Practicing Tai Chi had lower energy metabolism than walking but similar health benefits in terms of aerobic fitness, resting energy expenditure, body composition and self-perceived physical health

Study protocol for a comparative randomized controlled trial of Tai Chi and conventional exercise training on alleviating depression in older insomniacs

Background

Insomnia and depression are prevalent mental disorders that are often comorbid among older adults. Lifestyle intervention strategies incorporating Tai Chi or conventional exercise have been shown to alleviate symptoms of insomnia and depression. However, the comparative efficacy of these exercise modalities in individuals with both disorders has yet to be determined. Therefore, the aim of this study is to examine the efficacy of Tai Chi and conventional exercise for reducing depressive symptoms in older adults with chronic insomnia and depressive symptoms, when compared to a health education control.

Methods

This study is a prospective, assessor-blinded, three-arm, parallel group, randomized controlled trial. Older adults aged ≥60 years with a diagnosis of chronic insomnia and depressive symptoms will be randomly assigned to a Tai Chi, conventional exercise or health education control condition on a 1:1:1 basis. Interventions will last for 3 months, with a 6-month follow-up period. The primary outcome is depressive symptoms, assessed using the Hospital Anxiety and Depression Scale. Secondary outcomes include subjective sleep quality, 7-day actigraphy, 7-day sleep diary, anxiety symptoms, quality of life, medication usage and physical function. All measurements will be conducted at baseline, 3 months and 9 months by outcome assessors who are blinded to group allocation.

Discussion

This study will compare the efficacy of Tai Chi and conventional exercise in improving depression outcomes in older adults with chronic insomnia and depressive symptoms. Our results will shed light on the clinical potential of these interventions for combating insomnia and depression in older adults.

Effect of Taichi Chuan on health-related physical fitness in adults: A systematic review with meta-analysis

PURPOSE

Taichi Chuan was previously shown to benefit physical health, but the results were inconsistent. The main reason is that the mechanism is not clear and may be interpreted differently. In this systematic review, we analyzed the data obtained from various randomized controlled trials to identify the effectiveness of Taichi Chuan and the mechanism by which it improves the physical health of adults.

METHODS

We systematically searched various databases, including PubMed, Web of Science, Scopus, Embase, EBSCO Host, Science Direct, CNKI, Wan-Fang, and VPCS, and obtained 1448 articles for review. The articles were selected following the PICO eligibility criteria. We performed a systematic review and meta-analysis to interpret the results of the different studies.

RESULTS

We included 16 studies in the systematic review. Six of them were of very high quality, ten were of acceptable quality. Overall, the results showed that Taichi Chuan is beneficial to physical fitness, but not all indices supported this statement. Specifically, the effects were significant on Balance (ES = - 0.33; P = 0.02), BMI (ES = - 0.83; P < 0.00001), body fat (ES = - 0.45; P < 0.00001), and vital capacity (ES = 23.39; P = 0.01). However, there were no significant effects on systolic blood pressure (ES = 0.07; P = 0.94) and diastolic blood pressure (ES = 0.03; P = 0.97).

CONCLUSION

We found sufficient high-quality evidence to suggest that Taichi Chuan affects balance, BMI, body fat, vital capacity, and flexibility (sit-reach) in adults. The mechanism can be explained by low posture (balance) and moderate intensity of Taichi Chuan. However, no study has explained how to maintain concentration while keeping a dynamic low posture, which made it difficult to validate the finding that Taichi Chuan can reduce sympathetic tension under stress. In this study, we assumed that relaxation methods, which work on the central nervous system that links the body and the mind, might be the key explanation. However, further studies based on scientific, replicable methods need to be performed to confirm our findings.

The comparative effects of Tai chi versus non-mindful exercise on measures of anxiety, depression and general mental health: A systematic review and meta-analysis

BACKGROUND

Tai chi has been commonly used as an allied health strategy that can support the improvement of mental health for individuals, yet the comparative effects of Tai chi versus non-mindful exercise on measures of anxiety, depression and general mental health are unknown. This study aims to quantitatively estimate the comparative effects between Tai chi and non-mindful exercise on measures of anxiety, depression, and general mental health and examine whether selected moderators of theoretical or practical importance moderate the effects.

METHODS

Consistent with PRISMA guidelines for conduct and reporting, we located articles published before 31 Dec 2021 using Google Scholar, Pubmed, Web of Science, EBSCO (PsycArticles, PsycExtra, PsycInfo, Academic Search Premier, ERIC, MEDLINE). To be included in the analysis, studies were required to have (1) a design that randomly assigned participants to Tai chi and non-mindful exercise comparison condition or group. (2) anxiety, depression, or general mental health outcome measured at baseline and during or after Tai chi and exercise intervention. Study quality was judged using the tool for assessing study quality and reporting in exercise (TESTEX) for randomized controlled trials (RCTs). Three separate multilevel meta-analyses with random effects were performed to estimate the comparative effects of Tai chi versus non-mindful exercise on psychometric measures of anxiety, depression, and general mental health respectively. In addition, possible moderators were assessed accordingly for each meta-analysis.

RESULTS

Twenty-three studies that included measures of anxiety (10), depression (14), and general mental health (11) involved 4370 participants (anxiety, 950; depression, 1959; general mental health,1461) and yielded 30 effects on anxiety, 48 on depression, and 27 on general mental health outcomes. Tai Chi training consisted of 1-5 sessions per week, 20-83 min per session, and 6-48 weeks. After adjusting for nesting effects, the results showed significant small-to-moderate effects of Tai chi versus non-mindful exercise on the measure of anxiety (d = 0.28, 95 % CI, 0.08 to 0.48), depression (d = 0.20, 95 % CI, 0.04 to 0.36), and general mental health (d = 0.40, 95 % CI, 0.08 to 0.73). Further moderator analyses showed that baseline general mental health T-score and study quality influenced the effects of Tai chi versus non-mindful exercise on measure of general mental health.

CONCLUSION

Compared to non-mindful exercise, the small body of studies reviewed here tentatively supports that Tai chi is more effective in reducing anxiety and depression and improving general mental health than non-mindful exercise. Higher-quality trials are needed to standardize Tai chi and non-mindful exercise exposure, quantify mindfulness elements in Tai chi practice, and control expectations on conditions to better determine the psychological effects of both exercise properties.

Efficacy of traditional Chinese exercises in improving anthropometric and biochemical indicators in overweight and obese subjects: A systematic review and meta-analysis

BACKGROUND

The efficacy of traditional Chinese exercise (TCE)-based intervention in the improvement of anthropometric and biochemical indicators in overweight and obese patients is controversial. In this regard, the aim of this review was to summarize the evidence of TCE interventions to evaluate their effectiveness on the anthropometric and biochemical indicators of overweight and obese patients.

METHOD

Five databases were systematically searched for relevant articles published from inception to October 2022. Randomized controlled trials examining TCE intervention in overweight and obese patients The treatment effects were estimated using a random-effect meta-analysis model with standardized mean differences (Hedges' g). The categorical and continuous variables were used to conduct moderator analyses. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42022377632).

RESULT

Nine studies involving a total of 1297 participants were included in the final analysis. In the anthropometric indicators outcomes, the meta-analytic findings revealed large and significant improvements in body mass index (g = 1.44, 95% confidence interval [CI] = 1.27-1.61, P = .000, I2 = 99%), weight (g = 1.47, 95% CI = 1.25-1.68, P = .000, I2 = 95%), fat percentage (g = 1.22, 95% CI = 0.52-1.93, P = .000, I2 = 93%), and small and significant improvements in waist circumference (g = 0.38, 95% CI = 0.21-0.54, P = .000, I2 = 99%). In the biochemical indicators outcomes, the findings revealed large and significant improvements in low density lipoprotein (g = 2.08, 95% CI = 1.80-2.37, P = .000, I2 = 98%), moderate and significant improvements in triglyceride (g = 0.69, 95% CI = 0.56-0.81, P = .000, I2 = 96%), small and significant improvements in total cholesterol (g = 0.37, 95% CI = 0.19-0.54, P = .000, I2 = 77%), and high-density lipoprotein (g = -0.71, 95% CI = -0.86 to 0.57, P = .000, I2 = 99%). The moderator shows that the effects of TCE on anthropometric and biochemical indicators were moderated by frequency of exercise, exercise duration, and type of control group.

CONCLUSION

TCE intervention is a beneficial non-pharmacological approach to improving anthropometric and biochemical indicators in overweight and obese subjects, especially in body mass index, weight, fat percentage, triglyceride, and low-density lipoprotein. The clinical relevance of our findings is pending more extensive trials and more rigorous study designs to strengthen the evidence.

Mitigating effects and mechanisms of Tai Chi on mild cognitive impairment in the elderly

Mild cognitive impairment (MCI) is a major public health concern that endangers health and decreases the quality of life of the elderly around the world. A recent clinical guideline has recommended regular exercise (twice per week) for patients with MCI as part of an overall approach to management. Tai Chi, a form of light-to-moderate-intensity mind-body exercise, is particularly suitable for seniors. This review aims to summarize epidemiological studies related to the effects of Tai Chi on symptom remission in older adults with MCI and reveal the potential mechanisms. Evidence suggested that Tai Chi can improve cognitive functions and alleviate the accompanying symptoms of MCI in the elderly potentially by activating the expression of signals in different brain regions, altering their connectivity, increasing the brain volume, and modulating brain-derived neurotropic and inflammation factors. Studies comparing various types of Tai Chi may contribute to the identification of paradigms that have appropriate intensities and difficulty and exert good effects on older people with MCI. In addition, studies are warranted to determine the frequency and duration of training that can optimize the beneficial effects of Tai Chi on MCI.

Efficacy and feasibility of a 12-week Tai Chi training for the prophylaxis of episodic migraine in Hong Kong Chinese women: A randomized controlled trial

Background

Tai Chi has been broadly applied as alternative treatment for many neurological and psychological disorders. Whereas no study using Tai Chi as prophylactic treatment for migraine. The purpose of this study was to preliminarily examine the efficacy and feasibility of a 12-week Tai Chi training on migraine attack prevention in a sample of Chinese women.

Methods

A two-arm randomized controlled trial was designed. Women aged 18 to 65 years and diagnosed with episodic migraine were randomized to either Tai Chi group (TC group) or the waiting list control group. A modified 33-short form Yang-style Tai Chi training with 1 h per day, 5 days per week for 12 weeks was implemented in the TC group, with a 12-week follow up period. The control group received a "delayed" Tai Chi training at the end of the trial. The primary outcome was the differences in attack frequency between 4 weeks before baseline and at the 9-12 weeks after randomization. The intensity and duration of headache were also measured. The feasibility was evaluated by the maintenance of Tai Chi practice and satisfactory level of the participants toward training.

Results

Eighty-two women were randomized, finally 40 in TC group and 33 in control group were involved in the analysis. On average, women in TC group had 3.0 times (95% CI: -4.0 to -2.0, P < 0.01) and 3.6 days (95% CI: -4.7 to -2.5, P < 0.01) reduction of migraine attack per month. Compared with the control group, the differences were statistically significant (-3.7 attacks/month, 95% CI: -5.4 to -1.9; and -3.0 migraine days/month, 95% CI: -4.5 to -1.5; both P < 0.001). The intensity and duration of headache had 0.6 (95% CI: -1.2 to -0.0, P < 0.05) units and 1.2 (IQR: -5.0 to 1.1, P < 0.05) hours reduction in TC group, respectively. Most of the participants (69.2%-97.4%) were satisfied with the training. At the end of 24 weeks, on average, the participants maintained 1.5 times of practice per week and 20 min for each practice.

Conclusion

The 12-week Tai Chi training significantly decreased the frequency of migraine attack. It was acceptable and practicable among female migraineurs.

Clinical trial registration

www.ClinicalTrials.gov, identifier: NCT03015753.

Effectiveness of Tai Chi on Blood Pressure, Stress, Fatigue, and Sleep Quality among Chinese Women with Episodic Migraine: A Randomised Controlled Trial

The beneficial effects of Tai Chi on the cardiovascular risk profile and the migraine trigger factors among female migraineurs remain unknown. This study aimed to evaluate the effectiveness of a 12-week Tai Chi training on blood pressure (BP) and migraine-related trigger factors, including stress, fatigue, and sleep quality among Chinese women with episodic migraine. In this study, eligible Hong Kong Chinese women aged 18–65 years were randomly assigned to the Tai Chi group adopting a modified 33-short form of Yang style Tai Chi training for 12 weeks, followed by additional 12 weeks of self-practice or the waiting list control group that maintained the usual lifestyle for 24 weeks. The primary outcome was the changes in BP from the baseline to 12 and 24 weeks. The secondary outcomes included the stress level, fatigue, and sleep quality measured by the perceived stress scale (PSS), the numeric rating scale-fatigue (NRS-fatigue), and the Pittsburgh sleep quality index (PSQI), respectively. Significant between-group differences were found in systolic BP (−6.8 mmHg at 24 weeks, P=0.02), and a decreasing trend was significant across baseline, 12 weeks, and 24 weeks between groups (P < 0.05). The 12-week Tai Chi training significantly reduced the BP level and moderately improved stress level, fatigue status, and sleep quality among Chinese women with episodic migraine. Therefore, Tai Chi could be considered a promising mind-body exercise with good feasibility for migraineurs in the future. This trial is registered with registration number NCT03015753.

Effects of Tai-Chi and Running Exercises on Cardiorespiratory Fitness and Biomarkers in Sedentary Middle-Aged Males: A 24-Week Supervised Training Study

This study examined the effectiveness of Tai-Chi and running exercises on cardiorespiratory fitness and biomarkers in sedentary middle-aged adults under 24 weeks of supervised training. Methods Thirty-six healthy middle-aged adults (55.6 ± 5.3 yr) were randomly assigned into Tai-Chi, running and control groups. During a 24-week training period, the Tai-Chi and running groups were asked to perform exercises for 60 min/day and 5 days/week, which were supervised by Tai-Chi and running instructors throughout. Resting heart rate, lean mass, blood pressure and blood lipids were measured, and cardiorespiratory fitness (VO2max, Vmax and Peak heart rate) was assessed at the baseline and the 12- and 24-week interventions. Results Compared to the no-exercise control group, both the Tai-Chi and running groups significantly decreased resting heart rate, diastolic blood pressure and cardiorespiratory fitness and increased lean mass across the training session (p < 0.05). Compared to the Tai-Chi group, the running group showed greater improvement in VO2max and Vmax (p < 0.05) and reduced triglyceride and low-density lipoprotein cholesterol (p < 0.05). Conclusion Both Tai-Chi and running exercise showed beneficial effects on cardiorespiratory fitness and enhanced health-related outcomes in middle-aged adults. Although Tai-Chi exercises were less effective in VO2max than running, Tai-Chi may be considered as a plausible alternative to running exercises that can be achieved in the indoor-based setting.

Effects of Tai Chi on the Executive Function and Physical Fitness of Female Methamphetamine Dependents: A Randomized Controlled Trial

Purpose: Exercise improves the health and mental status of drug dependents. The way by which Tai Chi (TC) as a special exercise treatment affects executive functions (EFs) of methamphetamine (MA) dependents is yet to be established. This study aimed to explore the effects of TC on the EFs and physical fitness of MA dependents. Methods: A total of 76 female MA dependents were randomly assigned to the exercise and control groups. The exercise group underwent three 60-min sessions of TC training per week for 12 weeks. The control group was trained with conventional exercises including the 9th Guang Bo Ti Cao and square dance. Physical fitness and EF assessments that evaluated inhibitory control (IC, go/no-go task), working memory (3-back task) and cognitive flexibility (switching task) were performed at baseline and at 12 weeks. A repeated-measures ANOVA was applied to analyze the differences of group and time. Results: The exercise group showed decreased response time (RT) with a significant main effect of time on the go/no-go task [F (1, 68) = 9.6, p < 0.05]. The interaction effect between time and group was significant on accuracy [F (1, 61) = 4.73, p < 0.05], and the main effect of time was significant on RT [F (1, 61) = 4.66, p < 0.05] in the 3-back task of the exercise group. Significant changes in BMI [F (1, 68) = 19.57, p < 0.05], vital capacity [F (1, 68) = 6.00, p < 0.05], and systolic blood pressure [F (1, 68) = 6.11, p < 0.05] were observed in the exercise group. Conclusion: These findings showed that 3 months of TC training can improve the IC and maintain the working memory and cognitive flexibility of MA dependents. Other data implied that TC may improve the physical fitness of MA dependents. Clinical Trial Registration: http://www.chictr.org.cn/, ChiCTR1900022091.

A Randomized Trial of Tai Chi on Preventing Hypertension and Hyperlipidemia in Middle-Aged and Elderly Patients

In our randomized controlled trial, we investigated whether Wu-style Tai Chi (Tai Chi combined with Daoyin) as a potential exercise prescription is more effective than simplified Tai Chi in the prevention and treatment of hypertension and hyperlipidemia in the middle-aged and elderly. We randomly assigned 66 patients with hypertension and hyperlipidemia to one of the two groups: the Wu-style Tai Chi group or the simplified Tai Chi group; the simplified Tai Chi group only exercised simplified Tai Chi three times a week for 6 weeks. The Wu-style Tai Chi group participated in 60 min of Wu-style Tai Chi three times a week for 6 weeks. Serum biochemical tests were conducted at baseline and at the end of the study. Measurements of blood pressure were performed at the same time. Primary outcomes were compared within and between groups at baseline and at 6 weeks. The participants in the Wu-style Tai Chi group performed, at 6 weeks, significantly better than baseline on all of the primary outcomes (p value ≤ 0.05). The results also show significant difference within the simplified Tai Chi group from baseline to 6 weeks in TCHO (mmol/L), SBP (mmHg), and LDL-C (mmol/L) (p value < 0.05). From baseline to 6 weeks, the Wu-style Tai Chi group had significant differences at more test indexes in serum and blood pressure than the simplified Tai Chi group. At 6 weeks, the Wu-style Tai Chi group had a significantly greater mean improvement in the SBP (mmHg) than did the simplified Tai Chi group (mean between-group difference, −5.80 (mmHg) [95% CI, −14.01 to 2.41]; p = 0.007). The results showed that, compared with simplified Tai Chi, Wu-style Tai Chi had a better effect on hypertension in the middle-aged and elderly. At 6 weeks in LDL-C (mmol/L), the Wu-style Tai Chi group had significantly greater improvement between the two groups (means between-group difference, −0.45 (mmol/L) [95% CI, −0.89 to −0.17]; p = 0.03). The results showed that Wu-style Tai Chi protected the cardiovascular system of the middle-aged and elderly in improving LDL-C (mmol/L), and was more significant than simplified Tai Chi. After 6 weeks of exercise, Wu-style Tai Chi could effectively improve hyperlipidemia and hypertension. The total effective rate of cardiovascular disease was 90.00%. There was significant difference in the treatment effect of hypertension and hyperlipidemia between the two groups during 6 weeks (p = 0.039), showing that, in a small population of middle-aged and elderly subjects, Wu style Tai Chi could be useful in managing important CV risk factors, such as hypertension and hyperlipidemia.

Effectiveness of martial arts exercise on anthropometric and body composition parameters of overweight and obese subjects: a systematic review and meta-analysis

Background

Obesity is considered a top public health concern, and its prevalence is growing every day. Thus, interventions to address this problem should be encouraged and further studied. In this regard, the aim of this review was to summarize the evidence of martial arts interventions to evaluate their effectiveness on the anthropometric and body composition parameters of overweight and obese subjects.

Methods

A systematic literature search was conducted on January 26, 2020 using the PubMed, Medline, Lilacs, Cochrane, and Scielo databases. Reference lists of eligible articles and relevant reviews have also been examined. All randomized clinical trials on martial arts that evaluated the anthropometric and body composition parameters of overweight and obese subjects were included, and a narrative synthesis of eligible studies was conducted in accordance with PRISMA guidelines. The Downs & Black checklist was used to assess the quality of the studies. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42018086116).

Results

A total of 82 articles were identified from the initial search strategy. A further 2 articles were identified from the review of relevant bibliographies. Six studies encompassing 258 participants who were overweight or obese were included. Four studies reported Tai Chi practice, one study reported Kung Fu exercise, and another study reported martial arts exercise. The examined meta-analyses did not reveal significant benefits from martial arts practice over control groups after the experiment period for body mass index (− 1.34 kg/m²; 95% CI: − 2.72, 0.05), waist circumference (1.41 cm; 95% CI: − 0.72, 3.54) and percentage of body fat (− 0.75%; 95% CI: − 5.58, 4.08).

Conclusion

The scarcity, heterogeneity, short intervention time, small sample size, and significant methodological limitations of the available studies do not allow to conclude whether martial arts are effective in the anthropometric and body composition parameters of overweight and obese individuals. This study highlights the need for more research to assess the benefits of martial arts for overweight and obese individuals.

Lower Percentage of Fat Mass among Tai Chi Chuan Practitioners

The aim of the study was to analyze total and regional body composition in Tai Chi Chuan (TCC) middle-aged and elderly practitioners. A cross-sectional study on 139 Italian subjects was realized: 34 TCC practitioners (14 men, 20 women; 62.8 ± 7.4 years) and 105 sedentary volunteers (49 men, 56 women; 62.8 ± 6.4 years). Anthropometric measurements (height, weight, arm, waist, and calf circumferences), hand-grip strength, and physical capacity values were collected. Total and regional (arm, leg, and trunk) body composition was analyzed by means of specific bioelectrical impedance vector analysis (specific BIVA). TCC practitioners of both sexes were characterized by a normal nutritional status, normal levels of physical capacity, and normal values of hand-grip strength. Compared to controls, they showed lower percentages of fat mass (lower specific resistance) in the total body, the arm, and the trunk, and higher muscle mass (higher phase angle) in the trunk, but lower muscle mass in the arm. Sexual dimorphism was characterized by higher muscle mass (total body, arm, and trunk) and lower %FM (arm) in men; sex differences were less accentuated among TCC practitioners than in the control. TCC middle-aged and elderly practitioners appear to be less affected by the process of physiological aging and the associated fat mass changes, compared to sedentary people.

Effect of Tai Chi on Quality of Life, Body Mass Index, and Waist-Hip Ratio in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a worldwide public health concern with high morbidity and various progressive diabetes complications that result in serious economic expenditure and social burden. This systematic review aims to evaluate the effect of Tai Chi on improving quality of life (QoL), body mass index (BMI) and waist-hip ratio (WHR) in patients with T2DM.

METHOD

A systematic review and meta-analysis was performed following PRISMA recommendation. Four English databases and three Chinese databases were searched. The PEDro scale was used to assess the methodological quality of including studies. Study inclusion criteria: randomized controlled trials (RCTs) and quasi-experimental studies were included, patients with T2DM that adopted Tai Chi as intervention and QoL, BMI and/or WHR as outcome measurements.

RESULTS

Eighteen trials were included. The aggregated results of seven trials showed that Tai Chi statistically significantly improved QoL measured by the SF-36 on every domains (physical function: MD = 7.73, 95% confidence interval (CI) = 1.76 to 13.71, p = 0.01; role-physical function: MD = 9.76, 95% CI = 6.05 to 13.47, p < 0.001; body pain: MD = 8.49, 95% CI = 1.18 to 15.8, p = 0.02; general health: MD = 9.80, 95% CI = 5.77 to 13.82, p < 0.001; vitality: MD = 6.70, 95% CI = 0.45 to 12.94, p = 0.04; social function: MD = 9.1, 95% CI = 4.75 to 13.45, p < 0.001; role-emotional function: MD = 7.88, 95% CI = 4.03 to 11.72, p < 0.001; mental health: MD = 5.62, 95% CI = 1.57 to 9.67, p = 0.006) and BMI (MD = -1.53, 95% CI = -2.71 to -0.36, p < 0.001) compared with control group (wait list; no intervention; usual care; sham exercise).

CONCLUSION

Tai Chi could improve QoL and decrease BMI for patients with T2DM, more studies are needed to be conducted in accordance with suggestions mentioned in this review.

Effect of Tai Chi alone or as additional therapy on low back pain: Systematic review and meta-analysis of randomized controlled trials

BACKGROUND

This is the first systematic review evaluating and statistically synthesis the current studies regarding the effects of Tai Chi on pain and disability in patients with low back pain (LBP).

METHODS

Seven electronic databases including PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang and VIP information from inception to early March 2019 were searched. The Physiotherapy Evidence Database (PEDro) Scale was used to assess quality of all included randomized controlled trials (RCTs). The pooled effect size (weight mean difference, WMD) and 95% confidence interval (CI) were calculated to determine the effect of Tai Chi on pain and disability among LBP patients based on random effects model.

RESULTS

The aggregated results of the meta-analysis suggested that Tai Chi significantly decreased pain (WMD = -1.27, 95%CI -1.50 to -1.04, P < .00001, I = 74%) and improve function disability, Oswestry disability index (ODI) subitems: pain intensity (WMD = -1.70, 95% CI -2.63 to -0.76, P = .0004, I = 89%); personal care (WMD = -1.93, 95% CI -2.86 to -1.00, P < .0001, I = 90%); lifting (WMD = -1.69, 95% CI -2.22 to -1.15, P < .0001, I = 66%); walking (WMD = -2.05, 95% CI -3.05 to -1.06, P < .0001, I = 88%); standing (WMD = -1.70, 95% CI -2.51 to -0.89, P < .0001, I = 84%); sleeping (WMD = -2.98, 95% CI -3.73 to -2.22, P < .00001, I = 80%); social life (WMD = -2.06, 95% CI -2.77 to -1.35, P < 0.00001, I = 80%) and traveling (WMD = -2.20, 95% CI -3.21 to -1.19, P < .0001, I = 90%), Japanese Orthopedic Association (JOA) score (WMD = 7.22, 95% CI 5.59-8.86, P < .00001, I = 0%), Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) physical functioning (WMD = 3.30, 95% CI 1.92-4.68, P < .00001), and Roland-Morris Disability Questionnaire (RMDQ) (WMD = -2.19, 95% CI -2.56 to -1.82, P < .00001).

CONCLUSION

We drew a cautious conclusion that Tai Chi alone or as additional therapy with routine physical therapy may decrease pain and improve function disability for patients with LBP. Further trials are needed to be conducted with our suggestions mentioned in the systematic review.

The Beneficial Effects of Mind-Body Exercises for People With Mild Cognitive Impairment: a Systematic Review With Meta-analysis

OBJECTIVE

To objectively evaluate the most common forms of mind-body exercise (MBE) (tai chi, yoga, qigong) on cognitive function among people with mild cognitive impairment (MCI).

DATA SOURCES

We searched 6 electronic databases (Scopus, PubMed, PsycINFO, WanFang, Web of Science, CNKI) from inception until September 2018.

STUDY SELECTION

Nine randomized controlled trials and 3 nonrandomized controlled trials were included for meta-analysis.

DATA EXTRACTION

Two researchers independently performed the literature searches, study selection, data extraction, and methodological quality assessment using the revised Physiotherapy Evidence Database (PEDro) scale.

DATA SYNTHESIS

The pooled effect size (standardized mean difference [SMD]) was calculated while random-effect model was selected. Overall results of the meta-analysis (N=1298 people with MCI) indicated that MBE significantly improved attention (SMD=0.39, 95% confidence interval [CI] 0.07-0.71, P=.02, I²=31.6%, n=245), short-term memory (SMD=0.74, 95% CI 0.57-0.90, P<.001, I²=0%, n=861), executive function (SMD=-0.42, 95% CI -0.63 to -0.21, P<.001, I²=38.54%, n=701), visual-spatial/executive function (SMD=0.35, 95% CI 0.07-0.64, P<.05, I²=0%, n=285), and global cognitive function (SMD=0.36, 95% CI 0.2-0.52, P<.001, I²=15.12%, n=902). However, the significant positive effect on cognitive processing speed was not observed following MBE interventions (SMD=0.31, 95% CI -0.01 to 0.63, P=.054, I²=28.66%, n=233).

CONCLUSIONS

Study findings of this meta-analysis suggest that MBE have the potential to improve various cognitive functions in people with MCI.

Body Composition Outcomes of Tai Chi and Qigong Practice: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

PURPOSE

Meditative movement (MM) practices are increasingly being studied, including examination of the potential for these modalities to contribute to weight management.

METHODS

A search was conducted for randomized controlled trials testing one or both of two forms of MM, Tai Chi and Qigong, reporting effects on changes in body composition. Data from these studies were extracted and tabled, and a meta-analysis of studies with inactive control conditions was conducted. Risk of bias was assessed, and seven RCTs had a low risk of bias. Sources of bias include publication bias and selection of English only.

RESULTS

Publications meeting inclusion criteria yielded 24 studies (N = 1621 participants). Significant improvements in body composition, primarily body mass index, were noted for 41.7% of studies. A synthesis table describes the distribution of design factors, including type of comparison condition (inactive vs. active) and baseline body composition status (whether or not overweight/obese). A meta-analysis was conducted on 12 studies with inactive controls (using a random effects model) finding a small-to-medium treatment effect (SMD = - 0.388, CI = [- 0.732, - 0.044], t = 2.48, p < 0.03) for TC or QG interventions with a high level of heterogeneity.

CONCLUSIONS

Tai Chi and Qigong show demonstrable effects on body composition, when compared to inactive control conditions. Systematic evaluation and valid conclusions regarding the impact of Tai Chi and Qigong on body composition outcomes will require more targeted study designs and control of comparison conditions.

The Effect of Tai Chi on Cardiorespiratory Fitness for Coronary Disease Rehabilitation: A Systematic Review and Meta-Analysis

Background: Tai Chi that originated in China as a martial art is an aerobic exercise with low-to-moderate intensity and may play a role in cardiac rehabilitation.

Aim: To systematically review the effect of Tai Chi on cardiorespiratory fitness for coronary disease rehabilitation.

Methods: We performed a search for Chinese and English studies in the following databases: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database. The search strategy included terms relating to or describing Tai Chi and coronary disease, and there were no exclusion criteria for other types of diseases or disorders. Further, bibliographies of the related published systematic reviews were also reviewed. The searches, data extraction, and risk of bias (ROB) assessments were conducted by two independent investigators. Differences were resolved by consensus. RevMan 5.3.0 was used to analyze the study results. We used quantitative synthesis if the included studies were sufficiently homogeneous and performed subgroup analyses for studies with different control groups. To minimize bias in our findings, we used GRADEpro to grade the available evidence.

Results: Five studies were enrolled—two randomized controlled trials (RCTs) and three nonrandomized controlled trials (N-RCTs)—that included 291 patients. All patients had coronary disease. ROB assessments showed a relatively high selection and detection bias. Meta-analyses showed that compared to other types of low- or moderate-intensity exercise, Tai Chi could significantly improve VO₂max [MD = 4.71, 95% CI (3.58, 5.84), P < 0.00001], but it seemed less effective at improving VO₂max as compared to high-intensity exercise. This difference, however, was not statistically significant [MD = −1.10, 95% CI (−2.46, 0.26), P = 0.11]. The GRADEpro showed a low level of the available evidence.

Conclusion: Compared to no exercise or other types of exercise with low-to-moderate intensity, Tai Chi seems a good choice for coronary disease rehabilitation in improving cardiorespiratory fitness. However, owing to the poor methodology quality, more clinical trials with large sample size, strict randomization, and clear description about detection and reporting processes are needed to further verify the evidence.

A Review Study on the Beneficial Effects of Baduanjin

AIM

Baduanjin, a Chinese traditional Qigong exercise that focuses on a mind-body integration, is considered to be an effective exercise in promoting health. Thus, we systematically and critically evaluated the emerging literature relating to the effects of Baduanjin on health outcomes.

METHODS

We used seven English-language electronic databases for the literature search. At least one health-related parameter was reported in retrievable full-text Baduanjin intervention studies.

RESULTS

A total of 22 eligible studies were included. The inter-rater reliability between two review authors was 94.4% for selecting eligible studies. The results of individual studies support the notion that Baduanjin may be effective as an adjunctive rehabilitation method for improving cognitive functions in addition to psychological and physiological parameters among different age groups and various clinical populations (e.g., Parkinson's disease, chronic neck pain, chronic fatigue syndrome-like illness, psychological illness).

CONCLUSION

Before we draw a definitive conclusion relating to Baduanjin for health benefits, more methodologically rigorous studies with a long-term follow-up assessment should be further conducted to examine the effects of Baduanjin on health-related parameters and disease-specific measures in different health conditions. This review lends insight for future studies on Baduanjin and its potential application in preventive medicine and rehabilitation science.