (SF-36), Pittsburgh Sleep Quality of Index (PSQI), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). Results After the 12-weeks the Tai Chi group showed significan improvement in the WOMAC pain (mean difference, −5.09 points, p = 0.001), WOMAC stiffness (mean difference, −3.60 points, p = 0.002), WOMAC physical function (mean difference, −11.21 points, p = 0.001) compared to the control group. In addition, the Tai Chi group had also significant improvement in the BBS (mean difference, 1.70 points, p = 0.008), TUG (mean difference, −0.52s, p = 0.001), SF-36PCS (mean difference, 7.60 points, p = 0.001), MCS (mean difference, 7.30 points, p = 0.001), PSQI (mean difference, −3.71 points, p = 0.001), SDS (mean difference, −5.37 points, p = 0.025) and SAS (mean difference, −5.06 points, p = 0.002). Conclusion The modified Tai Chi exercises are an effective treatment for improved physical function and quality of life in elderly women with KOA. Clinical Trial Registration The trial was registered in Chinese Clinical Trial Registry (ChiCTR2000040721), http://www.chictr.org.cn/edit.aspx?pid=65419&htm=4.
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Affiliation(s)
- Jiulong Song
- Department of Sports and Health, Nanjing Sport Institute, Nanjing, China
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lijun Wei
- Maigaoqiao Community Health Service Center, Nanjing, China
| | - Kai Cheng
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Qiang Lin
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Peng Xia
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xinwei Wang
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiaoju Wang
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Ting Yang
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Baoyi Chen
- Maigaoqiao Community Health Service Center, Nanjing, China
| | - Aimei Ding
- Maigaoqiao Community Health Service Center, Nanjing, China
| | - Mingyi Sun
- Department of Tourism and Social Management, Nanjing Xiaozhuang University, Nanjing, China
| | - Anliang Chen
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Anliang Chen Xueping Li
| | - Xueping Li
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Anliang Chen Xueping Li
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Zheng H, Zhang D, Zhu Y, Wang Q. Effect of Tai Chi exercise on lower limb function and balance ability in patients with knee osteoarthritis: A protocol of a randomized controlled trial. Medicine (Baltimore) 2021; 100:e27647. [PMID: 34797287 PMCID: PMC8601362 DOI: 10.1097/md.0000000000027647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a chronic degenerative joint disease commonly occurring in middle-aged and elderly people. The main clinical manifestations are joint pain, limited activity, and decreased muscle strength resulting in decreased motor control ability. Exercise therapy is an effective method to enhance muscle strength of lower limbs, while China's traditional skill Tai Chi (TC) is a combination of activity and inertia, internal and external exercise therapy. In recent years, scholars at home and abroad have found that regular TC can effectively improve patients' lower limb function and balance ability. The purpose of this study is to explore the effects of TC on lower limb function and balance ability in patients with KOA. METHODS This is a prospective randomized controlled clinical trial. One hundred forty-six cases of KOA patients will be randomly divided into experimental group and control group according to 1:1 ratio, 73 cases in each group, the control group: sodium hyaluronate; experimental group: TC added on the basis of the control group. Both groups will receive standard treatment for 5 weeks and will be followed up for 3 months. Observation indicators include: the western Ontario and McMaster universities osteoarthritis index; hospital for special surgery knee score; balance stability index, liver and kidney function, adverse reaction rate, etc. SPSS 23.0 software will be used for data analysis. DISCUSSION This study will evaluate the effects of TC on lower limb function and balance ability of patients with KOA. The results of this trial will provide a clinical basis for the selection of exercise therapy for patients with KOA.
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Affiliation(s)
- Haoyun Zheng
- Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Dong Zhang
- Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Yonggang Zhu
- Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Qingfu Wang
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
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2021 revised algorithm for the management of knee osteoarthritis-the Chinese viewpoint. Aging Clin Exp Res 2021; 33:2141-2147. [PMID: 34189714 PMCID: PMC8302513 DOI: 10.1007/s40520-021-01906-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/01/2021] [Indexed: 12/19/2022]
Abstract
AIM The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) algorithm for the management of knee osteoarthritis (OA) is available worldwide from 2014, but in 2019 an update was published. Based on this algorithm, a Working Group (WG), including ESCEO members and Chinese experts, wished to see how the new ESCEO algorithm was perceived by Chinese experts in knee OA and how it was integrated into their clinical practice. METHODS A WG was held between members of the international ESCEO task force and a group of Chinese experts. RESULTS Non-pharmacological approach should be combined with pharmacological interventions. In step 1, symptomatic slow-acting drugs for osteoarthritis (SYSADOA) are the most important background drugs. Evidence, supported by high-quality research, is available only for crystalline glucosamine sulfate (pCGS) and chondroitin sulfate. Topical NSAIDs could be used as an additional option. In step 2, oral NSAIDs could be useful, but cardiovascular/renal/gastrointestinal profiles of the patients should be considered. Intra-articular hyaluronic acid and corticosteroids are alternative to oral NSAIDs, but the evidence is still limited. If steps 1 and 2 are not sufficient, weak opioids could be used. Overall, the conclusions of the ESCEO algorithm are accepted in China for products available in this country. The WG suggests the importance of economic studies, specifically made in China. CONCLUSION This work provides evidence-based advice to establish a treatment algorithm in knee OA, for practical implementation in clinical practice in China.
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2019 revised algorithm for the management of knee osteoarthritis: the Southeast Asian viewpoint. Aging Clin Exp Res 2021; 33:1149-1156. [PMID: 33774784 PMCID: PMC8081679 DOI: 10.1007/s40520-021-01834-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/11/2021] [Indexed: 02/06/2023]
Abstract
Background Since 2014, the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) algorithm for the management of knee osteoarthritis (OA) is available worldwide. Aim Based on this document, a Southeast Asia Working Group (SEAWG) wished to see how the new ESCEO algorithm developed in 2019 was perceived by Southeast Asian experts and how it was integrated into their clinical practice. Methods A SEAWG was set up between members of the international ESCEO task force and a group of Southeast Asian experts. Results Non-pharmacological management should always be combined with pharmacological management. In step 1, symptomatic slow-acting drugs for osteoarthritis are the main background therapy, for which high-quality evidence is available only for the formulations of patented crystalline glucosamine sulfate and chondroitin sulfate. In step 2, oral NSAIDs are a useful option, considering the cardiovascular/renal/gastrointestinal profiles of the individual patient. Intra-articular hyaluronic acid and corticosteroids are a possible alternative to oral NSAIDs, but limited evidence is available. If steps 1 and 2 do not give adequate relief of symptoms, tramadol can be used, but its safety is debated. In general, the indications of the ESCEO algorithm are important in Southeast Asian countries, but the reimbursement criteria of local health systems are an important aspect for adherence to the ESCEO algorithm. Conclusion This guidance provides evidence-based and easy-to-follow advice on how to establish a treatment algorithm in knee OA, for practical implementation in clinical practice in Southeast Asian countries.
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Zhang W, Roster K, Hays RD, Wang C. Analysis of Movement-Based Mind-Body Interventions to Guide the Implementation of Osteoarthritis Exercise Programs: A Descriptive Review of Randomized Controlled Trials. J Altern Complement Med 2021; 27:442-457. [PMID: 33902322 DOI: 10.1089/acm.2020.0420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Clear and complete reporting of the components of complex interventions is required in clinical trials to ensure that research can be reliably replicated and successfully translated into clinical practice. Movement-based mind-body exercises, such as Tai Chi, qigong, and Yoga (TQY), are considered complex interventions and recommended for individuals with osteoarthritis in the latest guidelines of the American College of Rheumatology. This review analyzes the intervention reporting of randomized controlled trials of TQY to guide the implementation in osteoarthritis exercise programs. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, and EMBASE for TQY exercise trials in osteoarthritis between 2000 and 2020. Pairs of researchers independently screened the records, extracted study characteristics, and assessed 19 items on the Consensus on Exercise Reporting Template (CERT) checklist. For each of these items, the numbers of studies that clearly reported the item were calculated. We then identified the items in the studies that are key to delivering home-based exercises for further analysis. Results: We included 27 publications reporting 22 TQY interventions in the analysis. None of the studies reported sufficient details on all the 19 CERT items. The median completeness of reporting score was 11 and ranged from 6 to 15 of 19. The most frequently incompletely reported items (number reporting and percentage of studies) were "starting level rule" (n = 1, 5%) and "progression rule" (n = 1, 5%). Other incompletely reported items included "fidelity or adherence (planned)" (n = 9, 41%), "motivations" (n = 9, 41%), and "progression description" (n = 5, 23%). Conclusions: The content analysis highlights motivational strategies for long-term adherence to home-based exercises, which may help clinicians develop interventions for their patients. Details of TQY exercises interventions for osteoarthritis are incompletely reported in the included studies. The study suggests that improvements in content reporting are especially needed on items related to exercise intensity and program progression decisions, and motivational strategies in future implementation.
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Affiliation(s)
- Weijun Zhang
- Center for East-West Medicine, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.,Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Ron D Hays
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chenchen Wang
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Department of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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Choo YT, Jiang Y, Hong J, Wang W. Effectiveness of Tai Chi on quality of life, depressive symptoms and physical function among community-dwelling older adults with chronic disease: A systematic review and meta-analysis. Int J Nurs Stud 2020; 111:103737. [DOI: 10.1016/j.ijnurstu.2020.103737] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/29/2020] [Accepted: 07/24/2020] [Indexed: 12/29/2022]
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Yu H, Wang H, Cao P, Ma T, Zhao Y, Xie F, Yao C, Zhang X. Complementary and alternative therapies for knee osteoarthritis: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2020; 99:e23035. [PMID: 33126393 PMCID: PMC7598879 DOI: 10.1097/md.0000000000023035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/07/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a degenerative disease, making a unique contribution to chronic pain, edema, and limited mobility of knee joint. This disease is an important factor affecting the quality of life of middle-aged and elderly people. Complementary and alternative medicine (CAM) therapies have been used clinically to treat KOA; however, the selection strategies of different CAM interventions in clinical practice are still uncertain, and the purpose of this study is to evaluate the efficacy and acceptability of different CAM therapies using systematic review and network meta-analysis. METHODS According to the strategy, the authors will retrieve a total of 7 electronic databases by October 2020, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chongqing VIP, and Wan-fang databases After a series of screening, 2 researchers will use Aggregate Data Drug Information System and Stata software to analyze the data extracted from the randomized controlled trials of CAM therapies for the KOA. 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 KOA. CONCLUSION The results of this study will provide references for evaluating the influence of different CAM therapies for KOA, and provide decision-making references for clinical research. ETHICS AND DISSEMINATION This study does not require ethical approval. The results will be disseminated through a peer-reviewed publication. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/GJMF4.
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Affiliation(s)
- Haiyang Yu
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
- Department of Orthopedics
| | - Haiyan Wang
- Department of Acupuncture and Moxibustion, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu Province, China
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Panju Cao
- Department of Spine, Baoji Hospital of Traditional Chinese Medicine, Baoji, Shanxi Province, China
| | - Tao Ma
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
| | | | - Feiyang Xie
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
| | - Chuanjiang Yao
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
| | - Xiaogang Zhang
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
- Department of Orthopedics
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Effectiveness of Traditional Chinese Exercise for Symptoms of Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217873. [PMID: 33121082 PMCID: PMC7662219 DOI: 10.3390/ijerph17217873] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022]
Abstract
Background: Growing evidences have advocated the potential benefits of traditional Chinese exercise (TCE) on symptomatic improvement of knee osteoarthritis (KOA). However, most of them have been derived from cross-sectional studies or case reports; the effectiveness of TCE therapies has not been fully assessed with a randomized control trial (RCT). In order to evaluate the combined clinical effectiveness of TCE for KOA, we conducted a systematic review and meta-analysis on the existing RCTs on KOA. Methods: A systematic search was performed in four electronic databases: PubMed, Web of Science, Cochrane Library, and EMBASE from the time of their inception to February 2020. All eligible RCTs were included in which TCE was utilized for treating KOA as compared to a control group. Two reviewers independently extracted the data and evaluated the risk of bias following the Cochrane Risk of Bias Tool for RCT. The symptoms of KOA evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were regarded as the primary outcomes in this study. Each outcome measure was pooled by a standardized mean difference (SMD) with 95% confidence intervals (CI). A meta-analysis was applied with a random or fixed effect model for the collected data to calculate the summary SMD with 95% CI based on different statistical heterogeneity. In addition, subgroup analyses were used to investigate heterogeneity and sensitivity analysis was carried out for the results of the meta-analysis. Egger’s test and the funnel plots were used to examine the potential bias in the RCTs. Results: A total of 14 RCTs involving 815 patients with KOA were included. Compared with a control group; the synthesized data of TCE showed a significant improvement in WOMAC/KOOS pain score (SMD = −0.61; 95% CI: −0.86 to −0.37; p < 0.001), stiffness score (SMD = −0.75; 95% CI: −1.09 to −0.41; p < 0.001), and physical function score (SMD = −0.67; 95% CI: −0.82 to −0.53; p < 0.001). Conclusions: Our meta-analysis suggested that TCE may be effective in alleviating pain; relieving stiffness and improving the physical function for patients with KOA. Yet; given the methodological limitations of included RCTs in this meta-analysis; more high-quality RCTs with large sample size and long-term intervention are required to further confirm the effectiveness and underlying mechanisms of TCE for treating KOA.
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Wu HY, Wang YR, Wen GW, Tang ZY, Yu YQ, Zhang JR, Liu P, Wu JH. Tai Chi on bone mineral density of postmenopausal osteoporosis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21928. [PMID: 32899027 PMCID: PMC7478652 DOI: 10.1097/md.0000000000021928] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Osteoporosis is a clinically common metabolic disease, especially in postmenopausal women. Tai Chi might be beneficial in osteoporosis patients. This study will be performed to examine the effects of Tai Chi on bone mineral density of postmenopausal osteoporosis. METHODS We will search the electronical databases and hand-searching journals or reference lists. The study screening and data extraction will be carried out by 2 investigators independently. The primary outcome is bone mineral density (lumbar spine, Ward's triangle, trochanter, proximal femur, femoral neck, or total hip). Secondary outcomes are pain score, alkaline phosphatase, osteocalcin, and adverse effects. Review Manager V.5.3 software will be used to compute the data. RESULTS The results of the study will provide a reliable evidence to assess the effects of Tai Chi on bone mineral density of postmenopausal osteoporosis. CONCLUSION The conclusion of our systematic review will answer whether Tai Chi is an effective intervention to improve bone mineral density of postmenopausal osteoporosis.
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Affiliation(s)
- Hai-Yang Wu
- Huangpu Branch, Shanghai Ninth People′s Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Yi-Ru Wang
- Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guo-Wei Wen
- Huangpu Branch, Shanghai Ninth People′s Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Zhen-Yin Tang
- Huangpu Branch, Shanghai Ninth People′s Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Yi-Qun Yu
- Huangpu Branch, Shanghai Ninth People′s Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Ji-Ren Zhang
- Huangpu Branch, Shanghai Ninth People′s Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Ping Liu
- Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jun-Hao Wu
- Huangpu Branch, Shanghai Ninth People′s Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
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Ren R, Tang G, Tang C, Zhang J, Xiao X, Zhang Q. The Tai Chi training for middle-aged and elderly patients with knee osteoarthritis: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2020; 99:e20242. [PMID: 32443360 PMCID: PMC7254839 DOI: 10.1097/md.0000000000020242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/14/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a disabling joint disease with an increasingly prevalence among the older individuals. Tai Chi, one of the ancient meditative movements, has been recognized to have clinical benefits for KOA. We aim to evaluate the efficacy and safety of Tai Chi for patients with KOA through this systematic review. METHODS Five English databases (Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, and CINAHL), 4 Chinese databases (CBM, CNKI, CQVIP, and Wanfang), and 5 clinical trial registration databases (ClinicalTrials.gov, ANZCTR, EU-CTR, ChiCTR, and ICTRP) will be searched from establishment of the database until November 31, 2019. Grey literature will be searched in SIGLE, Grey Net, Microsoft Academic, Google Scholar, Open Aire, World Wide Science.org, and WorldCat. There will be no restrictions on language. The randomized controlled trials of Tai Chi training for patients with KOA will be included. The primary outcome will be assessed according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Meta-analysis will be conducted with the use of RevMan 5.3. The specific process will refer to the Cochrane Handbook 5.1 for Systematic Review. RESULTS High-quality synthesis of current evidence on the efficacy and safety of Tai Chi training for KOA will be provided in this study. CONCLUSION This systematic review aims to present evidence for whether Tai Chi training is an effective intervention which can improve both physical condition and life quality in patients suffering KOA.
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Zampogna B, Papalia R, Papalia GF, Campi S, Vasta S, Vorini F, Fossati C, Torre G, Denaro V. The Role of Physical Activity as Conservative Treatment for Hip and Knee Osteoarthritis in Older People: A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:jcm9041167. [PMID: 32325775 PMCID: PMC7230847 DOI: 10.3390/jcm9041167] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/22/2020] [Accepted: 04/13/2020] [Indexed: 12/15/2022] Open
Abstract
The aim of this systematic review and meta-analysis is to determine the role of physical activity as a conservative treatment for older people with knee or hip osteoarthritis. The effect on pain, physical function, stiffness, quality of life, and dynamic balance of Aquatic Exercise, Land-based Exercise, and Sports were compared in a specific population composed of osteoarthritic patients aged 65 or over. A systematic search using Pubmed-Medline, Google Scholar, and the Cochrane Library was carried out to select randomized clinical trials, observational studies, or case series that evaluated outcome measures after physical activity. Twenty randomized controlled trials (RCTs) and two case series were included in this review. Four trials were at low risk of bias (A), 12 at unclear risk of bias (B), and four at high risk of bias (C). Compared to controls, Aquatic Exercise, Land-based Exercise, Tai Chi, and Yoga showed a small to high effect for improving pain, physical function, quality of life, and stiffness. Active exercise and sport are effective to improve pain and physical function in elderly people with osteoarthritis. Nevertheless, further studies are required to validate the use of land-based exercise, aquatic exercise, or sport to treat the symptoms of older adults that suffer from knee and hip osteoarthritis.
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Affiliation(s)
- Biagio Zampogna
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (R.P.); (G.F.P.); (S.C.); (S.V.); (F.V.); (G.T.); (V.D.)
- Correspondence: ; Tel.: +39-06-22541-8825
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (R.P.); (G.F.P.); (S.C.); (S.V.); (F.V.); (G.T.); (V.D.)
| | - Giuseppe Francesco Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (R.P.); (G.F.P.); (S.C.); (S.V.); (F.V.); (G.T.); (V.D.)
| | - Stefano Campi
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (R.P.); (G.F.P.); (S.C.); (S.V.); (F.V.); (G.T.); (V.D.)
| | - Sebastiano Vasta
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (R.P.); (G.F.P.); (S.C.); (S.V.); (F.V.); (G.T.); (V.D.)
| | - Ferruccio Vorini
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (R.P.); (G.F.P.); (S.C.); (S.V.); (F.V.); (G.T.); (V.D.)
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00100 Rome, Italy;
| | - Guglielmo Torre
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (R.P.); (G.F.P.); (S.C.); (S.V.); (F.V.); (G.T.); (V.D.)
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (R.P.); (G.F.P.); (S.C.); (S.V.); (F.V.); (G.T.); (V.D.)
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Easwaran K, Gopalasingam Y, Green DD, Lach V, Melnyk JA, Wan C, Bartlett DJ. Effectiveness of Tai Chi for health promotion for adults with health conditions: a scoping review of Meta-analyses. Disabil Rehabil 2020; 43:2978-2989. [PMID: 32070137 DOI: 10.1080/09638288.2020.1725916] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose: To complete a scoping review of meta-analyses summarizing evidence of the effectiveness of Tai Chi for adults with health conditions.Materials and Methods: Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health and the Cochrane Library from database inception to early September 2018. Multistage deduplication and screening processes identified full-length, unique, peer-reviewed meta-analyses. Two people independently appraised 42 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables.Results: "High" and "moderate" quality evidence indicates that Tai Chi can significantly benefit adults with health conditions including cancers, chronic obstructive pulmonary disease, coronary heart disease, depression, heart failure, hypertension, low back pain, osteoarthritis, osteoporosis, Parkinson's Disease and stroke. Outcomes included significant improvements in activities of daily living, balance, exercise capacity, gait, mastery, mental health, mobility, motor function, participation in daily life, physical function, quality of life, range of motion, and strength; with reductions in blood pressure, body mass index, depression, disability, dyspnea, falls, fatigue, pain, stiffness, and waist circumference.Conclusions: Healthcare providers now have information to advise clients with health conditions on the effectiveness of Tai Chi for overall health promotion.IMPLICATIONS FOR REHABILITATIONTai Chi is a form of safe, enjoyable, light-to-moderate aerobic physical activity for adults that is inexpensive to implement in diverse community settings.Adults with health conditions require physical activity for prevention of secondary impairments and over-all health promotion.This scoping review of meta-analyses elucidates "high" and "moderate" quality evidence of the effectiveness of Tai Chi in improving important outcomes for people with numerous health conditions.This information can be useful for healthcare providers who wish to recommend effective community-based physical activity to clients they are serving.
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Affiliation(s)
- Kobena Easwaran
- Physical Therapy, Elborn College, Western University, London, Canada
| | | | - Danielle D Green
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Veronica Lach
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Jordan A Melnyk
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Christina Wan
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Doreen J Bartlett
- Physical Therapy, Elborn College, Western University, London, Canada
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Brown A. Holistic/Integrative Interventions Relieve Knee Osteoarthritis Pain in Older Adults. J Nurse Pract 2020. [DOI: 10.1016/j.nurpra.2019.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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The safety of tai chi: A meta-analysis of adverse events in randomized controlled trials. Contemp Clin Trials 2019; 82:85-92. [DOI: 10.1016/j.cct.2019.06.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 04/23/2019] [Accepted: 06/19/2019] [Indexed: 02/06/2023]
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Effects of Tai Chi on partial anterior cruciate ligament injury: A single-blind, randomized-controlled trial. Turk J Phys Med Rehabil 2019; 65:160-168. [PMID: 31453557 DOI: 10.5606/tftrd.2019.2798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/09/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to investigate the effects of Tai Chi (TC) exercises on muscle strength, pain, proprioception, and knee function in patients with partial anterior cruciate ligament (ACL) injuries. Patients and methods Between March 2017 and January 2018, a total of 58 patients with partial ACL injuries (30 male, 28 female; mean age 25.5±6.4; range, 18 to 36 years) were included in the study. The patients were randomly divided into two groups: TC group (n=29) and control group (n=29). For both groups, an activity modification approach was applied. The TC group participated in a 24-week TC exercise program, while no exercise or home-based program was administered to the control group. Isokinetic knee extension and flexion muscle strengths were evaluated at angular velocities of 60°/sec and 180°/sec. The visual analog scale (VAS), isokinetic system, Lysholm Knee Scale (LKS), and International Knee Documentation Committee 2000 (IKDC-2000) were used for the evaluation of pain, proprioception, and knee function, respectively. Results Significant changes were found in the TC group for the knee extensor muscle strength measured at an angular velocity of 60°/sec (p=0.012) and 180°/sec (p=0.011), VAS pain (p=0.005), and proprioception (measured with isokinetic device) (p<0.001). While knee extensor muscle strength, pain, proprioception, LKS, and IKDC-2000 scores improved in the TC group, improvements were recorded only for LKS and IKDC-2000 scores in the control group. Conclusion Based on these results, we conclude that TC exercises can yield positive outcomes on the knee extensor muscle strength, pain, proprioception and knee function in patients with partial ACL injuries. Hence, TC exercises can be used as a novel method by researchers and clinicians in the treatment of partial ACL injuries.
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Zhang Y, Chai Y, Pan X, Shen H, Wei X, Xie Y. Tai chi for treating osteopenia and primary osteoporosis: a meta-analysis and trial sequential analysis. Clin Interv Aging 2019; 14:91-104. [PMID: 30655662 PMCID: PMC6322510 DOI: 10.2147/cia.s187588] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The aim of this meta-analysis was to evaluate the efficacy of Tai chi (TC) as an adjuvant treatment for osteopenia and primary osteoporosis. Methods We went through eight databases to identify relevant randomized controlled trials that compared TC with a control group. The primary outcome was osteoporosis-related fractures (fracture incidence). Meta-analyses and trial sequential analyses (TSA) were conducted using RevMan 5.3 and TSA 0.9. Results Fifteen randomized controlled trials involving a total of 857 patients were included in the analyses. No trials reported primary outcome; however, bone mineral density (BMD) values differed significantly in subgroup 1 (TC vs no treatment; weighted mean difference [WMD] =0.05 g/cm2, 95% CI 0.03 to 0.07; P<0.00001; P for heterogeneity =0.22, I2=22%) and subgroup 2 (TC vs conventional treatments; WMD =0.16 g/cm2, 95% CI 0.11 to 0.21; P<0.00001; P for heterogeneity =0.008, I2=75%). In addition, two trials compared TC with conventional treatments, which found a significant difference in bone gla protein (standardized mean difference =−1.18, 95% CI −1.66 to −0.70; P<0.00001; P for heterogeneity =0.58, I2=75%). The results of the BMD were confirmed by TSA. Also, TC may have a certain effect on the relief of osteoporotic pain (WMD = −2.61, 95% CI −3.51 to −1.71; WMD = −1.39, 95% CI −2.01 to −0.77). However, it did not promote the quality of life, level of serum calcium, serum phosphorus, and also had no effect on bone turnover markers. Conclusion Although there is no study monitoring fracture incidence, TC may be beneficial for patients in improving BMD values, level of bone gla protein, and relieving osteoporotic pain. However, due to the low methodological quality, current evidence for treating osteopenia and primary osteoporosis through TC is insufficient.
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Affiliation(s)
- Yili Zhang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China, .,School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yan Chai
- Department of Epidemiology, University of California, Los Angeles, CA, USA
| | - Xiaojie Pan
- Department of Human Nutrition and Health, Wageningen University and Health, Wageningen, The Netherlands
| | - Hao Shen
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China,
| | - Xu Wei
- Department of Scientific Research, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China,
| | - Yanming Xie
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China,
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Ceballos-Laita L, Estébanez-de-Miguel E, Martín-Nieto G, Bueno-Gracia E, Fortún-Agúd M, Jiménez-Del-Barrio S. Effects of non-pharmacological conservative treatment on pain, range of motion and physical function in patients with mild to moderate hip osteoarthritis. A systematic review. Complement Ther Med 2018; 42:214-222. [PMID: 30670244 DOI: 10.1016/j.ctim.2018.11.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 11/22/2018] [Accepted: 11/26/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The purpose of this review was to identify the effects of non-pharmacological conservative treatment on pain, range of motion and physical function in patients with mild to moderate hip osteoarthritis. DESIGN A systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. SETTING We searched MEDLINE, PEDro, Scopus and the Cochrane Library databases for randomized controlled trials related to non-pharmacological conservative treatments for hip osteoarthritis with the following keywords: "hip osteoarthritis," "therapeutics," "physical therapy modalities," and "combined physical therapy". The PEDro scale was used for methodological quality assessment and the Oxford Centre of Evidence-Based Medicine scale was used to assess the level of evidence. Outcomes measures related to pain, hip range of motion and physical function were extracted from these studies. RESULTS Twelve studies met the inclusion criteria. Most of the studies showed high level of evidence and only two showed low level of evidence. High quality of evidence showed that manual therapy and exercise therapy are effective in improving pain, hip range of motion and physical function. However, high quality studies based on combined therapies showed controversy in their effects on pain, hip range of motion and physical function. CONCLUSIONS Exercise therapy and manual therapy and its combination with patient education provides benefits in pain and improvement in physical function. The effects of combined therapies remain unclear. Further investigation is necessary to improve the knowledge about the effects of non-pharmacological conservative treatments on pain, hip range of motion and physical function.
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Affiliation(s)
- Luis Ceballos-Laita
- Department of Surgery, Ophtalmology and Physiotherapy, University of Valladolid, c/Universidad s/n, 42004, Soria, Spain.
| | - Elena Estébanez-de-Miguel
- Department of Physiatrist and Nursey, Faculty of Health Sciencies, University of Zaragoza, c/Domingo Miral s/n, 50010, Zaragoza, Spain.
| | - Gadea Martín-Nieto
- Department of Surgery, Ophtalmology and Physiotherapy, University of Valladolid, c/Universidad s/n, 42004, Soria, Spain.
| | - Elena Bueno-Gracia
- Department of Physiatrist and Nursey, Faculty of Health Sciencies, University of Zaragoza, c/Domingo Miral s/n, 50010, Zaragoza, Spain.
| | | | - Sandra Jiménez-Del-Barrio
- Department of Surgery, Ophtalmology and Physiotherapy, University of Valladolid, c/Universidad s/n, 42004, Soria, Spain.
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Complementary medicine use, views, and experiences: a national survey in England. BJGP Open 2018; 2:bjgpopen18X101614. [PMID: 30723800 PMCID: PMC6348322 DOI: 10.3399/bjgpopen18x101614] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 07/23/2018] [Indexed: 12/26/2022] Open
Abstract
Background In 2005,12% of the English population visited a complementary and alternative medicine (CAM) practitioner. Aim To obtain up-to-date general population figures for practitioner-led CAM use in England, and to discover people's views and experiences regarding access. Design & setting A face-to-face questionnaire survey was commissioned. A nationally representative adult quota sample (aged ≥15 years) was used. Method Ten questions were included within Ipsos MORI’s weekly population-based survey. The questions explored 12-month practitioner-led CAM use, reasons for non-use, views on NHS-provided CAM, and willingness to pay. Results Of 4862 adults surveyed, 766 (16%) had seen a CAM practitioner. People most commonly visited CAM practitioners for manual therapies (massage, osteopathy, chiropractic) and acupuncture, as well as yoga, pilates, reflexology, and mindfulness or meditation. Women, people with higher socioeconomic status (SES) and those in south England were more likely to access CAM. Musculoskeletal conditions (mainly back pain) accounted for 68% of use, and mental health 12%. Most was through self-referral (70%) and self-financing. GPs (17%) or NHS professionals (4%) referred and/or recommended CAM to users. These CAM users were more often unemployed, with lower income and social grade, and receiving NHS-funded CAM. Responders were willing to pay varying amounts for CAM; 22% would not pay anything. Almost two in five responders felt NHS funding and GP referral and/or endorsement would increase their CAM use. Conclusion CAM use in England is common for musculoskeletal and mental health problems, but varies by sex, geography, and SES. It is mainly self-referred and self-financed; some is GP-endorsed and/or referred, especially for individuals of lower SES. Researchers, patients, and commissioners should collaborate to research the effectiveness and cost-effectiveness of CAM and consider its availability on the NHS.
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Lorenc A, Feder G, MacPherson H, Little P, Mercer SW, Sharp D. Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions. BMJ Open 2018; 8:e020222. [PMID: 30327397 PMCID: PMC6196876 DOI: 10.1136/bmjopen-2017-020222] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To identify potentially effective complementary approaches for musculoskeletal (MSK)-mental health (MH) comorbidity, by synthesising evidence on effectiveness, cost-effectiveness and safety from systematic reviews (SRs). DESIGN Scoping review of SRs. METHODS We searched literature databases, registries and reference lists, and contacted key authors and professional organisations to identify SRs of randomised controlled trials for complementary medicine for MSK or MH. Inclusion criteria were: published after 2004, studying adults, in English and scoring >50% on Assessing the Methodological Quality of Systematic Reviews (AMSTAR); quality appraisal checklist). SRs were synthesised to identify research priorities, based on moderate/good quality evidence, sample size and indication of cost-effectiveness and safety. RESULTS We included 84 MSK SRs and 27 MH SRs. Only one focused on MSK-MH comorbidity. Meditative approaches and yoga may improve MH outcomes in MSK populations. Yoga and tai chi had moderate/good evidence for MSK and MH conditions. SRs reported moderate/good quality evidence (any comparator) in a moderate/large population for: low back pain (LBP) (yoga, acupuncture, spinal manipulation/mobilisation, osteopathy), osteoarthritis (OA) (acupuncture, tai chi), neck pain (acupuncture, manipulation/manual therapy), myofascial trigger point pain (acupuncture), depression (mindfulness-based stress reduction (MBSR), meditation, tai chi, relaxation), anxiety (meditation/MBSR, moving meditation, yoga), sleep disorders (meditative/mind-body movement) and stress/distress (mindfulness). The majority of these complementary approaches had some evidence of safety-only three had evidence of harm. There was some evidence of cost-effectiveness for spinal manipulation/mobilisation and acupuncture for LBP, and manual therapy/manipulation for neck pain, but few SRs reviewed cost-effectiveness and many found no data. CONCLUSIONS Only one SR studied MSK-MH comorbidity. Research priorities for complementary medicine for both MSK and MH (LBP, OA, depression, anxiety and sleep problems) are yoga, mindfulness and tai chi. Despite the large number of SRs and the prevalence of comorbidity, more high-quality, large randomised controlled trials in comorbid populations are needed.
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Affiliation(s)
- Ava Lorenc
- Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Gene Feder
- Population Health Sciences, Bristol Medical School, Bristol, UK
| | | | - Paul Little
- Primary Care and Population Science Unit, University of Southampton, Southampton, UK
| | - Stewart W Mercer
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Deborah Sharp
- Population Health Sciences, Bristol Medical School, Bristol, UK
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Innes KE, Selfe TK, Kandati S, Wen S, Huysmans Z. Effects of Mantra Meditation versus Music Listening on Knee Pain, Function, and Related Outcomes in Older Adults with Knee Osteoarthritis: An Exploratory Randomized Clinical Trial (RCT). EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:7683897. [PMID: 30245732 PMCID: PMC6136530 DOI: 10.1155/2018/7683897] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/31/2018] [Accepted: 08/08/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Disease-modifying treatments for OA remain elusive, and commonly used medications can have serious side effects. Although meditation and music listening (ML) have been shown to improve outcomes in certain chronic pain populations, research in OA is sparse. In this pilot RCT, we explore the effects of two mind-body practices, mantra meditation (MM) and ML, on knee pain, function, and related outcomes in adults with knee OA. METHODS Twenty-two older ambulatory adults diagnosed with knee OA were randomized to a MM (N=11) or ML program (N=11) and asked to practice 15-20 minutes, twice daily for 8 weeks. Core outcomes included knee pain (Knee Injury and Osteoarthritis Outcome Score [KOOS] and Numeric Rating Scale), knee function (KOOS), and perceived OA severity (Patient Global Assessment). Additional outcomes included perceived stress (Perceived Stress Scale), mood (Profile of Mood States), sleep (Pittsburgh Sleep Quality Index), and health-related quality of life (QOL, SF-36). Participants were assessed at baseline and following completion of the program. RESULTS Twenty participants (91%) completed the study (9 MM, 11 ML). Compliance was excellent; participants completed an average of 12.1±0.83 sessions/week. Relative to baseline, participants in both groups demonstrated improvement post-intervention in all core outcomes, including knee pain, function, and perceived OA severity, as well as improvement in mood, perceived stress, and QOL (Physical Health) (p's≤0.05). Relative to ML, the MM group showed greater improvements in overall mood and sleep (p's≤0.04), QOL-Mental Health (p<0.07), kinesiophobia (p=0.09), and two domains of the KOOS (p's<0.09). CONCLUSIONS Findings of this exploratory RCT suggest that a simple MM and, possibly, ML program may be effective in reducing knee pain and dysfunction, decreasing stress, and improving mood, sleep, and QOL in adults with knee OA.
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Affiliation(s)
- Kim E. Innes
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Terry Kit Selfe
- Department of Biomedical and Health Information Services, Health Science Center Libraries, University of Florida, Gainesville, FL, USA
| | - Sahiti Kandati
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
- School of Dentistry, SUNY-Buffalo, Buffalo, NY, USA
| | - Sijin Wen
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Zenzi Huysmans
- College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, WV, USA
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The Effects of Routine Physiotherapy Alone and in Combination with Either Tai Chi or Closed Kinetic Chain Exercises on Knee Osteoarthritis: A Comparative Clinical Trial Study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.62600] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tuncer T, Cay FH, Altan L, Gurer G, Kacar C, Ozcakir S, Atik S, Ayhan F, Durmaz B, Eskiyurt N, Genc H, GokceKutsal Y, Gunaydin R, Hepguler S, Hizmetli S, Kaya T, Kurtais Y, Saridogan M, Sindel D, Sutbeyaz S, Sendur OF, Ugurlu H, Unlu Z. 2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis. Rheumatol Int 2018; 38:1315-1331. [PMID: 29777340 DOI: 10.1007/s00296-018-4044-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/05/2018] [Indexed: 12/19/2022]
Abstract
In a Turkish League Against Rheumatism (TLAR) project, evidence-based recommendations for the management of knee osteoarthritis (OA) was developed for the first time in our country in 2012 (TLAR-2012). In accordance with developing medical knowledge and scientific evidence, recommendations were updated. The committee was composed of 22 physical medicine and rehabilitation specialists (4 have rheumatology subspeciality also) and an orthopaedic surgeon. Systematic literature search were applied on Pubmed, Embase, Cochrane and Turkish Medical Index for the dates between January the 1st 2012 and January the 29th of 2015. The articles were assessed for quality and classified according to hierarchy for the level of evidence, and the selected ones sent to committee members electronically. They were asked to develop new recommendations. In the meeting in 2015, the format of the recommendations was decided to be patient-based and considering the grade and the severity of the disease. By the discussion of the each item under the light of new evidences, the final recommendations were developed. Each item was voted electronically on a 10-cm visual analogue scale (VAS) and the strength of recommendation (SoR) was calculated. In the light of evidences, totally 11 titles of recommendations were developed; the first 7 were applicable to each patient in every stages of the disease, remaining were for defined specific clinical situations. The mean SoR value of the recommendations was between 7.44 and 9.93. TLAR-2012 recommendations were updated in a new format. We think that, present recommendations will be beneficial for the physicians who manage, as well as the patients who suffer from the disease.
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Affiliation(s)
- Tiraje Tuncer
- School Of Medicine, Physical Medicine Rehabilitation, Akdeniz University, Antalya, Turkey
| | - Fatih Hasan Cay
- Antalya Training and Research Hospital, Physical Medicine Rehabilitation and Rheumatology, University of Health Sciences, Antalya, Turkey.
| | - Lale Altan
- School of Medicine, Physical Medicine Rehabilitation, Uludağ University, Bursa, Turkey
| | - Gulcan Gurer
- School of Medicine, Physical Medicine Rehabilitation and Rheumatology, Adnan Menderes University, Aydın, Turkey
| | - Cahit Kacar
- School Of Medicine, Physical Medicine Rehabilitation and Rheumatology, Akdeniz University, Antalya, Turkey
| | - Suheda Ozcakir
- School of Medicine, Physical Medicine Rehabilitation, Uludağ University, Bursa, Turkey
| | - Sahap Atik
- School of Medicine, Orthopaedics and Traumatology, Gazi University, Ankara, Turkey
| | - Figen Ayhan
- Ankara Training and Research Hospital, Physical Medicine Rehabilitation, University Of Health Sciences, Ankara, Turkey
| | - Berrin Durmaz
- School of Medicine, Physical Medicine Rehabilitation, Ege University, Izmir, Turkey
| | - Nurten Eskiyurt
- Istanbul School of Medicine, Physical Medicine Rehabilitation (Retired), İstanbul University, Istanbul, Turkey
| | - Hakan Genc
- Ankara Training and Research Hospital, Physical Medicine Rehabilitation, University Of Health Sciences, Ankara, Turkey
| | - Yesim GokceKutsal
- School of Medicine, Physical Medicine Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Rezzan Gunaydin
- Physical Medicine Rehabilitation, Medical Park İzmir Hospital, Izmir, Turkey
| | - Simin Hepguler
- School of Medicine, Physical Medicine Rehabilitation, Ege University, Izmir, Turkey
| | - Sami Hizmetli
- School of Medicine, Physical Medicine Rehabilitation and Rheumatology Physical Medicine Rehabilitation, Cumhuriyet University, Sivas, Turkey
| | - Taciser Kaya
- Bozyaka Training and Research Hospital, Physical Medicine Rehabilitation, University of Health Sciences, Izmir, Turkey
| | - Yesim Kurtais
- School of Medicine, Physical Medicine Rehabilitation, Ankara University, Ankara, Turkey
| | - Merih Saridogan
- Cerrahpaşa School of Medicine, Physical Medicine Rehabilitation, İstanbul University, Istanbul, Turkey
| | - Dilsad Sindel
- İstanbul School of Medicine, Physical Medicine Rehabilitation, İstanbul University, Istanbul, Turkey
| | - Serap Sutbeyaz
- Kayseri Training and Research Hospital, Physical Medicine Rehabilitation, University of Health Sciences, Kayseri, Turkey
| | - Omer Faruk Sendur
- School of Medicine, Physical Medicine Rehabilitation, Adnan Menderes University, Aydın, Turkey
| | - Hatice Ugurlu
- School of Medicine, Physical Medicine Rehabilitation, Necmettin Erbakan University, Konya, Turkey
| | - Zeliha Unlu
- School of Medicine, Physical Medicine Rehabilitation, Celal Bayar University, Manisa, Turkey
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Wang C, Schmid CH, Fielding RA, Harvey WF, Reid KF, Price LL, Driban JB, Kalish R, Rones R, McAlindon T. Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial. BMJ 2018; 360:k851. [PMID: 29563100 PMCID: PMC5861462 DOI: 10.1136/bmj.k851] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration. DESIGN Prospective, randomized, 52 week, single blind comparative effectiveness trial. SETTING Urban tertiary care academic hospital in the United States between March 2012 and September 2016. PARTICIPANTS 226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group. INTERVENTIONS Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone. MAIN OUTCOME MEASURES The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient's global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life. RESULTS FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient's global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with the same intensity and duration (24 weeks, twice weekly) had greater benefit (between group difference in FIQR scores=16.2 points, 8.7 to 23.6, P<0.001). The groups who received tai chi for 24 weeks showed greater improvements than those who received it for 12 weeks (difference in FIQR scores=9.6 points, 2.6 to 16.6, P=0.007). There was no significant increase in benefit for groups who received tai chi twice weekly compared with once weekly. Participants attended the tai chi training sessions more often than participants attended aerobic exercise. The effects of tai chi were consistent across all instructors. No serious adverse events related to the interventions were reported. CONCLUSION Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment, for a variety of outcomes for patients with fibromyalgia. Longer duration of tai chi showed greater improvement. This mind-body approach may be considered a therapeutic option in the multidisciplinary management of fibromyalgia. TRIAL REGISTRATION ClinicalTrials.gov NCT01420640.
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Affiliation(s)
- Chenchen Wang
- Center for Complementary and Integrative Medicine and Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Christopher H Schmid
- Department of Biostatistics and Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI, USA
| | - Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Tufts University School of Medicine, Boston, USA
| | - William F Harvey
- Center for Complementary and Integrative Medicine and Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Kieran F Reid
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Tufts University School of Medicine, Boston, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | - Jeffrey B Driban
- Center for Complementary and Integrative Medicine and Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Robert Kalish
- Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Ramel Rones
- Center for Mind-Body Therapies, Boston, MA, USA
| | - Timothy McAlindon
- Center for Complementary and Integrative Medicine and Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA
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Jiménez-Martín PJ, Liu H, Meléndez Ortega A. The importance of differentiating the three modalities of Tai Chi Chuan practice in clinical trials – A critical review. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2017.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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35
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Shakouri A, Adljouy N, Balkani S, Mohamadi M, Hamishehkar H, Abdolalizadeh J, Kazem Shakouri S. Effectiveness of topical gel of medical leech (Hirudo medicinalis) saliva extract on patients with knee osteoarthritis: A randomized clinical trial. Complement Ther Clin Pract 2017; 31:352-359. [PMID: 29246745 DOI: 10.1016/j.ctcp.2017.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/29/2017] [Accepted: 12/05/2017] [Indexed: 01/07/2023]
Abstract
Leech saliva extract (LSE) in the liposome-based gel was used as a supplementary treatment to relief the signs and symptoms of osteoarthritis (OA). The saliva of medical leech was extracted and nano liposomes were used to formulate the supplement to enhance skin absorption. A clinical trial was designed to evaluate the therapeutic effects of LSE liposomal gel. Lenquesne and VAS questionnaires were used as indexes of this supplement therapy efficacy for 30 days. Questionnaires analysis showed that after one-month administration of LSE liposomal gel, patients' pain was relieved approximately up to 50%; also, due to reduction in joint inflammation and stiffness, the range of motion was increased and the patients' quality of life was enhanced (p < 0.001). LSE nano scaled liposomal gel as an innovative supplement therapy in OA patients, makes desirable therapeutic approach, which seems to make a significant impact on patient's quality of life and self-care capability.
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Affiliation(s)
- Amir Shakouri
- Traditional Medicine Faculty, Tabriz university of Medical Sciences, Tabriz, Iran; Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasim Adljouy
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sanaz Balkani
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Mohamadi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamed Hamishehkar
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jalal Abdolalizadeh
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Paramedical Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Seyed Kazem Shakouri
- Physical Medicine & Rehabilitation Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
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Effect of Taijiquan practice versus wellness education on knee proprioception in patients with knee osteoarthritis: a randomized controlled trial. J TRADIT CHIN MED 2017. [DOI: 10.1016/s0254-6272(18)30040-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Lee AC, Driban JB, Price LL, Harvey WF, Rodday AM, Wang C. Responsiveness and Minimally Important Differences for 4 Patient-Reported Outcomes Measurement Information System Short Forms: Physical Function, Pain Interference, Depression, and Anxiety in Knee Osteoarthritis. THE JOURNAL OF PAIN 2017; 18:1096-1110. [PMID: 28501708 PMCID: PMC5581239 DOI: 10.1016/j.jpain.2017.05.001] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/27/2017] [Indexed: 01/11/2023]
Abstract
Patient-Reported Outcomes Measurement Information System (PROMIS) instruments can provide valid, interpretable measures of health status among adults with osteoarthritis (OA). However, their ability to detect meaningful change over time is unknown. We evaluated the responsiveness and minimally important differences (MIDs) for 4 PROMIS Short Forms: Physical Function, Pain Interference, Depression, and Anxiety. We analyzed adults with symptomatic knee OA from our randomized trial comparing Tai Chi and physical therapy. Using baseline and 12-week scores, responsiveness was evaluated according to consensus standards by testing 6 a priori hypotheses of the correlations between PROMIS and legacy change scores. Responsiveness was considered high if ≥5 hypotheses were confirmed, and moderate if 3 or 4 were confirmed. MIDs were evaluated according to prospective change for people achieving previously-established MID on legacy comparators. The lowest and highest MIDs meeting a priori quality criteria formed a MID range for each PROMIS Short Form. Among 165 predominantly female (70%) and white (57%) participants, mean age was 61 years and body mass index was 33. PROMIS Physical Function had 5 confirmed hypotheses and Pain Interference, Depression, and Anxiety had 3 or 4. MID ranges were: Depression = 3.0 to 3.1; Anxiety = 2.3 to 3.4; Physical Function = 1.9 to 2.2; and Pain Interference = 2.35 to 2.4. PROMIS Physical Function has high responsiveness, and Depression, Anxiety, and Pain Interference have moderate responsiveness among adults with knee OA. We established the first MIDs for PROMIS in this population, and provided an important standard of reference to better apply or interpret PROMIS in future trials or clinical practice. PERSPECTIVE This study examined whether PROMIS Short Form instruments (Physical Function, Pain Interference, Depression, and Anxiety) were able to detect change over time among adults with knee OA, and provided minimally important change estimates for each measure. This standard of reference can help apply or interpret these instruments in the future.
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Affiliation(s)
- Augustine C Lee
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts
| | - Jeffrey B Driban
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts
| | - Lori Lyn Price
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts; Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts
| | - William F Harvey
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts
| | - Angie Mae Rodday
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
| | - Chenchen Wang
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts.
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Wang Y, Shan W, Li Q, Yang N, Shan W. Tai Chi Exercise for the Quality of Life in a Perimenopausal Women Organization: A Systematic Review. Worldviews Evid Based Nurs 2017; 14:294-305. [PMID: 28742289 DOI: 10.1111/wvn.12234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Improvement of the quality of life in perimenopausal women has recently become an important global health issue. Extensive research reports provide evidence of Tai Chi for the quality of life, but no systematic review has individually investigated Tai Chi as a main intervention on the quality of life in perimenopausal women. OBJECTIVE To assess clinical evidence of Tai Chi for the quality of life in perimenopausal women. METHODS Studies related to the effect of Tai Chi on the quality of life in perimenopausal women in the databases of China and abroad were searched. RevMan version 5.2 software was used, and the Medical Outcomes Study 36-item short form health survey (SF-36) and bone mineral density (BMD) were selected as evaluation indices. RESULTS Five trials were included. The results of this study showed that Tai Chi had a significant effect on bodily pain, general health, vitality, mental health of SF-36, and the spine dimension of BMD, as supported by the following data: bodily pain (Standard Mean Difference [SMD] = -3.63; 95% confidence interval [CI] [-6.62, -0.64]; p = .02); general health (SMD = -5.08; 95% CI [-7.60, -2.56]; p < .0001); vitality (SMD = -5.67; 95% CI [-8.54, -2.81], p = .0001); mental health (SMD = -2.51; 95% CI [-4.82, -0.20], p = .03); and spine dimension of BMD (SMD = -0.06; 95% CI [-0.10, -0.01]; p = .01). However, Tai Chi had no effect on physical function, emotional health, social function, role-physical of SF-36, and the hip dimension of BMD, as supported by the following data: physical function (SMD = -1.79; 95% CI [-5.15, 1.57]; p = .30); emotional health (SMD = -2.90; 95% CI [-7.23, 1.43], p = .19]; social function (SMD = -2.23, 95% CI [-5.08, 0.61], p = .12; role-physical (SMD = - 1.18; 95% CI [-4.84, 2.47], p = .53; and hip dimension of BMD (SMD = -0.01; 95% CI [-0.03, 0.01]; p = .31). LINKING EVIDENCE TO ACTION This systematic review found significant evidence for Tai Chi improving bodily pain, general health, vitality, mental health of SF-36, and the spine dimension of BMD in patients with perimenopausal syndrome. Findings suggest that Tai Chi might be recommended as effective and safe adjuvant treatment for patients with perimenopausal syndrome. More high-quality randomized controlled trials are urgently needed to confirm these results.
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Affiliation(s)
- Ying Wang
- Nurse Practitioner, Nursing School of Chengde Medical University, Chengde City, Hebei Province, China
| | - Weichao Shan
- Associate Professor, Affiliated Hospital of Chengde Medical University, Chengde City, Hebei Province, China
| | - Qing Li
- Lecturer, Nursing School of Chengde Medical University, Chengde City, Hebei Province, China
| | - Na Yang
- Teaching Assistant, Nursing School of Chengde Medical University, Chengde City, Hebei Province, China
| | - Weiying Shan
- Professor, Science and Technology Department of Chengde Medical University, Chengde City, Hebei Province, China
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Bender TTA, Marinova M, Radbruch L, Conrad R, Jobst D, Mücke M. [Knee joint pain with signs of arthrosis]. Schmerz 2017; 31:319-333. [PMID: 28293735 DOI: 10.1007/s00482-017-0199-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Chronic pain in the knee joint is most commonly caused by osteoarthritis, especially in elderly patients but can be due to other causes, such as rheumatoid arthritis. The diagnostics include an exact patient medical history and a clinical examination, which often already provide clear indications of the cause of the knee pain. Subsequently, further diagnostics can then be considered, such as radiological procedures and laboratory diagnostics. The treatment is determined by the cause and the individual patient and aims to reduce pain and to preserve the mobility of the joint. Generally, therapy consists of pain management and physiotherapy as well as alternative therapeutic procedures, mostly in combination. Proximal tibial opening wedge osteotomy can be useful; however, partial or total knee arthroplasty should only be considered when conservative treatment options have been exhausted.
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Affiliation(s)
- T T A Bender
- Zentrum für seltene Erkrankungen Bonn, Universitätsklinikum Bonn, Bonn, Deutschland
| | - M Marinova
- Radiologische Klinik, Universitätsklinikum Bonn, Bonn, Deutschland
| | - L Radbruch
- Zentrum für Palliativmedizin, Malteser Krankenhaus Seliger Gerhard Bonn/Rhein-Sieg, Bonn, Deutschland.,Institut für Hausarztmedizin, Universitätsklinikum Bonn, Bonn, Deutschland
| | - R Conrad
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - D Jobst
- Institut für Hausarztmedizin, Universitätsklinikum Bonn, Bonn, Deutschland
| | - M Mücke
- Zentrum für seltene Erkrankungen Bonn, Universitätsklinikum Bonn, Bonn, Deutschland. .,Institut für Hausarztmedizin, Universitätsklinikum Bonn, Bonn, Deutschland. .,Klinik für Palliativmedizin, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland.
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40
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Brosseau L, Taki J, Desjardins B, Thevenot O, Fransen M, Wells GA, Imoto AM, Toupin-April K, Westby M, Gallardo ICÁ, Gifford W, Laferrière L, Rahman P, Loew L, Angelis GD, Cavallo S, Shallwani SM, Aburub A, Bennell KL, Van der Esch M, Simic M, McConnell S, Harmer A, Kenny GP, Paterson G, Regnaux JP, Lefevre-Colau MM, McLean L. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs. Clin Rehabil 2017; 31:582-595. [PMID: 28183188 DOI: 10.1177/0269215517691083] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To identify effective mind-body exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning non-traditional land-based exercises for knee osteoarthritis. METHODS A systematic search and adapted selection criteria included comparative controlled trials with mind-body exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement). RESULTS The four high-quality studies identified demonstrated that various mind-body exercise programs are promising for improving the management of knee osteoarthritis. Hatha Yoga demonstrated significant improvement for pain relief (Grade B) and physical function (Grade C+). Tai Chi Qigong demonstrated significant improvement for quality of life (Grade B), pain relief (Grade C+) and physical function (Grade C+). Sun style Tai Chi gave significant improvement for pain relief (Grade B) and physical function (Grade B). CONCLUSION Mind-body exercises are promising approaches to reduce pain, as well as to improve physical function and quality of life for individuals with knee osteoarthritis.
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Affiliation(s)
- Lucie Brosseau
- 1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Jade Taki
- 2 Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Brigit Desjardins
- 3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Odette Thevenot
- 3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Marlene Fransen
- 4 Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - George A Wells
- 5 School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Karine Toupin-April
- 7 Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, Faculty of Medicine and School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Marie Westby
- 8 Mary Pack Arthritis Program, Vancouver Coastal Health, Department of Physical Therapy, University of British Columbia, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | | | - Wendy Gifford
- 10 School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Lucie Laferrière
- 11 Canadian Forces Health Services Group Headquarters, National Defense, Ottawa, Ontario, Canada
| | - Prinon Rahman
- 12 Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Laurianne Loew
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Gino De Angelis
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Sabrina Cavallo
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Ala' Aburub
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Kim L Bennell
- 14 Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Martin Van der Esch
- 15 Department of Rehabilitation, Reade Centre for Rehabilitation and Rheumatology, Amsterdam, Netherlands, Faculty of Health. ACHIEVE, Centre of Applied Research and School of Physiotherapy, University of Applied Sciences, Amsterdam, Netherlands
| | - Milena Simic
- 16 Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Sara McConnell
- 17 Department of Medicine, St. Joseph's Health Care Centre, Toronto, Ontario, Canada
| | - Alison Harmer
- 18 Faculty of Health Sciences, Clinical and Rehabilitation Sciences Research Group, University of Sydney, Sydney, Australia
| | - Glen P Kenny
- 3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Gail Paterson
- 19 The Arthritis Society, Ottawa Office, Ontario Division, Ottawa, Ontario, Canada
| | - Jean-Philippe Regnaux
- 20 Centre de recherche Epidémiologie et Biostatistique, Hôpital Hôtel-Dieu, Paris, France
| | | | - Linda McLean
- 1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Zhang Y, Huang L, Su Y, Zhan Z, Li Y, Lai X. The Effects of Traditional Chinese Exercise in Treating Knee Osteoarthritis: A Systematic Review and Meta-Analysis. PLoS One 2017; 12:e0170237. [PMID: 28121996 PMCID: PMC5266306 DOI: 10.1371/journal.pone.0170237] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 12/31/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Traditional Chinese exercise (TCE) includes a variety of exercise, which is being accepted by more and more people in the treatment of knee osteoarthritis (OA) from different countries. With the attendant, many clinical reports focus on it. Our meta-analysis aimed to systematically assess the effects of traditional Chinese exercise on pain, stiffness, physical function, quality of life, mental health and adverse events in people with knee osteoarthritis. METHODS PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), the Web of Science, and Chinese Biomedical Literature Database (CBM) were searched from the time of their inception through April 2016 and risk of bias was independently assessed by two authors. Outcome measures included pain, physical functional, joint stiffness, quality of life, mental health and safety. For pooled outcomes, standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. RESULTS Eight randomized controlled trials with a sample size of 375 cases met the criteria to be included in the study indicating that high quality literature is lacking in this field. Results of the meta-analysis showed that short-term TCE could relieve pain (SMD: -0.77;95% CI: -1.13 to -0.41; P<0.0001), improve physical function (SMD -0.75; 95% CI: -0.98 to -0.52; P<0.00001), and alleviate stiffness (SMD: -0.56; 95%: CI -0.96 to -0.16; P<0.006), but had no significant effect on quality of life (SMD: 0.57; 95% CI: 0.17 to 0.97; P = 0.005), and mental health (SMD 4.12; 95% CI: -0.50 to 8.73; P = 0.08). Moreover, TCE was not associated with serious adverse events. CONCLUSIONS Our systematic review revealed that short-term TCE was potentially beneficial in terms of reducing pain, improving physical function and alleviating stiffness. These results may suggest that TCE could prove useful as an adjuvant treatment for patients with knee OA. Further studies are urgently needed to confirm these results.
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Affiliation(s)
- Yingjie Zhang
- Department of Rehabilitation Medicine College, Fujian University of Traditional Chinese Medicine, No.1 Qiuyang Road, Shangjie, Minhou, Fuzhou, Fujian, People’s Republic of China
| | - Lulu Huang
- Department of Rehabilitation Medicine College, Fujian University of Traditional Chinese Medicine, No.1 Qiuyang Road, Shangjie, Minhou, Fuzhou, Fujian, People’s Republic of China
| | - Youxin Su
- Department of Traumatology and Orthopedics College, Fujian University of Traditional Chinese Medicine, No.1 Qiuyang Road, Shangjie, Minhou, Fuzhou, Fujian, People’s Republic of China
| | - Zhengxuan Zhan
- Department of Rehabilitation Medicine College, Fujian University of Traditional Chinese Medicine, No.1 Qiuyang Road, Shangjie, Minhou, Fuzhou, Fujian, People’s Republic of China
| | - Yanan Li
- Department of Rehabilitation Medicine College, Fujian University of Traditional Chinese Medicine, No.1 Qiuyang Road, Shangjie, Minhou, Fuzhou, Fujian, People’s Republic of China
| | - Xingquan Lai
- Department of Rehabilitation Medicine College, Fujian University of Traditional Chinese Medicine, No.1 Qiuyang Road, Shangjie, Minhou, Fuzhou, Fujian, People’s Republic of China
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The Effects of Tai Chi and Neck Exercises in the Treatment of Chronic Nonspecific Neck Pain: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2016; 17:1013-27. [DOI: 10.1016/j.jpain.2016.06.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 03/24/2016] [Accepted: 06/10/2016] [Indexed: 12/19/2022]
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Zhu Q, Huang L, Wu X, Wang L, Zhang Y, Fang M, Liu Y, Li JX. Effects of Tai Ji Quan training on gait kinematics in older Chinese women with knee osteoarthritis: A randomized controlled trial. JOURNAL OF SPORT AND HEALTH SCIENCE 2016; 5:297-303. [PMID: 30356529 PMCID: PMC6188600 DOI: 10.1016/j.jshs.2016.02.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/09/2015] [Accepted: 12/18/2015] [Indexed: 05/07/2023]
Abstract
BACKGROUND Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis (OA), little is known about its potential benefits on gait characteristics among older Chinese women who have a high prevalence of both radiographic and symptomatic knee OA. This study aims to assess the efficacy of a tailored Tai Ji Quan intervention on gait kinematics for older Chinese women with knee OA. METHODS A randomized controlled trial involving 46 older women in Shanghai, China, with clinically diagnosed knee OA. Randomized (1:1) participants received either a 60 min Tai Ji Quan session (n = 23) 3 times weekly or a 60 min bi-weekly educational session (n = 23) for 24 weeks. Primary outcomes were changes in gait kinematic measures from baseline to 24 weeks. Secondary outcomes included changes in scores on the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Short Physical Performance Battery (SPPB). RESULTS After 24 weeks the Tai Ji Quan group demonstrated better performance in gait velocity (mean difference, 8.40 cm/s, p = 0.01), step length (mean difference, 3.52 cm, p = 0.004), initial contact angle (mean difference, 2.19°, p = 0.01), and maximal angle (mean difference, 2.61°, p = 0.003) of flexed knees during stance phase compared to the control group. In addition, the Tai Ji Quan group showed significant improvement in WOMAC scores (p < 0.01) (mean difference, -4.22 points in pain, p = 0.002; -2.41 points in stiffness, p < 0.001; -11.04 points in physical function, p = 0.006) and SPPB scores (mean difference, 1.22 points, p < 0.001). CONCLUSION Among older Chinese women with knee OA, a tailored Tai Ji Quan intervention improved gait outcomes. The intervention also improved overall function as indexed by the WOMAC and SPPB. These results support the use of Tai Ji Quan for older Chinese adults with knee OA to both improve their functional mobility and reduce pain symptomatology.
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Affiliation(s)
- Qingguang Zhu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
- Department of Physical Therapy with Chinese Massage, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Lingyan Huang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Xie Wu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Yunya Zhang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Min Fang
- Department of Physical Therapy with Chinese Massage, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Yu Liu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
- Corresponding author.
| | - Jing Xian Li
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa K1N 6N5, Canada
- Corresponding author.
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The Effects of Tai Chi Chuan on Improving Mind-Body Health for Knee Osteoarthritis Patients: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:1813979. [PMID: 27635148 PMCID: PMC5011213 DOI: 10.1155/2016/1813979] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/27/2016] [Accepted: 07/19/2016] [Indexed: 01/18/2023]
Abstract
Purpose. To conduct a meta-analysis and systematic review examining whether Tai Chi Chuan could have mental and physical benefits for patients with knee osteoarthritis. Methods. MEDLINE, PUBMED, EMBASE, and CINAHL databases were searched for relevant studies. Data of the studies were collected, and outcomes were classified using the International Classification of Functioning, Disability, and Health model. Effect sizes of the mental and physical components were determined, along with the recommendation grades of Philadelphia Panel Classification System for Tai Chi Chuan on knee osteoarthritis. Results. Eleven studies were selected and retrieved from the databases. The results of meta-analysis revealed that the effects of Tai Chi Chuan were observed for physical components in the body functions and structures domain. The effects favoring Tai Chi Chuan were observed in the physical component in the activities and participation domain. Insufficient data was included in the meta-analysis of the mental component. Conclusions. The review revealed that Tai Chi Chuan had beneficial outcomes for patients with knee osteoarthritis. The evidence-based results represented that it had small-to-moderate effects on body functions and structures, activities, and participation of physical component. However, there was insufficient evidence to support that Tai Chi Chuan had beneficial mental effect.
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Solloway MR, Taylor SL, Shekelle PG, Miake-Lye IM, Beroes JM, Shanman RM, Hempel S. An evidence map of the effect of Tai Chi on health outcomes. Syst Rev 2016; 5:126. [PMID: 27460789 PMCID: PMC4962385 DOI: 10.1186/s13643-016-0300-y] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 07/14/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND This evidence map describes the volume and focus of Tai Chi research reporting health outcomes. Originally developed as a martial art, Tai Chi is typically taught as a series of slow, low-impact movements that integrate the breath, mind, and physical activity to achieve greater awareness and a sense of well-being. METHODS The evidence map is based on a systematic review of systematic reviews. We searched 11 electronic databases from inception to February 2014, screened reviews of reviews, and consulted with topic experts. We used a bubble plot to graphically display clinical topics, literature size, number of reviews, and a broad estimate of effectiveness. RESULTS The map is based on 107 systematic reviews. Two thirds of the reviews were published in the last five years. The topics with the largest number of published randomized controlled trials (RCTs) were general health benefits (51 RCTs), psychological well-being (37 RCTs), interventions for older adults (31 RCTs), balance (27 RCTs), hypertension (18 RCTs), fall prevention (15 RCTs), and cognitive performance (11 RCTs). The map identified a number of areas with evidence of a potentially positive treatment effect on patient outcomes, including Tai Chi for hypertension, fall prevention outside of institutions, cognitive performance, osteoarthritis, depression, chronic obstructive pulmonary disease, pain, balance confidence, and muscle strength. However, identified reviews cautioned that firm conclusions cannot be drawn due to methodological limitations in the original studies and/or an insufficient number of existing research studies. CONCLUSIONS Tai Chi has been applied in diverse clinical areas, and for a number of these, systematic reviews have indicated promising results. The evidence map provides a visual overview of Tai Chi research volume and content. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42014009907.
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Affiliation(s)
| | | | - Paul G Shekelle
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,VA Evidence-based Synthesis Program (ESP) Center, Los Angeles, CA, USA.,University of California, Los Angeles, CA, USA.,Evidence-based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Isomi M Miake-Lye
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,VA Evidence-based Synthesis Program (ESP) Center, Los Angeles, CA, USA
| | - Jessica M Beroes
- VA Evidence-based Synthesis Program (ESP) Center, Los Angeles, CA, USA
| | - Roberta M Shanman
- Evidence-based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Susanne Hempel
- Evidence-based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA.
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Deveza LA, Hunter DJ. Pain Relief for an Osteoarthritic Knee in the Elderly: A Practical Guide. Drugs Aging 2016; 33:11-20. [PMID: 26659733 DOI: 10.1007/s40266-015-0331-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In view of the increasing prevalence of knee osteoarthritis (OA) in the population worldwide, optimal management is critical to decrease the burden of this condition and minimize disability and personal suffering. Current care is based on a sequence of non-pharmacological, pharmacological, and surgical modalities, targeted to improving pain and function in the elderly population. The aim of this article is to provide a practical view of the efficacy of therapeutic options available along with clinically relevant considerations on the management of knee OA in this demographic group.
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Affiliation(s)
- Leticia A Deveza
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Reserve Road, St. Leonards, Sydney, NSW, 2065, Australia
| | - David J Hunter
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Reserve Road, St. Leonards, Sydney, NSW, 2065, Australia.
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Kong LJ, Lauche R, Klose P, Bu JH, Yang XC, Guo CQ, Dobos G, Cheng YW. Tai Chi for Chronic Pain Conditions: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sci Rep 2016; 6:25325. [PMID: 27125299 PMCID: PMC4850460 DOI: 10.1038/srep25325] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 04/14/2016] [Indexed: 12/02/2022] Open
Abstract
Several studies reported that Tai Chi showed potential effects for chronic pain, but its role remains controversial. This review assessed the evidence regarding the effects of Tai Chi for chronic pain conditions. 18 randomized controlled trials were included in our review. The aggregated results have indicated that Tai Chi showed positive evidence on immediate relief of chronic pain from osteoarthritis (standardized mean difference [SMD], −0.54; 95% confidence intervals [CI], −0.77 to −0.30; P < 0.05). The valid duration of Tai Chi practice for osteoarthritis may be more than 5 weeks. And there were some beneficial evidences regarding the effects of Tai Chi on immediate relief of chronic pain from low back pain (SMD, −0.81; 95% CI, −1.11 to −0.52; P < 0.05) and osteoporosis (SMD, −0.83; 95% CI, −1.37 to −0.28; P = 0.003). Therefore, clinicians may consider Tai Chi as a viable complementary and alternative medicine for chronic pain conditions.
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Affiliation(s)
- Ling Jun Kong
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Petra Klose
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jiang Hui Bu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao Cun Yang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chao Qing Guo
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Ying Wu Cheng
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Schitter AM, Nedeljkovic M, Ausfeld-Hafter B, Fleckenstein J. Changes in self-reported symptoms of depression and physical well-being in healthy individuals following a Taiji beginner course - Results of a randomized controlled trial. Brain Behav 2016; 6:e00429. [PMID: 27088053 PMCID: PMC4782252 DOI: 10.1002/brb3.429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 09/23/2015] [Accepted: 12/16/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Taiji is a mind-body practice being increasingly investigated for its therapeutic benefits in a broad range of mental and physical conditions. The aim of this study was to investigate the potential preventive effects of Taiji practice in healthy individuals with regard to their depressive symptomatology and physical well-being. METHODS Seventy healthy Taiji novices were randomly assigned to a Taiji intervention group, that is, Taiji beginner course (Yang-Style Taiji, 2 h per week, 12 weeks) or a control group comprised of the waiting list for the course. Self-reported symptoms of depression (CES-D) and physical well-being (FEW-16) were assessed at baseline, at the end of the intervention, as well as 2 months later. RESULTS The included participants had a mean age of 35.5 years. Physical well-being in the Taiji group significantly increased when comparing baseline to follow-up (FEW-16 sum score T(27) = 3.94, P = 0.001, 95% CI 0.17 to 0.55). Pearson's correlation coefficients displayed a strong negative relationship between self-reported symptoms of depression and physical well-being (P's < 0.001, r's ≥ -0.54). CONCLUSION In this randomized controlled trial, we found significant evidence that a Taiji beginner course of 3 months duration elicits positive effects with respect to physical well-being in healthy individuals, with improvements pronouncing over time. Physical well-being was shown to have a strong relationship with depressive symptoms. Based on these results, the consideration of Taiji as one therapeutic option in the development of multimodal approaches in the prevention of depression seems justifiable.
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Affiliation(s)
| | - Marko Nedeljkovic
- University of Bern Institute of Complementary Medicine IKOM Bern Switzerland
| | | | - Johannes Fleckenstein
- University of Bern Institute of Complementary Medicine IKOM Bern Switzerland; Goethe-University Frankfurt Institute of Sports Medicine Frankfurt Germany
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Lauche R, Wayne PM, Dobos G, Cramer H. Prevalence, Patterns, and Predictors of T'ai Chi and Qigong Use in the United States: Results of a Nationally Representative Survey. J Altern Complement Med 2016; 22:336-42. [PMID: 26981616 DOI: 10.1089/acm.2015.0356] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE This study examined the prevalence, patterns, and predictors of t'ai chi and qigong use in the U.S. general population. DESIGN Cross-sectional survey. METHODS Data from the 2012 National Health Interview Survey (n = 34,525). Weighted frequencies were used to analyze lifetime and 12-month prevalence and patterns of use. Independent predictors of practice were analyzed by using logistic regression models. Analyzes were conducted in 2015. RESULTS The lifetime and 12-month prevalence of t'ai chi/qigong practice were 3.1% and 1.2%, respectively. The 12-month prevalence was associated with age older than 30 years; being African American, Asian, or other ethnic origin; living in the West; being college educated and single; and being a light to heavy alcohol consumer. Almost 39% of users attended formal classes. T'ai chi/qigong was practiced for wellness/disease prevention and to improve energy, immune function, athletic performance, or memory/concentration. Stress, arthritis, and joint problems were the most frequent specific health problems for practice. CONCLUSIONS Despite an only marginal increase of t'ai chi/qigong practice in the United States over the past 10 years, the proportion of minorities among practitioners has increased significantly. Gaps between clinical application and research are discussed.
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Affiliation(s)
- Romy Lauche
- 1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen , Essen, Germany .,2 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney , Sydney, Australia
| | - Peter M Wayne
- 3 Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, MA
| | - Gustav Dobos
- 1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen , Essen, Germany
| | - Holger Cramer
- 1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen , Essen, Germany .,2 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney , Sydney, Australia
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Field T. Knee osteoarthritis pain in the elderly can be reduced by massage therapy, yoga and tai chi: A review. Complement Ther Clin Pract 2016; 22:87-92. [DOI: 10.1016/j.ctcp.2016.01.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 12/24/2015] [Accepted: 01/12/2016] [Indexed: 10/22/2022]
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