Combined Tai Chi and cognitive interventions for older adults with or without cognitive impairment: A meta-analysis and systematic review

Effects of Dalcroze Eurhythmics Exercise Versus Multicomponent Exercise on Physical and Cognitive Function, and Falls in Older Adults: The EPHYCOS Randomized Controlled Trial

Currently, robust evidence is lacking to support one exercise type over another in the prevention of physical and cognitive decline and falls among older adults, primarily because of the lack of comparative trials of proven interventions. Therefore, a 12-month randomized, single-blind, comparative effectiveness trial is conducted, in which 142 older adults at high risk for falls are randomized (1:1) to receive an evidence-based Dalcroze Eurhythmics (DE) exercise program (once weekly, group-based) or an evidence-based multicomponent (MULTI) exercise program incorporating balance, functional, and strength training activities (twice weekly, group- and home-based), for 12 months. The primary outcome is gait variability under dual-task at 12 months. At 12 months, the DE group has significant improvements compared with MULTI group on gait under both dual-task (adjusted β for stride variability: -2.3, 95%CI, -3.1 to -1.4; p < 0.001) and single-task, and on a variety of secondary physical and cognitive/executive function outcomes. The adjusted hazard ratio for falls is 0.58 (95%CI, 0.37 to 0.93) for the DE group compared with MULTI group. In conclusion, DE exercise is more effective than MULTI exercise in improving physical and cognitive function and reducing falls in older adults. The mechanisms underlying DE exercise-induced benefits remain to be fully elucidated.

Effects of combat sports on cognitive function in older people: a systematic review

INTRODUCTION

This systematic review aimed to analyze the available body of published peer-reviewed studies on the effects of combat sports compared with active/passive control on cognitive function and electrophysiological markers of brain activity in older people.

EVIDENCE ACQUISITION

The studies were searched in Scopus, Web of Science, PubMed, MEDLINE, and PsycINFO databases from deadline to June 2023. The PRISMA, TESTEX, RoB, and GRADE scales assessed the evidence's methodological quality and certainty of evidence. The protocol was registered in PROSPERO (code: CRD42022361695).

EVIDENCE SYNTHESIS

After reviewing 3768 studies, seven combat sports interventions (score ≥60% in methodological quality) were selected, composed of 381 older people (63% female), with a mean age of 66 years. In the selected studies, interventions based on judo, karate, and taekwondo were carried out, where it was not possible to verify the benefits of combat sports in cognitive function and electrophysiological markers of brain activity regarding active/passive control groups, although the individual results of the analyzed studies indicate that the practice of combat sports favor selective attention, divided attention, executive function, visual perception, and cognitive processing speed in older people.

CONCLUSIONS

The available evidence does not allow a definite recommendation regarding combat sports as an effective cognitive function intervention in older people.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

SYSTEMATIC REVIEW REGISTRATION

PROSPERO [ CRD42022364385 ].