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Liu H, Chen X, Li Y, Gao Z, Huang W, Jiang Z. Neuromuscular control strategies of the lower limb during a typical Tai Chi brush knee and twist step in practitioners with and without knee pain: a pilot study. Res Sports Med 2024; 32:679-694. [PMID: 37246805 DOI: 10.1080/15438627.2023.2219799] [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: 01/03/2023] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Abstract
As a complex movement, Tai Chi (TC) could be challenging for knee control, and the compensatory changes in TC biomechanics of knee pain patients are unknown. The Brush Knee and Twist Step (BKTS) is a typical TC movement that involves basic leg motion repeated in the whole TC. This pilot study examined electromyography and retro-reflective marker trajectory data to investigate neuromuscular control strategies of the lower extremity during BKTS in TC practitioners with and without knee pain. Twelve experienced TC practitioners with (n = 6) and without knee pain (n = 6) participated. Our results revealed that knee pain practitioners presented muscle imbalance in the vastus medialis-vastus lateralis and vastus lateralis-biceps femoris, and poor alignment of the knee with the toes in TC lunge. Additionally, they adaptively developed rigid coordination strategies, showing higher levels of lower limb muscle co-contraction and activity compared to controls. Training programs for TC practitioners with knee pain should be designed to modify both abnormal muscle synergy patterns and incorrect lunge during TC, which may improve exercise safety.
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Affiliation(s)
- Hong Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaolin Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yaping Li
- Department of Rehabilitation, Fujian Provincial Hospital, Fuzhou, China
| | - Zhen Gao
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- The First Clinical Medical College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Wujie Huang
- Department of Rehabilitation, Shenzhen Children's Hospital, Shenzhen, China
| | - Zheng Jiang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Chen Y, Jin C, Tang H, Yu J, Wang Y, Chen S, Miao W, Zhang S, Wang X. Effects of sedentary behaviour and long-term regular Tai Chi exercise on dynamic stability control during gait initiation in older women. Front Bioeng Biotechnol 2024; 12:1353270. [PMID: 38784770 PMCID: PMC11111940 DOI: 10.3389/fbioe.2024.1353270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/11/2024] [Indexed: 05/25/2024] Open
Abstract
Background: Sedentary behaviour has been associated with an increased risk of falls among older adults. Although gait initiation (GI) is a promising tool used to assess fall risk, it has yet to be quantitatively evaluated for dynamic stability in sedentary populations. Tai Chi exercise is believed to be effective in preventing falls in older adults, but its effect on GI stability has not been quantified. This study aims to compare the stability of GI in sedentary older individuals versus those who are long-term Tai Chi exercisers by using a quantitative approach. Methods: This study included 17 sedentary older women without exercise habits (age: 65.59 ± 3.66 years, average daily sitting time: 8.735 ± 1.847 h/day) and 19 older women who regularly engage in Tai Chi exercise (age: 65.58 ± 3.63 years, years of exercise: 9.84 ± 3.48 years). Every participant underwent five trials of self-paced GI walking tests. Eight cameras and four force plates were used to obtain kinematic and kinetic parameters. The trajectory of the centre of mass (CoM) and the position of the foot placement were recorded. The anterior-posterior (A-P) and medio-lateral (M-L) dynamic stability at the onset and end moments of the single-legged support was calculated using CoM and gait spatiotemporal parameters. The stepping dynamic stability and foot placement positions of both groups were compared. Results: The Tai Chi group had greater stability in the M-L directions at the swing leg's toe-off moment and in the M-L and A-P directions at the heel-strike moment, as well as significantly larger step length, step width and step speed during locomotion than sedentary older women. However, the stability in the A-P directions at the swing leg's toe-off moment and the foot inclination angle was not statistically different between the two groups. Conclusion: Long-term regular Tai Chi exercise can enhance the dynamic stability of GI in older women, and effectively improve their foot placement strategy during GI. The findings further confirm the negative effect of sedentary on the stability control of older women and the positive role of Tai Chi in enhancing their gait stability and reducing the risk of falls.
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Affiliation(s)
- Yuxia Chen
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Henan Sports Science and Technology Center (Henan Anti-Doping Center), Zhengzhou, Henan, China
| | - Chunxia Jin
- Huanghe Science and Technology College, Zhengzhou, Henan, China
| | - Hongyuan Tang
- Henan Sports Science and Technology Center (Henan Anti-Doping Center), Zhengzhou, Henan, China
| | - Jinglun Yu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Yuanxin Wang
- Henan Provincial Third People’s Hospital, Zhengzhou, Henan, China
| | - Shaolun Chen
- Henan Provincial Third People’s Hospital, Zhengzhou, Henan, China
| | - Wensheng Miao
- China Research Center on Aging, Beijing, Beijing, China
| | - Shengnian Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Xiangdong Wang
- School of Physical Education, Jimei University, Xiamen, Fujian, China
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Liu H, Gong H, Chen P, Zhang L, Cen H, Fan Y. Biomechanical effects of typical lower limb movements of Chen-style Tai Chi on knee joint. Med Biol Eng Comput 2023; 61:3087-3101. [PMID: 37624535 DOI: 10.1007/s11517-023-02906-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
The load and stress distribution on cartilage and meniscus of the knee joint in typical lower limb movements of Chen-style Tai Chi (TC) and deep squat (DS) were analyzed using finite element (FE) analysis. The loadings for this analysis consisted of muscle forces and ground reaction force (GRF), which were calculated through the inverse dynamic approach based on kinematics and force plate measurements obtained from motion capture experiments. Thirteen experienced practitioners performed four typical TC movements, namely, single whip (SW), brush knee and twist step (BKTS), stretch down (SD), and part the wild horse's mane (PWHM), which exhibit lower posture and greater lower limb force compared to other TC styles. The results indicated that TC required greater lower limb muscle strength than DS, resulting in greater knee joint forces. The stress on the medial cartilage in SW and BKTS fell within a range conductive to maintaining the balance between anabolism and catabolism of cartilage matrix. This was due to the fact that SW and BKTS reduce the medial to total tibiofemoral contact force ratios through knee abduction, which may effectively alleviate mild medial knee osteoarthritis (KOA). However, the greater medial contact force ratios observed in SD and PWHM resulted in great contact stresses that may aggravate the pain of patients with KOA. To mitigate these effects, practitioners should consider elevating their postures appropriately to reduce knee flexion angles, especially during the single-leg support phase. This adjustment can decrease the required muscle strength, load and stress on the knee joint.
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Affiliation(s)
- Haibo Liu
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - He Gong
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China.
| | - Peng Chen
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Le Zhang
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Haipeng Cen
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
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Li H, Peng F, Lyu S, Ji Z, Li X, Liu M. Newly compiled Tai Chi (Bafa Wubu) promotes lower extremity exercise: a preliminary cross sectional study. PeerJ 2023; 11:e15036. [PMID: 36935910 PMCID: PMC10019341 DOI: 10.7717/peerj.15036] [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: 11/22/2022] [Accepted: 02/20/2023] [Indexed: 03/14/2023] Open
Abstract
Background Tai Chi (Bafa Wubu) is a new type of simplified Tai Chi widely practiced by Tai Chi enthusiasts that has developed and perfected simplified Tai Chi movement and enriched Tai Chi practice methods. When practicing, Tai Chi athletes and enthusiasts can choose the Bafa Wubu movements to practice according to their physical conditions. The purpose of this article is to discuss the mechanism by which Bafa Wubu promotes lower extremity exercise from the perspective of exercise biomechanics. Objectives This article aims to explore the scientific training methods and technical characteristics of Bafa Wubu, and its contribution to comprehensive exercise of the lower extremities, by analyzing the biomechanical characteristics of the lower extremities of participants who practice Bafa Wubu at different levels and by comparing their ground reaction force, lower limb joints, and muscles during Bafa Wubu. Methods A total of 16 male participants were recruited and divided into an amateur group (N = 8) and a professional group (N = 8). The data were collected by a BTS 3D infrared-based motion capture system, and Kistler 3D force plate. The lower extremity joint forces and muscle strength were calculated by anybody simulation software with inverse dynamics. Results During elbowing and leaning sideways with steps sideways (ELS), the ground reaction force of the professional group was significantly higher than that of the amateur group in the sagittal, vertical, and frontal axes (P < 0.01). While stepping forward, backward, and sideways, the professional group's joints loading at the hip, knee, and ankle was always higher in the vertical direction (P < 0.01). Furthermore, during warding off with steps forward (WOF), laying with steps forward (LF), and rolling back with steps backward (RBB), hip joint loading increased in the med-lat direction. During actions with steps backward and sideways, the professional group's ankle flexion/extension torque and hip abduction/rotation torque were significantly larger than those of the amateur group (P < 0.01). Different actions in Bafa Wubu activate muscles to different degrees, whereas the iliacus is mainly responsible for stabilizing postures when practitioners perform standing knee lifting motions. Conclusions Professional groups who have been practicing Tai Chi (Bafa Wubu) for a long time have higher ground reaction force, and the force on the three joints of the lower extremities is different for various movements, which has positive significance for exercising the joints of the lower extremities. In addition, various motions activate muscles of different types at different levels. For amateurs to practice different movements to stimulate the muscles, targeted areas of practice promote the lower extremity muscles' synergistic force. In summary, the muscles and joints of the lower extremity can obtain comprehensive and balanced exercise through Bafa Wubu.
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Affiliation(s)
- Haojie Li
- School of P.E and Sports, Beijing Normal University, Beijing, Haidian, China
| | - Fang Peng
- Department of PE, Peking University, Beijing, Haidian, China
| | - Shaojun Lyu
- School of P.E and Sports, Beijing Normal University, Beijing, Haidian, China
| | - Zhongqiu Ji
- School of P.E and Sports, Beijing Normal University, Beijing, Haidian, China
| | - Xiongfeng Li
- School of P.E and Sports, Beijing Normal University, Beijing, Haidian, China
| | - Mingyu Liu
- School of P.E and Sports, Beijing Normal University, Beijing, Haidian, China
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Xing L, Bao Y, Wang B, Shi M, Wei Y, Huang X, Dai Y, Shi H, Gai X, Luo Q, Yin Y, Qin D. Falls caused by balance disorders in the elderly with multiple systems involved: Pathogenic mechanisms and treatment strategies. Front Neurol 2023; 14:1128092. [PMID: 36908603 PMCID: PMC9996061 DOI: 10.3389/fneur.2023.1128092] [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: 12/20/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Falls are the main contributor to both fatal and nonfatal injuries in elderly individuals as well as significant sources of morbidity and mortality, which are mostly induced by impaired balance control. The ability to keep balance is a remarkably complex process that allows for rapid and precise changes to prevent falls with multiple systems involved, such as musculoskeletal system, the central nervous system and sensory system. However, the exact pathogenesis of falls caused by balance disorders in the elderly has eluded researchers to date. In consideration of aging phenomenon aggravation and fall risks in the elderly, there is an urgent need to explore the pathogenesis and treatments of falls caused by balance disorders in the elderly. The present review discusses the epidemiology of falls in the elderly, potential pathogenic mechanisms underlying multiple systems involved in falls caused by balance disorders, including musculoskeletal system, the central nervous system and sensory system. Meanwhile, some common treatment strategies, such as physical exercise, new equipment based on artificial intelligence, pharmacologic treatments and fall prevention education are also reviewed. To fully understand the pathogenesis and treatment of falls caused by balance disorders, a need remains for future large-scale multi-center randomized controlled trials and in-depth mechanism studies.
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Affiliation(s)
- Liwei Xing
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China.,The First Clinical Medical School, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Yi Bao
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Binyang Wang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Mingqin Shi
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Yuanyuan Wei
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Xiaoyi Huang
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Youwu Dai
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Hongling Shi
- Department of Rehabilitation Medicine, The Third People's Hospital of Yunnan Province, Kunming Yunnan, China
| | - Xuesong Gai
- Department of Rehabilitation Medicine, The First People's Hospital of Yunnan Province, Kunming Yunnan, China
| | - Qiu Luo
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Yong Yin
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Dongdong Qin
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
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Liu X, Jiang C, Fan R, Liu T, Li Y, Zhong D, Zhou L, Liu T, Li J, Jin R. The effect and safety of Tai Chi on bone health in postmenopausal women: A meta-analysis and trial sequential analysis. Front Aging Neurosci 2022; 14:935326. [PMID: 36177477 PMCID: PMC9513206 DOI: 10.3389/fnagi.2022.935326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTai Chi may be a promising exercise to prevent and control bone loss in postmenopausal women. This meta-analysis and trial sequential analysis aimed to evaluate the effect and safety of Tai Chi on bone health in postmenopausal women.MethodSeven databases were searched from their inceptions to 11 May 2022 to collect randomized controlled trials (RCTs) investigating the effect and safety of Tai Chi on bone health in postmenopausal women. Two independent reviewers identified the eligible studies, extracted data, and assessed the risk of bias of included studies using the revised Cochrane risk-of-bias tool for randomized trials. The primary outcome was the bone mineral density (BMD), and secondary outcomes included bone turnover markers and calcaneus quantitative ultrasound. Subgroup analyses were conducted based on the duration of Tai Chi. Sensitivity analyses and publication bias assessment were performed. RevMan software (version 5.4.1) and R software (version 3.6.1) were used for data synthesis. The certainty of evidence was rated with the Grading of recommendations assessment, development, and evaluation (GRADE) system. We also performed the trial sequential analysis to evaluate the reliability of the evidence.ResultsA total of 25 reports involving 24 studies were included. Four studies were considered as high overall risk of bias, and the rest were some concerns. Among included studies, there were three comparisons including Tai Chi vs. non-intervention, Tai Chi vs. other exercises, and Tai Chi plus nutraceutical vs. nutraceutical. Compared with non-intervention, Tai Chi was more effective to improve BMD of lumbar spine (MD = 0.04, 95% CI 0.02 to 0.07, I2 = 0%, low certainty), femoral neck (MD = 0.04, 95% CI 0.02 to 0.06, I2 = 0%, low certainty), and trochanter (MD = 0.02, 95% CI 0.00 to 0.03, I2 = 0%, very low certainty), but there was no significant difference in increasing the BMD of Ward's triangle (MD = 0.02, 95% CI −0.01 to 0.04, I2 = 0%, very low certainty). Trial sequential analysis showed that the effect of Tai Chi vs. non-intervention on the BMD of lumbar spine and femoral neck was reliable, but the effect on the BMD of trochanter and Ward's triangle needed further verification. The subgroup analyses suggested that Tai Chi training for over 6 months had greater improvement in BMD of the lumbar spine, femoral neck, and trochanter than non-intervention. No significant differences were observed in the above outcomes of Tai Chi vs. other exercises, and Tai Chi plus nutraceutical vs. nutraceutical. There was insufficient evidence to support the effect of Tai Chi on bone turnover markers and calcaneus quantitative ultrasound. Few Tai Chi relevant adverse events occurred.ConclusionTai Chi may be an optional and safe exercise for improving BMD loss in postmenopausal women, and practicing Tai Chi for more than 6 months may yield greater benefits. However, more rigorously designed RCTs are required to verify the benefits and to explore the optimal protocol of Tai Chi exercise for bone health.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=309148, identifier: CRD42022309148.
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Affiliation(s)
- Xiaobo Liu
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chengzhi Jiang
- Department of Rehabilitation Medicine, Sichuan Science City Hospital, Mianyang, China
| | - Rong Fan
- Department of Rehabilitation Medicine, Nanbu County People's Hospital, Nanchong, China
| | - Tianyu Liu
- School of Sport and Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuxi Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Luxiang Zhou
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tao Liu
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Juan Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Juan Li
| | - Rongjiang Jin
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Integrated Traditional Chinese and Western Medicine Hospital of Panzhihua City, Panzhihua, China
- Rongjiang Jin
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Effectiveness of a Hybrid Exercise Program on the Physical Abilities of Frail Elderly and Explainable Artificial-Intelligence-Based Clinical Assistance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19126988. [PMID: 35742237 PMCID: PMC9223164 DOI: 10.3390/ijerph19126988] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 02/01/2023]
Abstract
Background: Due to the low physical fitness of the frail elderly, current exercise program strategies have a limited impact. Eight-form Tai Chi has a low intensity, but high effectiveness in the elderly. Inspired by it, we designed an exercise program that incorporates eight-form Tai Chi, strength, and endurance exercises, to improve physical fitness and reverse frailty in the elderly. Additionally, for the ease of use in clinical practice, machine learning simulations were used to predict the frailty status after the intervention. Methods: For 24 weeks, 150 frail elderly people completed the experiment, which comprised the eight-form Tai Chi group (TC), the strength and endurance training group (SE), and a comprehensive intervention combining both TC and SE (TCSE). The comparison of the demographic variables used one-way ANOVA for continuous data and the chi-squared test for categorical data. Two-way repeated measures analysis of variance (ANOVA) was performed to determine significant main effects and interaction effects. Eleven machine learning models were used to predict the frailty status of the elderly following the intervention. Results: Two-way repeated measures ANOVA results before the intervention, group effects of ten-meter maximum walking speed (10 m MWS), grip strength (GS), timed up and go test (TUGT), and the six-minute walk test (6 min WT) were not significant. There was a significant interaction effect of group × time in ten-meter maximum walking speed, grip strength, and the six-minute walk test. Post hoc tests showed that after 24 weeks of intervention, subjects in the TCSE group showed the greatest significant improvements in ten-meter maximum walking speed (p < 0.05) and the six-minute walk test (p < 0.05) compared to the TC group and SE group. The improvement in grip strength in the TCSE group (4.29 kg) was slightly less than that in the SE group (5.16 kg). There was neither a significant main effect nor a significant interaction effect for TUGT in subjects. The stacking model outperformed other algorithms. Accuracy and the F1-score were 67.8% and 71.3%, respectively. Conclusion: A hybrid exercise program consisting of eight-form Tai Chi and strength and endurance exercises can more effectively improve physical fitness and reduce frailty among the elderly. It is possible to predict whether an elderly person will reverse frailty following an exercise program based on the stacking model.
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Guo CY, Ma YJ, Liu ST, Zhu RR, Xu XT, Li ZR, Fang L. Traditional Chinese Medicine and Sarcopenia: A Systematic Review. Front Aging Neurosci 2022; 14:872233. [PMID: 35645784 PMCID: PMC9136040 DOI: 10.3389/fnagi.2022.872233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/21/2022] [Indexed: 12/01/2022] Open
Abstract
Sarcopenia has become a key challenge for healthy aging in older adults. However, it remains unclear whether traditional Chinese medicine can effectively treat sarcopenia. This systematic review analyzes the current evidence for the effect of traditional Chinese medicine (TCM) on sarcopenia. We searched for articles regarding sarcopenia treated by TCM in Cochrane library, PubMed, SinoMed, Web of Science, Embase, and the China National Knowledge Infrastructure (from inception until 10 December 2021). Two researchers independently screened the literature in accordance with the inclusion and exclusion criteria designed by PICOS principles. The risk of bias was assessed by the Cochrane Risk of Bias (ROB) tool. The quality of evidence was assessed by the grading of recommendations, assessment, development, and evaluation (GRADE). Participants' characteristics, interventions, and the relevant results of the included studies were extracted and synthesized in a narrative way. The total number of participants in the 21 included studies was 1,330. Most of the studies evaluated physical function (n = 20) and muscle strength (n = 18), and a small number of studies (n = 6) assessed muscle mass. Overall, it was found that TCM had a positive impact on muscle strength (grip strength, chair stand test) and physical function (6-m walking speed, timed up and go test, sit and reach) in patients with sarcopenia, inconsistent evidence of effects on muscle mass. However, the small sample size of the included studies led to imprecision in the results, and the presence of blinding of the studies, allocation concealment, and unreasonable problems with the control group design made the results low grade. Among these results, the quality of evidence for grip strength (n = 10) was of medium grade, and the quality of evidence related to the remaining indicators was of low grade. This systematic review showed that traditional Chinese Qigong exercises and Chinese herbal medicine have a positive and important effect on physical performance and muscle strength in older adults with sarcopenia. Future high-quality multicenter randomized controlled trials (RCTs) with large samples are needed to determinate whether acupuncture and other therapies are effective in treating sarcopenia.
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Affiliation(s)
- Chao-yang Guo
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yun-jing Ma
- Department of Rehabilitation, Shanghai East Hospital, Shanghai, China
| | - Shu-ting Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ran-ran Zhu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao-ting Xu
- Institute of TCM International Standardization, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhen-rui Li
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Fang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Research on Knee Joint Load and Influencing Factors of Typical Tai Chi Movements. Appl Bionics Biomech 2022; 2022:6774980. [PMID: 35310685 PMCID: PMC8924602 DOI: 10.1155/2022/6774980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background Tai chi is recognized worldwide for its rehabilitation abilities and healthcare benefits. However, in recent years, some movements associated with tai chi have been shown to damage the lower limb joints. The purpose of this study was to investigate and compare the effects of different movements, postures, center of mass (COM) movements, and range of knee movement of tai chi exercises on knee joint load. Methods Fourteen professional tai chi practitioners in two postures (high and low) were enrolled to perform the following four typical tai chi movements: wild horse's mane (WHM), repulse monkey (RM), wave-hand in cloud (WHIC), and grasp the bird's tail (GBT). Kinematic and kinetics data were synchronously collected using the Vicon infrared high-speed motion capture system and a three-dimensional (3D) force measurement platform. Variance analysis and partial correlation analysis were performed to investigate factors influencing peak knee joint moment and vertical ground reaction force (VGRF). Results The results showed that the peak knee extension and abduction moment were larger in WHM and RM than those in WHIC and GBT (p < 0.05). WHM was associated with greater rotation moment than the other typical movements (p < 0.05). VGRF and joint moment among different poses were significantly different. Low-pose tai chi typical movements were associated with greater VGRF, knee joint extension and abduction, and rotation moments than high-pose movements (p < 0.05). The anteroposterior and mediolateral COM displacements were strongly and positively associated with VGRF (p < 0.001), while the mediolateral COM displacement was negatively associated with knee extension moment (p < 0.001). The knee internal-external rotation ROM and anteroposterior and mediolateral COM displacements were positively associated with knee abduction moment (p < 0.01). Conclusion For long-term tai chi exercises, choosing a suitable posture based on an individual exercise level and reasonable control of knee ROM and COM displacement can reduce the risk of knee injury during exercise.
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Faisal MAA, Chowdhury MEH, Khandakar A, Hossain MS, Alhatou M, Mahmud S, Ara I, Sheikh SI, Ahmed MU. An investigation to study the effects of Tai Chi on human gait dynamics using classical machine learning. Comput Biol Med 2022; 142:105184. [PMID: 35016098 DOI: 10.1016/j.compbiomed.2021.105184] [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: 10/31/2021] [Revised: 12/16/2021] [Accepted: 12/26/2021] [Indexed: 11/03/2022]
Abstract
Tai Chi has been proven effective in preventing falls in older adults, improving the joint function of knee osteoarthritis patients, and improving the balance of stroke survivors. However, the effect of Tai Chi on human gait dynamics is still less understood. Studies conducted in this domain only relied on statistical and clinical measurements on the time-series gait data. In recent years machine learning has proven its ability in recognizing complex patterns from time-series data. In this research work, we have evaluated the performance of several machine learning algorithms in classifying the walking gait of Tai Chi masters (people expert on Tai Chi) from the normal subjects. The study is designed in a longitudinal manner where the Tai Chi naive subjects received 6 months of Tai Chi training and the data was recorded during the initial and follow-up sessions. A total of 57 subjects participated in the experiment among which 27 were Tai Chi masters. We have introduced a gender, BMI-based scaling of the features to mitigate their effects from the gait parameters. A hybrid feature ranking technique has also been proposed for selecting the best features for classification. The research reports 88.17% accuracy and 93.10% ROC AUC values from subject-wise 5-fold cross-validation for the Tai Chi masters' vs normal subjects' walking gait classification for the "Single-task" walking scenarios. We have also got fairly good accuracy for the "Dual-task" walking scenarios (82.62% accuracy and 84.11% ROC AUC values). The results indicate that Tai Chi clearly has an effect on the walking gait dynamics. The findings and methodology of this study could provide preliminary guidance for applying machine learning-based approaches to similar gait kinematics analyses.
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Affiliation(s)
- Md Ahasan Atick Faisal
- Department of Electrical and Electronic Engineering, University of Dhaka, Dhaka, 1000, Bangladesh
| | | | - Amith Khandakar
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar
| | - Md Shafayet Hossain
- Department of Electrical, Electronics and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi, Selangor, 43600, Malaysia
| | - Mohammed Alhatou
- Neuromuscular Division, Hamad General Hospital and Department of Neurology, Alkhor Hospital, Doha, 3050, Qatar
| | - Sakib Mahmud
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar
| | - Iffat Ara
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar
| | - Shah Imran Sheikh
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar
| | - Mosabber Uddin Ahmed
- Department of Electrical and Electronic Engineering, University of Dhaka, Dhaka, 1000, Bangladesh.
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Meta-Analysis of Elderly Lower Body Strength: Different Effects of Tai Chi Exercise on the Knee Joint-Related Muscle Groups. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2021:8628182. [PMID: 34976101 PMCID: PMC8716219 DOI: 10.1155/2021/8628182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/09/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine whether lower body strength such as keen extension and flexion strength may be improved by Tai Chi exercise in older adults from the perspective of evidence-based medicine. METHODS Databases of PubMed, Embase, and Cochrane Library were searched up to July 1, 2021. Randomized clinical trials are adopted to compare Tai Chi exercise with sedentary behavior or other low intensity exercise in terms of influence on lower body strength rehabilitation, especially keen extension and flexion strength in people aged over 60. A meta-analysis was performed to discuss outcomes of lower body strength, knee muscle strength, and knee extension/flexion strength. RESULTS A total of 25 randomized trials involving 1995 participants fulfilled the inclusion criteria. (1) Tai Chi exercise significantly improved elderly lower body strength (-0.54, [-0.81, -0.28], p < 0.00001, I 2 = 74%), but there was no differential improvement in the strength of the knee joints (0.10, [-0.02, 0.23], p=0.11, I 2 = 34%). (2) Elderly individual lower body strength declined with age, while this trend was suppressed by Tai Chi exercise (-0.35, [0.14, 0.56], p=0.001, I 2 = 70%). (3) Although Tai Chi exercise did no significantly improve the large muscle group of knee joint extensor like quadriceps femoris (3.15, [-0.69, 6.99], p=0.24, I 2 = 26%), it showed marked enhancement to the strength of deep small muscle group of knee joint flexor (10.25, [6.90, 13.61], p < 0.00001, I 2 = 0%). The heterogeneity might be caused by distinguished measurements of muscle strength. Therefore, Tai Chi exercise specifically enhanced some certain muscle strength of knee joints and improved muscle fitness rehabilitation as well as function activity for elderly. CONCLUSIONS In this RCT meta-analysis, Tai Chi exercise has positive effects on lower body strength of elderly. Although no obvious improvement on the knee extensor is observed, it may be used as a rehabilitation treatment for training stable deep muscle groups to improve the knee flexion strength significantly.
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Individual analysis of dynamic stability for twenty-four Tai Chi forms among persons with knee osteoarthritis: A pilot study. Gait Posture 2021; 86:22-26. [PMID: 33668007 PMCID: PMC8085069 DOI: 10.1016/j.gaitpost.2021.02.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Tai Chi (TC) training has been increasingly used to prevent falls. However, the underlying biomechanical mechanisms of TC training which influence fall risk remain unknown. As a result, the selection of TC forms differs among studies, leading to inconsistent results. RESEARCH QUESTION Is dynamic stability different between the simplified 24 Yang-style TC forms among adults with knee osteoarthritis? METHODS Ten participants with mild to moderate knee osteoarthritis were recruited. Under one-on-one instruction by an experienced TC master, each participant learned how to correctly perform the 24-form TC movements. Participants' full-body kinematic and kinetic data was collected during walking trials and performance of the respective TC forms. Their dynamic stability was calculated in both sagittal and frontal planes and compared between each TC form and regular walking. RESULTS The results indicate that dynamic stability in both planes significantly varies among forms. Moreover, some forms pose a greater challenge to dynamic stability in comparison to others. The most challenging TC forms are Form 8 for stability in the sagittal plane and Form 10 in the frontal plane. Among all forms, Form 1 appears to be the least challenging. SIGNIFICANCE Our findings could provide foundational information to identify the best TC forms for optimizing the effectiveness of TC-based fall prevention interventions.
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Roos PE, Mituniewicz A, Liu W. Biomechanical joint loading mechanism of Tai Chi gait in individuals with knee osteoarthritis: A pilot simulation study. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3. [PMID: 34179829 PMCID: PMC8232348 DOI: 10.1016/j.ocarto.2021.100158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives: Tai Chi (TC) has shown beneficial effects on joint function in knee osteoarthritis (OA). Biomechanical mechanisms of knee joint contact load (JCL) and muscle activations during TC are less understood. The purpose of this biomechanical simulation study was to examine JCL of TC gait, the most common used TC from and its causal interactions with muscle activations in knee OA. Design: Six knee OA and five healthy participants were recruited. Their full body motion of TC gait was collected. The JCL and muscle forces were quantified using a musculoskeletal simulation approach based on collected kinematics and kinetics. The JCL and muscle activations were compared between knee OA and healthy control group. In addition, the muscle contributions to the JCL were determined and compared between the two groups. Results: Knee OA subjects had lower peak anterior-posterior shear forces and higher lateral shear forces than healthy control subjects during TC gait. Knee OA subjects also showed higher activations of knee flexor muscles than control subjects. Both knee extensor and flexors of the knee OA group were contributing to JCL and in the control group mainly the knee extensors. Conclusions: Our simulation results showed the JCL, muscle forces profiles, and muscle contributions to the JCL during TC gait in knee OA. The findings of this study provided a direct scientific link between JCL and muscle forces during TC gait in knee OA. This would allow us to develop more effective TC interventions for knee OA in the future.
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Affiliation(s)
| | | | - Wei Liu
- Dean’s Office, School of Health Professions, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
- Corresponding author.
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Knee joint biomechanics of simplified 24 Tai Chi forms and association with pain in individuals with knee osteoarthritis: A pilot study. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3. [PMID: 34212157 PMCID: PMC8245205 DOI: 10.1016/j.ocarto.2021.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objectives Tai Chi (TC) is a multi-beneficial exercise for improving health and function in knee osteoarthritis (OA). Biomechanical insights of 24 TC forms at the knee joint are not well understood. We aimed to examine knee joint biomechanics of TC actions form by form and their interactions with pain in individuals with knee OA. Methods Ten knee OA participants were recruited. Their full body motion during performance of 24 TC forms was collected. The knee joint biomechanics were determined by using an inverse dynamic approach based on collected full body kinematics and kinetics. In addition, the knee joint pain level was scored during each TC form. The joint moments were compared between walking trials and each TC form. The relationship between knee joint biomechanics and pain scale was assessed. Results The knee adduction moment for five TC forms was different from the walking trial. The knee extension moment for 21 TC forms differed from the walking trial. For TC trials, the knee extension moment, but not the adduction moment, was positively correlated with pain level. Similarly, the knee extension moment was moderately proportional to pain level during the walking trials, but not the adduction moment. Conclusions Our pilot results explored the knee joint biomechanics profiles of individual TC forms and examined their associations with knee joint pain. The findings in this study could provide scientific basis to select the best TC forms for the purpose of reducing knee joint pain among individuals with knee OA.
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