Health benefits of traditional Chinese sports and physical activity for older adults: A systematic review of evidence

Dilemmas in Elderly Diabetes and Clinical Practice Involving Traditional Chinese Medicine

Diabetes is a widespread chronic disease that occurs mainly in the elderly population. Due to the difference in pathophysiology between elderly and young patients, the current clinical practice to treat elderly patients with anti-diabetes medications still faces some challenges and dilemmas, such as the urgent need for early diagnosis and prevention, and an imbalance between restricted dietary intake and the risk of undernutrition. Traditional Chinese medicine (TCM) offers various treatment regimens that are actively utilized in the field of diabetes management. Through multiple targets and multiple pathways, TCM formulas, medicinal herbs, and active natural products enhance the efficacy of diabetes prevention and diabetes control measures, simplify complex medication management, and improve common symptoms and common diabetic complications in elderly people. Historically, natural products have played a key role in material composition analysis of TCM and mechanism interpretation to enable drug discovery. However, there have been few conclusions on this topic. This review summarizes the development of TCM for the prevention and management of diabetes in elderly people, existing evidence-based clinical practices, and prospects for future development.

Effects of different Chinese traditional exercises on sleep quality and mental health of adults: systematic review and meta-analysis

OBJECTIVE

To evaluate the effects of traditional Chinese exercises on sleep quality and mental health in adults with different health statuses. METHOD   : This review was registered a priori (CRD42023382188) and executed according to PRISMA statement guidelines. We searched the databases CNKI, China Biology Medicine disc (CBM), Wangfang, PubMed, Web of Science, and Embase from the date of database creation to March 2023. Two researchers independently screened the literature, extracted the data, evaluated the methodological quality of the included literature, and then used Revman 5.4 and Stata 17.0 for the corresponding statistical analysis and graphing.

RESULTS

Thirty-four randomized controlled trials (RCTs) were included, with a total sample of 2563 adults (1276 in the experimental group and 1287 in the control group). The meta-analysis results showed that traditional Chinese exercise significantly improved sleep quality in different groups [WMD =  - 1.58, 95% CI =  - 2.17, - 1.00, P < 0.00001] and that Badaanjin was better than Taijiquan in improving sleep quality. For mental health, traditional Chinese exercise had good effects on anxiety [WMD =  - 1.66, 95% CI =  - 2.64, - 0.69, P = 0.0009] and depression [WMD =  - 1.67, 95% CI =  - 3.23, - 0.11, P = 0.04].

CONCLUSION

Traditional Chinese exercises can improve the quality of sleep and mental health in different groups of people and are highly recommended for good health effects.

The impact of physical activity on household out-of-pocket medical expenditure among adults aged 45 and over in urban China: The mediating role of spousal health behaviour

Background

Increasing medical expenditure is viewed as one of the critical challenges in the context of population ageing. Physical activity (PA), as a primary prevention strategy for promoting health, is considered as an effective way to curb the excessive growth in medical expenditure. This study aimed to analyze the association between PA and the household out-of-pocket medical expenditure (HOPME) among Chinese urban adults aged 45 and over, and to explore the mediating role of spousal health behaviour.

Methods

This study analyzed a nationally longitudinal survey: 2014-2018 China Family Panel Studies (CFPS). Fixed effects regression model was applied to estimate the association between PA and annual HOPME. Sobel model was utilized to test the mediating effect.

Results

(1) PA was negatively associated with the annual HOPME among urban resident aged 45 and over in China. Exercising 1-5 times per week and maintaining the duration of each exercise session at 31-60 min were effective in reducing annual HOPME. (2) Spousal PA played a significant mediating role in the relationship between respondent's PA and annual HOPME. (3) The negative association between the respondent's PA and HOPME were found among women and those aged between 45 and 65, so was the mediating effect of spouse's PA.

Conclusion

Individual PA not only directly reduces HOPME but also indirectly contributes to this reduction by enhancing the PA levels of their spouses. To capitalize on these benefits, more actions should be taken to increase the availability of PA facilities, enhance the public awareness of PA's benefits, and encourage residents to consistently engage in regular PA.

A change in social participation affects cognitive function in middle-aged and older Chinese adults: analysis of a Chinese longitudinal study on aging (2011-2018)

Background

One of the biggest challenges facing older adults is cognitive decline and social participation has always been considered a protective factor. However, it is not clear whether social participation predicts cognitive function in this population, rather than depressive symptoms, self-reported health, and activities of daily life, with sufficient capacity to detect unique effects.

Methods

This study included adults aged 45 and above in China (N = 5,258) who participated in a large national older adult health survey and provided data from 2011, 2013, 2015, and 2018. The unique associations between the predictors of social participation and cognitive function over time and context were evaluated in the Latent Growth Model (LGM).

Results

Among the 5,258 participants in our study, an overall cognitive decline was observed. Social participation predicts two dimensions of cognitive function, with a degree of impact comparable to depressive symptoms, self-reported health, and activities of daily life. Among them, social participation exhibits a noteworthy prognostic impact on episodic memory during the same period. The regression coefficient is approximately 0.1 (p < 0.05) after controlling other mixed variables (depressive symptoms, self-reported health, and activities of daily life). In contrast, social participation is also a significant predictor of mental intactness in the same period, with a regression coefficient of 0.06 (p < 0.05), even if all mixed variables are controlled.

Conclusion

Over time, the correlation strength of social participation is comparable to other recognized cognitive function prediction indicators, indicating that promoting social participation among middle-aged and older Chinese adults is a meaningful way to improve cognitive function degradation, which has important policy and practical significance.

The Effects of Different Exercise Interventions on Patients with Subjective Cognitive Decline: A Systematic Review and Network Meta-Analysis

BACKGROUND AND OBJECTIVE

Exercise is a promising non-pharmacological therapy for subjective cognitive decline, but it is unclear which type of exercise is most effective. The objective was to assess the comparative effects and ranks of all exercise-based interventions on cognitive function in patients with subjective cognitive decline (SCD).

METHOD

In this network meta-analysis, Online databases for Web of Science, PubMed, Embase, Medline, Cochrane Library and PsycINFO were searched from inception to April 30, 2023. The included studies are randomized controlled trials assessing the efficacy of exercise interventions for individuals with SCD. The primary outcome measure is memory, while secondary outcome measures encompass executive function, attention, verbal fluency, and global cognitive function. Represented using Standardized Mean Differences (SMDs) along with their 95% Confidence Intervals (CIs). Bias assessment was conducted in accordance with the 'Cochrane Risk of Bias Assessment Tool, 2nd Edition' (RoB 2). Pairwise meta-analysis was carried out using the 'meta-analysis' module within STATA 14.0, and network meta-analysis was performed using the 'mvmeta' and 'network' packages available in STATA 14.0. Registration number CRD42023289687.

RESULT

This study included a total of 11 randomized controlled trials, encompassing 1,166 patients. Mind-body exercise was found to be efficacious in enhancing or sustaining memory (SMD: 0.58, 95%CI: 0.06 ~ 1.10) and executive function (SMD: 0.41, 95%CI: 0.09 ~ 0.73) in individuals with subjective cognitive decline. Furthermore, mind-body exercise exhibited the highest probability of being the most effective measures for improving or preventing the decline in memory (surface under cumulative ranking curve (SUCRA) value: 90.4) and executive function (SUCRA value: 91.8). The second-ranked moderate-intensity aerobic exercise has also shown a positive effect on the improvement of executive function in patients with subjective cognitive decline (SMD: 0.23, 95%CI: 0.03 ~ 0.43, SUCRA value: 68.2). However, we did not observe a significant effectiveness of exercise interventions on verbal fluency, attention, and overall cognitive function in subjective cognitive decline.

CONCLUSION

Mind-body exercise may potentially be the optimal strategies for enhancing memory and executive function in individuals with subjective cognitive decline. Additionally, moderate-intensity aerobic exercise has shown a modest positive effect on executive function in subjective cognitive decline. When resources permit, practical application of these findings may be considered. Nevertheless, further support for the conclusions of this study is warranted through larger sample sizes and well-designed multicenter trials.

Associations of long-term exposure to air pollution and physical activity with the risk of systemic inflammation-induced multimorbidity in Chinese adults: results from the China multi-ethnic cohort study (CMEC)

OBJECTIVE

Previous studies proved the effect of long-term exposure to air pollution or physical activity (PA) on the risk of systemic inflammation-induced multimorbidity (SIIM), while the evidence regarding their joint effects was rare, especially in low- and middle-income countries. Therefore, we aimed to examine the extent of interaction or joint relations of PA and air pollution with SIIM.

METHODS

This study included 72,172 participants from China Multi-Ethnic Cohort.The average concentrations of ambient particulate matter pollutants (PM1, PM2.5, and PM10) were estimated using satellite-based random forest models. Self-reported information on a range of physical activities related to occupation, housework, commuting, and leisure activities was collected by an interviewer-administered questionnaire. A total of 11 chronic inflammatory systemic diseases were assessed based on self-reported lifetime diagnosis or medical examinations. SIIM was defined as having ≥ 2 chronic diseases related to systemic inflammation. Logistic regression models were used to assess the complex associations of air pollution particulate matter and PA with SIIM.

RESULTS

We found positive associations between long-term air pollution particulates exposure and SIIM, with odds ratios (95%CI) of 1.07 (1.03 to 1.11), 1.18 (1.13 to 1.24), and 1.08 (1.05 to 1.12) per 10 µg/m3 increase in PM1, PM2.5, and PM10. No significant multiplicative interaction was found between ambient air pollutant exposure and PA on SIIM, whereas negative additive interaction was observed between long-term exposure to PM2.5 and PA on SIIM. The positive associations between low volume PA and SIIM were stronger among those exposed to high-level air pollution particulates. Compared with individuals engaged in high volume PA and exposed to low-level ambient air pollutants, those engaged in low volume PA and exposed to high-level ambient air pollutants had a higher risk of SIIM (OR = 1.49 in PM1 exposure, OR = 1.84 in PM2.5 exposure, OR = 1.19 in PM10 exposure).

CONCLUSIONS

Long-term (3 years average) exposure to PM1, PM2.5, and PM10 was associated with an increased risk of SIIM. The associations were modified by PA, highlighting PA's importance in reducing SIIM for all people, especially those living in high-level air pollution regions.

Effects of Yijinjing combined with resistance training on body fat distribution and hepatic lipids in middle-aged and older people with prediabetes mellitus: A randomized controlled trial

PURPOSE

This randomized controlled trial aimed to study the effects of Yijinjing plus Elastic Band Resistance exercise on intrahepatic lipid (IHL), body fat distribution, glucolipid metabolism and biomarkers of inflammation in middle-aged and older people with pre-diabetes mellitus (PDM).

PARTICIPANTS AGESND METHODS

34 PDM participants (mean age, 62.62 ± 4.71 years; body mass index [BMI], 25.98 ± 2.44 kg/m2) were randomly assigned to the exercise group (n = 17) or control group (n = 17). The exercise group performed moderate-intensity Yijinjing and Elastic Band Resistance training 5 times per week for 6 months. The control group maintained their previous lifestyle. We measured body composition (body weight and body fat distribution), IHL, plasma glucose, lipid and the homeostatic model assessment of insulin resistance (HOMA-IR), inflammatory cytokines at baseline and 6 months.

RESULTS

Compared with baseline, exercise significantly reduced IHL (reduction of 1.91 % ± 2.61 % vs an increase of 0.38 % ± 1.85 % for controls; P = 0.007), BMI (reduction of 1.38 ± 0.88 kg/m2 vs an increase of 0.24 ± 1.02 kg/m2 for controls; P = 0.001), upper limb fat mass, thigh fat mass and whole body fat mass. Fasting glucose, HOMA-IR, plasma total cholesterol (TC), and triglyceride (TG) were decreased in the exercise group (P < 0.05). There were no effects of exercise on liver enzyme levels and inflammatory cytokines. The decrease in IHL was positively correlated with the decreases in BMI, body fat mass and HOMA-IR.

CONCLUSION

Six months of Yijinjing and resistance exercise significantly reduced hepatic lipids and body fat mass in middle-aged and older people with PDM. These effects were accompanied by weight loss, improved glycolipid metabolism and insulin resistance.

Endurance training changes the expression of miR-1 and miR-133 and predicted genes in slow and fast twitch muscles

PURPOSE OF THE RESEARCH

Endurance training can modify signaling and gene expression pathways that play a pivotal role in determining the phenotype of the fibers. The present study aimed to investigate the effects of endurance training on the expression of some myomiRs and related genes in slow and fast twitch muscles.

METHODS

Twenty healthy male adult Wistar rats (281 ± 14 g) were randomized to either control (n = 10) or treated (n = 10). The treated group performed an endurance program for eight weeks (running on a treadmill for eight weeks, 50 min, 23 m/min). After the end of the training protocol, the slow (soleus) and fast (EDL) twitch muscles were removed to assess the miR-1, miR-133 expression, and hdac4, mef2c genes, and protein by real-time PCR and western blot, respectively.

RESULTS

The soleus muscle miR-1 expression and mef2c gene in the treated group were significantly lower compared control (p = 0.0001). In contrast, miR-133 and hdac4 gene expression of the soleus muscle of the treated group increased significantly (p = 0001), and the EDL miR-133 and mef2c expression of the treated group increased in the compared control group (p = 0.0001). The EDL MEF2c protein expression in the treated group significantly decreased compared to the control group, although the expression of EDL HDAC4 protein significantly increased (p = 0.0001).

CONCLUSIONS

Endurance training changes the expression of the miR-1, miR-133, and their predicted genes in slow and fast twitch muscles. Also, the rate of HDAC4 and MEF2c protein synthesis, which are upstream and downstream of these myomiRs, was affected by endurance training.

Effects of traditional Chinese mind–body exercises on older adults with cognitive impairment: A systematic review and meta-analysis

Objective

To determine the effectiveness of traditional Chinese mind–body exercises in improving cognition, memory, and executive function in older adults with cognitive impairment.

Data sources

Relevant English and Chinese language studies published until September 14th, 2022 were retrieved from PubMed, Web of Science, Cochrane Library, Embase, CINAHL, WAN FANG DATA, VIP Information, CNKI, and SinoMed databases.

Review methods

Randomized controlled trials assessing traditional Chinese mind–body exercises (Tai Chi, Baduanjin, Qigong, Mind–Body Therapies, and Yijinjing) in older adults with cognitive impairment were included. Two researchers independently identified eligible studies and extracted data. A risk-of-bias assessment was performed using the Cochrane Risk of Bias Tool.

Results

This study included 15 randomized controlled trials (1,127 participants) from China, Thailand and American. Most studies had a high risk of bias in the blinding of participants and researchers, one study had a high risk of bias in the random sequence generation and two studies had a high risk of bias in the incomplete outcome data. Compared with conventional therapy alone, traditional Chinese mind–body exercises significantly improved global cognitive function (p &lt; 0.00001), and Baduanjin could improve the global cognitive function (p &lt; 0.00001), memory function (p &lt; 0.0001), and executive function (p &lt; 0.0001) outcomes after treatment, and significantly improved some dimensional scores on the auditory verbal learning test after treatment (p = 0.04).

Conclusion

Compared with conventional therapy, traditional Chinese mind–body exercises (Tai Chi, Baduanjin, and Qigong) significantly improved global cognitive function, and Baduanjin could improve global cognitive function, memory function, and executive function in older adults with cognitive impairment.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/#searchadvanced, CRD42022327563.

Barriers, Facilitators, and Sustainers in Tai Ji Quan Practice: A Mixed-Methods RE-AIM Assessment of College Students Versus the General Population

BACKGROUND

Tai Ji Quan (TJQ) has broad appeal to people of all ages and backgrounds. This study aimed to examine a variety of individual and environmental factors in the dissemination of TJQ to diverse practicing communities in China.

METHODS

A mixed-methods approach was utilized in the research design. Quantitative data were collected via an online survey using a national sample (N = 737), whereas qualitative data came from focus groups and in-depth interviews. Analysis was performed along the RE-AIM dimensions of reach, efficacy, adoption, implementation, and maintenance.

RESULTS

We divided TJQ experience into 4 distinct categories (nonlearners, current learners, quitters, and retainers) and observed significant patterns of variation along lines of occupation groups and age cohorts. A significant male/female difference was detected in TJQ experience among college students but not the general public, and having practicing family members was an important predictor of personal TJQ history. Varied TJQ experience has a significant impact on perceptions of TJQ's miscellaneous values as well as level of satisfaction with its health outcomes.

CONCLUSIONS

Both individual (personal) and environmental (settings) factors are important in shaping personal decisions in TJQ engagement. An ecological approach coordinating individual factors and settings resources is essential in promoting TJQ to the general population.

Global trends of traditional Chinese exercises for musculoskeletal disorders treatment research from 2000 to 2022: A bibliometric analysis

Background

Traditional Chinese exercise has been shown to be effective in relieving long-term chronic pain, physical dysfunction, decreased ability to participate in society and decreased quality of life in musculoskeletal diseases. In recent years, there has been a steady increase in publications on the treatment of musculoskeletal disorders by traditional Chinese exercises. The purpose of this study is to review the characteristics and trends of Chinese traditional exercise studies on musculoskeletal diseases published since 2000 through bibliometric analysis, and identify current research hotspots, so as to guide the direction of future research.

Methods

Publications regarding traditional Chinese exercises for musculoskeletal disorders from 2000 to 2022 were downloaded from the Web of Science Core Collection. VOSviewer 1.6.18 and CiteSpace V software were used for bibliometric analyses. Bibliometric visualization and comparative analysis were conducted for authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords.

Results

A total of 432 articles were obtained, with an upward trend over time. The most productive countries and institutions in this field are the USA (183) and Harvard University (70). Evidence-based Complementary and Alternative Medicine (20) was the most prolific journal, Cochrane Database System Review (758) was the most commonly cited journal. Wang Chenchen published the largest number of articles (18). According to high frequency keywords, the hot spot musculoskeletal disorder and the type of traditional Chinese exercise are knee osteoarthritis and Tai Chi.

Conclusion

This study provides a scientific perspective for the research of traditional Chinese exercises for musculoskeletal disorders and provides valuable information for researchers to discover the current research status, hot spots and new trends of future research.

Associations between digital gaming behavior and physical activity among Finnish vocational students

Abstract

Digital gaming is considered to be a major sedentary lifestyle among youth. The time spent on digital gaming may also affect the physical behavior of young adults.

Objective

This study aimed to investigate the associations between various characteristics of digital gaming behavior (i.e., gaming time, device, and game type) and participation in physical activity among Finnish vocational students.

Materials and methods

The research employed a cross-sectional survey design. The analyzed sample consisted of 773 students (455 males, 318 females) from eight vocational school units in Northern Finland who regularly played digital games. Data were collected via an online self-reported questionnaire, which included questions concerning average weekly time spent on digital gaming, preferred device, favorite types of games, and physical activity.

Results

The students spent an average of two hours each day playing digital games. Males preferred to play using personal computers (PCs), whereas mobile gaming was more popular among females. Shooter (42.4%) and entertainment (64.2%) games were the most popular game types among males and females, respectively. The results revealed that male gender and PC gaming were both positively related to physical inactivity among vocational school students. A preference toward sport games was inversely related with physical inactivity.

Conclusion

The presented findings can be utilized to develop interventions that target the prevention of sedentary behavior among vocational students. Further longitudinal studies will be required to reliably assess the relationship between digital gaming and physical activity.

Improving gross motor skills of children through traditional games skills practiced along the contextual interference continuum

Gross motor skills (GMS) are the foundation for humans reaching an optimum level of motor competence necessary to undergo normal development, maintain health, and achieve athletic excellence. Yet, there is evidence that GMS levels of children are on a decline globally. Therefore, the main purpose of this study was to investigate the effectiveness of traditional cultural games (TCG) skills, practiced according to different amounts of contextual interference (CI), on the acquisition and retention of GMS. A total of 103 Pakistani primary school children aged between 7 and 10 years were recruited for this study. Participants were randomly assigned to four practice groups with different amounts of CI: Block (B) (low interference), gradually increasing (GI) (moderate interference), random (R) (high interference), and game-based (high interference). The Test of Gross Motor Development (TGMD-2) was used to assess four tasks [overhead throw (OT), underhand throw (UT), catch (C), and throwing to a target]. The test was administered on four occasions: during pre-test, post-test, retention, and transfer. The results showed that the R group outperformed all the other groups in the post-test and the retention test. Meanwhile, in the transfer test, both R and Game-Based groups performed better than the B and GI groups. There were no differences between the R and Game-Based groups during transfer. Practicing TCG skills according to a random order was better for the acquisition and learning of GMS. The CI effect was evident, whereby high interference practice schedules were superior to low and moderate interference practice schedules.

Influence of social distancing on physical activity among the middle-aged to older population: Evidence from the nationally representative survey in China

Background

Group-based physical activity is an important positive factor assisting the middle-aged to older population to be regularly physically active, especially inside a society with a large population and highly sociable environment. However, when group-based physical activity is restricted during a public health crisis such as the infectious disease pandemic, the influence of social distancing on physical activity among this vulnerable group needs to be recognized.

Objectives

This study aimed to investigate the influence of social distancing on physical activity among the middle-aged to older Chinese population at the national level.

Methods

Data from a nationally representative social follow-up survey (China Family Panel Studies, CFPS) for 2018 and 2020 were used. Physical activity level in year 2018 was set as the baseline to be compared with that for each individual in 2020, when China implemented social distancing during the COVID-19. Chinese population with an age greater than 45 years were included, and three levels of physical activity were established. Logistic models were developed to identify sociodemographic characteristic that may be associated with a higher probability of worse PA behaviors during the social distancing.

Results

Over 46% respondents could be described as being Physically Inactivity during 2018 and this proportion increased to 67.2% in 2020. Respondents who live in the Northeast or rural regions, having a spouse, being employed, having a low level of education, and being of low-income level showed a higher decrease in physical activity compared to other groups. However, individuals living with chronic diseases emerge as being more likely to maintain positive habits with respect to physical activity in this context.

Conclusion

Social distancing during the COVID-19 pandemic has significantly influenced the extent of physical activity among middle-aged to older Chinese residents. This is especially true in respect to middle-aged and elderly people who are at increased risk of chronic diseases. Given this, there is a clear need to consider effective modalities for physical activity in the context of social distancing based on home quarantine and city lockdown. Furthermore, specific health-related strategies need to be considered in relation to different regions and populations.

Functional Benefits of Hard Martial Arts for Older Adults: A Scoping Review

The present scoping review focused upon the functional benefits of hard martial arts training for older adults. The AXIS Critical Appraisal Tool was used to appraise all studies included in the review. A systematic literature search identified 265 papers via electronic database and ten papers from additional sources. Of these, six studies featuring 240 participants were included in the final scoping review. Of the included studies, three were randomized control trials and three were comparative studies with concurrent controls. The available studies outlined improvements in functional fitness parameters for older adults participating in hard martial arts training (strength 9.3-34%; mobility 9.5-13.6%; aerobic endurance 13.4%; flexibility 11.1-316.7%; balance 20.5%). However, inconsistencies in training stimulus and a limited number of studies highlight the need for further research before hard martial arts can be recommended for older adults. Based upon the limited available literature, to improve functional fitness, hard martial arts training should be conducted for 60 to 90 minutes, at least twice a week for a minimum of eleven weeks.

Association of physical activity with vascular aging in a population with intermediate cardiovascular risk, analysis by sex: MARK study

Background

The aim of this study was to analyze the association of physical activity and its intensity with arterial stiffness and vascular aging and differences by sex in a Spanish population with intermediate cardiovascular risk.

Methods

Cross-sectional study. A total of 2475 individuals aged 35–75 years participated in the study. Brachial–ankle pulse wave velocity (baPWV) was measured using a VaSera VS-1500^® device. Based on the age and sex percentile presented by the participants, the latter were classified as follows: those with a percentile above 90 and presenting established cardiovascular disease were classified as early vascular aging (EVA); those with a percentile between 10 and 90 were classified as normal vascular aging (NVA) and those with a percentile below 10 were classified as healthy vascular aging (HVA). Physical activity was analyzed through the short version of the Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ).

Results

The mean age of the participants was 61.34 ± 7.70 years, with 61.60% men. Of the total sample, 86% were sedentary (83% men vs 90% women). The total physical activity showed a negative association with baPWV (β = − 0.045; 95% CI − 0.080 to − 0.009). Intense physical activity showed a negative relationship with baPWV (β = − 0.084; 95% CI − 0.136 to − 0.032). The OR of the total physical activity and the intense physical activity carried out by the subjects classified as NVA with respect to those classified as HVA was OR = 0.946; (95% CI 0.898 to 0.997) and OR = 0.903; (95% CI 0.840 to 0.971), and of those classified as EVA it was OR = 0.916; (95% CI 0.852 to 0.986) and OR = 0.905; (95% CI 0.818 to 1.000). No association was found with moderate- or low-intensity physical activity.

Conclusions

The results of this study suggest that, when intense physical activity is performed, the probability of presenting vascular aging is lower. In the analysis by sex, this association is only observed in men.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13293-022-00456-w.

This study is the first to find a negative association between total physical activity and arterial stiffness and vascular aging in adults with intermediate cardiovascular risk.

This study also shows that the association of physical activity with arterial stiffness and vascular aging in adults with intermediate cardiovascular risk varies depending on its intensity, with a negative association being found only with intense physical activity.

In the analysis by sex, the results found suggest that the association is greater in men.

Health and Fitness Comparisons Among Middle-Aged and Older Adults with Long-Term Participation in Four Different Sports

Physical activity is known to confer numerous health benefits. However, few studies have assessed the prolonged impact of participation in different sports on health and fitness. The purpose of this cross-sectional study was to compare the impact of long-term participation (i.e., ≥9 years) in four different sports, including two traditional Chinese (Tai Chi; diabolo) and two modern sports (aerobics; track and field [TF]) on health and fitness measures among middle-aged and older adults. Participants (n=252, 56.6±8.5y, 66% female) completed the following measures: height, weight, BMI, waist circumference, waist-hip ratio (WHR), body fat%, resting blood pressure (BP) and heart rate, vital capacity, grip strength, reaction time, flexibility, balance. Compared to Tai Chi, aerobics was associated with lower systolic BP and fat%, and greater vital capacity, while TF was associated with lower systolic BP, shorter reaction time, greater vital capacity and better balance (p-values<0.05). Diabolo was associated with lower WHR compared to aerobics and Tai Chi, and greater vital capacity than Tai Chi (p-values<0.05). No significant differences were observed across sports in other measures. Long-term participation in four sports might have different effects on BP, vital capacity, balance, reaction time, body fat, and central adiposity. Individuals who prefer to choose traditional sports (Tai Chi, diabolo) may anticipate similar long-term effects on resting heart rate, BMI, muscle mass, and grip strength compared to those who perform modern sports (aerobics, TF). Information presented in this study may be valuable when designing population, group and individually-tailored PA recommendations in culturally diverse individuals.

Effects of traditional Chinese medicine-based exercises on cognitive function in older people with mild cognitive impairment: A systematic review and meta-analysis

This study evaluated the effects of traditional Chinese medicine based exercise (TCE) on cognitive outcomes for patients with mild cognitive impairment (MCI), and tried to identify the most effective TCE modality. A systematic review and meta-analysis of randomized controlled trials were conducted. Ten studies met the inclusion criteria. TCE interventions were classified into three types: (a) Tai Chi, (b) Baduanjin, and (c) Qigong. The pooled analysis showed that, overall, TCE had beneficial effects on global cognition and memory. Subgroup analysis further demonstrated that Baduanjin had a larger effect size on global cognition than the other TCE modalities. By contrast, Tai Chi had a larger effect size on memory than the other modalities. This study implied that TCE is a promising exercise option for improving cognition in MCI. However, further studies with a more rigorous study design are warranted to support or falsify the findings of the present review.

Physical and Motor Fitness Tests for Older Adults Living in Nursing Homes: A Systematic Review

This systematic review aimed to identify the physical/motor fitness tests for nursing home residents and to examine their psychometric properties. Electronic databases were searched for articles published between January 2005 and October 2021 using MeSh terms and relevant keywords. Of the total of 4196 studies identified, 3914 were excluded based on title, abstracts, or because they were duplicates. The remaining 282 studies were full-text analyzed, and 41 were excluded, resulting in 241 studies included in the review. The most common physical component assessed was muscle strength; 174 (72.2%) studies assessed this component. Balance (138 studies, 57.3%) and agility (102 studies, 42.3%) were the second and third components, respectively, most widely assessed. In this review, we also describe the most used assessment tests for each physical/motor component. Some potentially relevant components such as manual dexterity and proprioception have been little considered. There are few studies assessing the psychometric properties of the tests for nursing home residents, although the data show that, in general, they are reliable. This review provides valuable information to researchers and health-care professionals regarding the physical/motor tests used in nursing home residences, helping them select the screening tools that could most closely fit their study objectives.

Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map

Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes.

Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects.

Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia.

Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.

Gray and White Matter Changes Associated with Psychophysical Functions Induced by Diabolo Training in Young Men

Learning a skill has been demonstrated to relate to neural plasticity in both animal and human brains. Performing diabolo consists of different tricks and may cause brain structural changes associated with psychophysical functions. Therefore, the purpose of this study was to investigate gray matter (GM) and white matter (WM) changes associated with psychophysical functions induced by diabolo training in healthy subjects. Fourteen healthy right-handed male subjects were enrolled to receive the diabolo training. Whole brain T1-weighted images and diffusion tensor imaging (DTI) data were acquired from all subjects on a 3.0 T magnetic resonance scanner before and after the training. Voxel-based morphometry (VBM), surface-based morphometry (SBM), and voxel-wise DTI analysis were carried out to detect the GM volume, cortical thickness, and WM diffusion changes using T1-weighted image and DTI data, respectively. In addition, two-arm coordination and mirror-drawing tests were performed to evaluate their psychophysical functions before and after 2, 4, 6 and 8 weeks of training. Analysis of variance was performed to understand whether the psychophysical functions changed over time after the training. The results showed that the psychophysical functions were significantly changed over time during the training. The VBM and SBM analyses revealed that the GM volume and cortical thickness were significantly increased in the brain areas associated with visual, motor, sensory, and spatial cognition functions. The voxel-wise DTI analysis further demonstrated that the mean diffusivity was significantly reduced in the genu of corpus callosum. Moreover, significant correlations were revealed between the increase rate of GM volume and the improvement rate of psychophysical functions in the left angular gyrus. The results suggest that the diabolo training may induce increased GM volume associated with improved psychophysical function in the brain region involved in spatial cognition and attention. Therefore, we conclude that the diabolo training may improve psychophysical function which might be reflected by the increased GM volume in the angular gyrus.

Effects of anti-aging interventions on intestinal microbiota

Identifying ways to deal with the challenges presented by aging is an urgent task, as we are facing an aging society. External factors such as diet, exercise and drug therapy have proven to be major elements in controlling healthy aging and prolonging life expectancy. More recently, the intestinal microbiota has also become a key factor in the anti-aging process. As the intestinal microbiota changes with aging, an imbalance in intestinal microorganisms can lead to many age-related degenerative diseases and unhealthy aging. This paper reviews recent research progress on the relationship between intestinal microorganisms and anti-aging effects, focusing on the changes and beneficial effects of intestinal microorganisms under dietary intervention, exercise and drug intervention. In addition, bacteriotherapy has been used to prevent frailty and unhealthy aging. Most of these anti-aging approaches improve the aging process and age-related diseases by regulating the homeostasis of intestinal flora and promoting a healthy intestinal environment. Intervention practices based on intestinal microorganisms show great potential in the field of anti-aging medicine.

The Effect of Commuting Time on Job Stress in Obese Men With Different Exercise Frequency in China

Previous studies have mainly focused on the independent impact of commuting time, exercise, and stress on people. There are few studies regarding the impact of the combined effect of multiple factors on special populations such as obese people. As obesity has become increasingly widespread in China, we studied the impact of commuting time on work stress on Chinese obese men (who exercise regularly vs. who exercise irregularly). We performed a secondary retrospective analysis of the cross-sectional data from the 2014 China Labor Force Dynamics Survey. We found that long commute times and less exercise have a positive effect on the increase in stress, but the effect is less evident for people who exercise regularly. Commuters traveling on foot are more stressed than those traveling by car. This study also found that commuting time had a significant impact on the perceived work stress of obese men who exercised irregularly. But the relationship between commuting time and work stress was different among groups with different commuting styles. For obese men who commuted on foot or motorcycle, commuting time had a significant impact on their job stress. However, for obese men who commuted by bicycle, bus, or car, commuting time had no significant effect on job stress. Additionally, active and passive commuting have different effects on stress. Active commuters tend to be more stressed, while passive commuters do not show a significant impact.

New Frontiers in the Prevention, Diagnosis, and Treatment of Alzheimer's Disease

One of the major puzzles in medical research and public health systems worldwide is Alzheimer's disease (AD), reaching nowadays a prevalence near 50 million people. This is a multifactorial brain disorder characterized by progressive cognitive impairment, apathy, and mood and neuropsychiatric disorders. The main risk of AD is aging; a normal biological process associated with a continuum dynamic involving a gradual loss of people's physical capacities, but with a sound experienced view of life. Studies suggest that AD is a break from normal aging with changes in the powerful functional capacities of neurons as well as in the mechanisms of neuronal protection. In this context, an important path has been opened toward AD prevention considering that there are elements of nutrition, daily exercise, avoidance of toxic substances and drugs, an active social life, meditation, and control of stress, to achieve healthy aging. Here, we analyze the involvement of such factors and how to control environmental risk factors for a better quality of life. Prevention as well as innovative screening programs for early detection of the disease using reliable biomarkers are becoming critical to control the disease. In addition, the failure of traditional pharmacological treatments and search for new drugs has stimulated the emergence of nutraceutical compounds in the context of a "multitarget" therapy, as well as mindfulness approaches shown to be effective in the aging, and applied to the control of AD. An integrated approach involving all these preventive factors combined with novel pharmacological approaches should pave the way for the future control of the disease.

TaiChi and Qigong for Depressive Symptoms in Patients with Chronic Heart Failure: A Systematic Review with Meta-Analysis

Background

Depression is a debilitating comorbidity of heart failure (HF) that needs assessment and management. Along with mind-body exercise to deal with HF with depression, the use of TaiChi and/or Qigong practices (TQPs) has increased. Therefore, this systematic review assesses the effects of TQPs on depression among patients with HF.

Methods

Randomized controlled trials (RCTs) that examined the effect of TQPs on depression in patients with HF were searched by five databases (PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, CINAHL, and China National Knowledge Infrastructure (CNKI)). With standardized mean difference (SMD) and 95% confidence intervals (95% CI), random-effects meta-analyses of the effect of TQPs on depressive symptoms were performed.

Results

Of eight included RCTs, seven (481 patients) provided data for the meta-analysis. The pooling revealed that TQPs contribute to depression remission in HF (SMD -0.66; 95% CI -0.98 to -0.33, P < 0.0001; I ² = 64%). Its antidepressive effect was not influenced by intervention duration or exercise setting, but rather by ejection fraction subtype, depressive severity, and depression instruments. The beneficial effects were preserved when the study with the largest effect was removed.

Conclusion

This study suggests that TQPs might be a good strategy for alleviating depressive symptoms in patients with HF. And rigorous-design RCTs, which focus on the identified research gaps, are needed to further establish the therapeutic effects of TQPs for depression in HF.

Bibliometric Evaluation of Global Tai Chi Research from 1980-2020

While studies on the health benefits of Tai Chi have sprung up over the past four decades, few have engaged in collecting global data, estimating the developing trends, and conducting reviews from the perspective of visualization and bibliometric analysis. This study aimed to provide a summary of the global scientific outputs on Tai Chi research from 1980 to 2020, explore the frontiers, identify cooperation networks, track research trends and highlight emerging hotspots. Relevant publications were downloaded from the Web of Science Core Collection (WoSCC) database between 1980 and 2020. Bibliometric visualization and comparative analysis of authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords were systematically conducted using CiteSpace software. A total of 1078 publications satisfied the search criteria, and the trend of annual related publications was generally in an upward trend, although with some fluctuations. China (503) and Harvard University (74) were the most prolific country and institution, respectively. Most of the related researches were published in the journals with a focus on sport sciences, alternative medicine, geriatrics gerontology, and rehabilitation. Our results indicated that the current concerns and difficulties of Tai Chi research are “Intervention method”, “Targeted therapy”, “Applicable population”, “Risk factors”, and “Research quality”. The frontiers and promising domains of Tai Chi exercise in the health science field are preventions and rehabilitations of “Fall risk”, “Cardiorespiratory related disease”, “Stroke”, “Parkinson’s disease”, and “Depression”, which should receive more attention in the future.

Understanding community-dwelling Chinese older adults' engagement in physical activity: A grounded theory study

BACKGROUND AND OBJECTIVE

Limited information is available on the process of Chinese older adults' initiation, engagement, and maintenance of physical activity (PA), thus limiting the development of effective PA promotion programs. The purpose of the study was to investigate Chinese old adults' perspectives and experiences with PA engagement and to develop a conceptual model illustrating the process of how community-dwelling Chinese older adults engage in PA.

RESEARCH DESIGN AND METHODS

This study used grounded theory methodology. Nineteen community-dwelling Chinese older adults age over 60 years participated. We conducted semi-structured in-depth interviews with participants. Open, axial, and selective coding, along with constant comparative analysis was performed to analyze the data.

RESULTS

Participants described PA engagement as a complex and dynamic process, consisting of three stages: Getting started, Participating in PA, and Making PA Part of Life. The transition from one stage to the next was driven by an increasing internalized motivation towards PA through Seeing benefits. Many participants described that Staying in Groups was a key strategy for them to keep physically active. Moreover, Restructuring occurred when Chinese older adults encountered trigger situations.

DISCUSSION AND IMPLICATIONS

This study identified the stages of how community-dwelling Chinese older adults engage in to perform and maintain PA. The developed conceptual model can inform future interventions for promoting PA among Chinese older adults.

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.

The Feasibility and Positive Effects of Wuqinxi Exercise on the Cognitive and Motor Functions of Patients with Parkinson's Disease: A Pilot Study

Introduction

Parkinson's disease (PD) is a chronic degenerative disease of the central nervous system common in middle-aged and elderly people, which has a serious impact on patients' cognitive and motor functions. Exercise can improve the nonmotor symptoms of PD patients, but the optimal type of exercise for the cognitive function of patients is unclear. Therefore, the purpose of this study is the impact of 12 weeks of Wuqinxi exercise on the cognitive and motor function in PD patients.

Methods

Thirty PD patients participated in the study and were randomly assigned to two groups: Wuqinxi group (n = 15) or stretching group (n = 15). All the participants performed a 12-week exercise program twice a week, 90 min/session. The assessments were conducted before and after exercise intervention, included cognitive function (frontal assessment battery (FAB); Stroop test I and II), motor functions (Unified Parkinson's Disease Rating Scale Part III (UPDRS-III); timed up and go (TUG)).

Results

We found the FAB and Stroop I scores were significantly higher in the Wuqinxi group than in the stretching group. Participants in the Wuqinxi group significantly improved their UPDRS-III (17.73 ± 9.88) and TUG (10.50 ± 1.79) score after 12 weeks of training intervention.

Conclusion

The results show that the use of Wuqinxi for rehabilitation therapy for cognition is feasible, widely accepted, and effective in patients with Parkinson's disease. This study provides preliminary evidence for further large-scale and controlled studies.

Physical activity and its association with cognitive function in middle- and older-aged Chinese: Evidence from China Health and Retirement Longitudinal Study, 2015

BACKGROUND

Despite the known benefits of physical activity (PA) on cognitive function, the specific dimensions of PA that are associated with cognitive function require further research in China. We aimed to explore the patterns of PA and elucidate the association between cognitive function and different levels of PA in middle aged and elderly Chinese individuals.

METHODS

A total of 8,023 participants aged ≥45 years were selected from the China Health and Retirement Longitudinal Study. The PA intensity was categorized as: vigorous (VPA), moderate (MPA), and light (LPA). The associations of frequency and duration of PA at different intensities with cognitive function were examined using the multivariable linear model, including all respondents and urban-rural subgroups.

RESULTS

Compared with those who had no VPA, those who spent 6-7 days/week (β = -0.59, 95% CI: -1.10, -0.09) or more than 240 min/each time on VPA had poorer cognitive function among rural respondents, whereas cognitive function was only associated with the duration in urban respondents. Compared with those who had no MPA, the rural respondents who spent 1-5 days/week (β = 0.66, 95% CI: 0.12, 1.20) or 6-7days/week, or spent < 2 hours each time had better cognitive function. For LPA, frequency and duration were both positively associated with cognitive function, and were observed in both rural and urban sub-groups.

CONCLUSIONS

The association between cognitive function and PA depended largely on the intensity and area. Cultural context and geographical differences should be considered when designing intervention policies.Highlights The prevalence of PA increased as the intensity decreased and was higher in rural respondents than in urban respondents.Cognitive function was related to the intensity, frequency, and duration of PA. However, the magnitude and direction of the association depended mainly on the intensity and geographical area.VPA was negatively correlated with cognitive function, and the association was significant only in rural respondents. However, MPA and LPA were positively correlated with cognitive function, while the association between LPA and cognitive function was significant in both rural and urban respondents.

Physical Inactivity, Non-Communicable Diseases and National Fitness Plan of China for Physical Activity

BACKGROUND

China has the world's largest population, going under health transition due to industrialization, urbanization, and a sedentary lifestyle. About 82% of China's disease burden is due to the prevalence of non-communicable diseases (NCDs). Physical activity (active travel) is the best preventive measure against NCDs. The Chinese government has introduced several steps to improve national fitness and overcome NCDs among the aging population. Exercise and sports play a vital role in promoting physical activity and helpful in accomplishing the national fitness level for Healthy China under the national fitness plan (NFP).

OBJECTIVE

The current study aimed to explore the role of national fitness plan (NFP) in promoting physical activity and health well-being preventing NCDs under built environment intervention.

METHODS

The study was exploratory, and the mixed-method approach was used to analyze the primary and secondary data. Quantitative content analysis was used to analyze the collected data. A purposive sampling technique was used to collect the primary data from those individuals rich in knowledge about the National Fitness Plan (NFP) of China and its role in promoting physical activity for physical fitness.

RESULTS

The majority of the participants (32.0%) said that the national fitness plan helps promote sports environment and health. About 28.0% reported that NFP helps promote cycling and walk environments for physical activity and health promotion and preventing non-communicable diseases (NCDs).

CONCLUSION

Participation in physical exercise and sports is the preferred approach to prevent different diseases. In the context of rising active living among the Chinese people, the facilities such as built environment and green parks under the national fitness plan (NFP) for sports play a crucial role in the mitigation of NCDs.

Effect of 1 Year of Qigong Exercise on Cognitive Function Among Older Chinese Adults at Risk of Cognitive Decline: A Cluster Randomized Controlled Trial

Background: The rapidly aging Chinese population is showing an increase in age-related illnesses, including mild cognitive impairment and Alzheimer disease. The best types of physical activity for the improvement of cognition remain unknown. This study aimed to compare the effectiveness of a tailored qigong exercise with that of stretching exercise in the maintenance of cognitive abilities in Chinese elders at risk of cognitive decline. Methods: Seventy-four community-dwelling adults aged ≥60 years were screened for eligibility. Using a randomized control group design, participants with scores ≥19 on the Chinese version of the Montreal Cognitive Assessment-Basic (MoCA) were allocated to a 1-year qigong intervention (n = 33) and a stretching control exercise group (n = 33). The primary outcome was the MoCA score, as a measure of global cognitive function, and secondary outcomes were globe cognition and five domain scores on the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The MoCA and RBANS were administered at baseline and 1 year after intervention to assess the effect of the exercises on cognitive decline. Results: Twenty-five of 33 (75.8%) participants in the qigong group and 26 of 33 (78.8%) participants in the control group completed the 1-year exercise programs. A bivariate test revealed strong correlation between MoCA and RBANS total scores after the intervention (r = 0.517, p < 0.01). Generalized estimating equations revealed a lower risk of progression of cognitive decline at 1 year in the qigong group than in the control group (odds ratio, 0.314; 95% confidence interval, 0.103-0.961; p = 0.04). Two-way repeated-measures ANOVA followed by post hoc t tests with Bonferroni corrections indicated that MoCA and RBANS scores were significantly higher in the qigong group than in the control group (MoCA and RBANS global cognition, memory, visuospatial/constructional ability, and language, all p < 0.01), with the exception of RBANS attention score (p > 0.05). Conclusions: One year of qigong practice was significantly superior to stretching exercise not only for the prevention of cognitive decline progression, but also for the improvement of several cognitive functions, among older Chinese adults at risk of cognitive decline.

Wuqinxi Exercise Improves Hand Dexterity in Patients with Parkinson's Disease

Objective

This study was designed to evaluate the effect of Wuqinxi after one session and 12-week intervention on hand dexterity in patients with Parkinson's disease (PD).

Methods

Forty-six elderly participants with mild-to-moderate PD were randomly assigned to the groups trained with Wuqinxi (n = 23) or stretching (n = 23). All participants practiced 60 min session of either of these exercises, 2 sessions a week for 12 weeks in standing position. The score of Purdue Pegboard Test (PPT) and time for Soda Pop Test (SPT) were performed to assess hand dexterity and motor function along assessing the 39 items of Parkinson's Disease Questionnaire before and after 12-week interventions. In addition, the PPT scores were compared before vs. after one session of either of these two exercise modes.

Results

Single session with either Wuqinxi or stretching exercise tended to improve PPT scores in PD patients. Furthermore, the improved SPT time was significant (P < 0.01) following 12-week training interventions with Wuqinxi (−1.32 ± 0.38 sec) or stretching (−0.89 ± 0.16 sec), which showed no group difference (P=0.734). However, only the participants in Wuqinxi group significantly improved the PPT scores of the dominant hand (+0.61 ± 1.34), both hand (+1.83 ± 3.13) and assemble (+2.04 ± 3.44) performance after 12-week training intervention. In parallel with improved hand dexterity and motor function, 12-week Wuqinxi training also significantly improved the patient's emotional wellbeing.

Conclusion

The Wuqinxi intervention could be safely and effectively applied to improve hand dexterity following single-session exercise or 12-week training, which were accompanied by improved quality of life in patients with mild-to-moderate PD.

Effects of Attitude, Motivation, and Eagerness for Physical Activity among Middle-Aged and Older Adults

Background

Although physical activity (PA) is a noninvasive and cost-effective method of improving the quality of health, global statistics show that only a few middle-aged and older adults engage in the recommended PAs. This is due to a lack of motivation and companionship.

Objective

This study analyses the attitudes and self-determined motivation of Chinese middle-aged and older adults for PAs and their eagerness to participate in PAs such as sports, exercise, and recreational and cultural activities (RCAs), from attitudinal, eagerness, and motivational objectives of PAs perspective.

Methods

A cross-sectional study was carried out on 840 middle-aged (35-54 years) and older adults (55+ years). To determine their attitude, eagerness, and self-determined motivation for PA, we used attitudinal, Eagerness for Physical Activity Scale (EPAS), and Situational Motivational Scale (SIMS). The data were analyzed with SPSS 23.0.

Results

The results show that 39.1% of the participants were not satisfied with PAs. Compared with females, males reported a less positive attitude towards PAs. Moreover, a positive attitude decreases with age. Participants' motivation and eagerness in activities such as RCAs, exercise, and sports are decreasing. Regarding self-determined motivation, there are gender differences in RCAs, but there is none for exercise and sports participation.

Conclusion

The findings show the importance of RCAs and the support of family and friends enhancing the eagerness, attitude, and motivation to participate in PAs. Furthermore, the findings can help to create more effective PA programs for middle-aged and older adults. By engaging in RCAs, participants can reap the benefits of PAs. Participating in RCAs can lead to social equity in health.

A single-arm feasibility study of community-delivered Baduanjin (Qigong practice of the eight Brocades) training for frail older adults

BACKGROUND

Frailty is a common geriatric syndrome, characterized by reduced physiologic reserve and increased vulnerability to stressors, due to cumulative decline in multiple physiological systems. We studied the feasibility of a community-delivered Baduanjin (BDJ) training program among pre-frail/frail community-dwelling older people. We examined (1) safety (adverse events) and physical and psychological effects; and (2) feasibility of recruitment, retention, adherence; recruitment efforts, and any program challenges, so as to inform future studies.

METHODS

Our study was a single arm pre-post study in a community setting. Sixteen-week group BDJ training (2×/week in the first 4 weeks and 3×/week thereafter) was co-designed and implemented by community-based providers in Singapore. Recruitment, attendance, and adverse events were recorded throughout the training. A participants' survey was also administered after the training program. Effects of the intervention on physical and functional outcomes (hand grip strength, knee extension strength, Time Up and Go (TUG), Physiological Profile Assessment (PPA), 30-s Sit-to-Stand test, 6-m fast gait speed test), frailty outcomes (frailty score and status), and other outcomes (Maastricht Questionnaire (MQ), Fall Efficacy Scale (FES), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS), and EQ-5D-5L) were examined before and after the program.

RESULTS

Of 31 older adults screened to be frail, 15 met inclusion criteria and 3 refused participation, resulting in 12 older adults (9 women) enrolled into the program. During the program, one participant was hospitalized (unrelated to BDJ training) and the other 11 (aged 77 ± 6 years; 2 frail, 9 prefrail at baseline) completed the program with average overall attendance of 89%. Most (89%) of the 44 training sessions had attendance > 80%. The program received positive feedback with no training-related adverse events. Participants either reversed (n = 2) or maintained (n = 9) their frailty statuses. There post-training outcomes in hand grip strength, knee extension strength, TUG, MQ, FES, MoCA, GDS, and EQ-5D-5L index score appeared to be better. The reduction of frailty and PPA fall risk scores was of moderate-to-large effect size.

CONCLUSIONS

Community-delivered BDJ training program was safe and feasible for prefrail/frail older adults with the potential to improve physical and cognitive function, reduce fall risk, improve psychological well-being, and reverse frailty status.

How Individuals’ Characteristics Influence Their Wellbeing through Physical Activity and Sport: Motivated by the Signaling Theory

Sports activities engagement is a sustainable lifestyle that can signal that individuals have the potential to become successful. The lifetime wellbeing that comes from participating in sports activities results in a general and global policy agenda encouraging populations to be part of it. However, prior studies have seldom tested how individuals’ characteristics influence their wellbeing through sports activities engagement from a lifetime perspective. In the current study, based on the conservation of resources and signaling theories, we suggest that with a high level of personal control and self-esteem, individuals will proactively maintain a good lifestyle by engaging in more sports activities. Moreover, this engagement is not only good for these individuals’ physical and mental health, but will also bring them much more life satisfaction than others. A large and representative sample with 12,686 participants collected from over 35-year surveys across different social classes in the United States is used to test our hypotheses. The results indicate that individuals’ characteristics will indeed influence their wellbeing, even after 40 years of age, by changing their sports activities engagement, which includes both light activities such as walking and vigorous activities such as running and swimming. Potential theoretical contributions and policy implications are also proposed.

The Benefits of T'ai Chi for Older Adults with Chronic Back Pain: A Qualitative Study

Objective: To determine the perceived benefits of t'ai chi in older adults with chronic low-back pain (cLBP). Design: A qualitative analysis from a randomized controlled feasibility trial. Subjects: Eighteen participants (65+ years old) with cLBP of at least moderate intensity. Intervention: A 36-week intervention beginning with twice weekly classes for 12 weeks, weekly classes for 6 weeks, biweekly classes for 6 weeks, and monthly classes for 12 weeks. Participants were asked to practice at home on nonclass days and videos were provided to assist in that process. Outcome Measures: Participants in the focus groups were asked to provide feedback on their experiences with the study as well as the benefits of their t'ai chi practice. We used demographic and class attendance data to describe the sample. Results: Regarding the benefits of t'ai chi practice, five major themes were identified: functional benefits, pain reduction/pain relief, psychospiritual benefits, the importance of social support in learning t'ai chi, and the integration of t'ai chi into daily activities. The most common functional benefits were improvements in balance, flexibility, leg strength, and posture. Some reported pain reduction or pain relief, but others did not. Increased relaxation, mindfulness, and a sense of connectedness were subthemes that emerged from psychospiritual benefits. Social support benefits included motivation to attend class and group support while learning a new skill. Finally, improved body awareness allowed participants to integrate t'ai chi skills into their daily activities. Conclusions: This qualitative analysis demonstrates the multifaceted benefits of t'ai chi for older adults living with cLBP.

Effects of Meditation and Mind-Body Exercises on Older Adults' Cognitive Performance: A Meta-analysis

BACKGROUND AND OBJECTIVES

Meditation and mind-body exercises are suggested to delay decline or enhance cognitive capabilities in older adults. However, their effectiveness remains uncertain. This study assessed the effectiveness of meditation and mind-body exercises to improve cognition in elderly people aged 60 years or above. Moderator variables were also explored.

RESEARCH DESIGN AND METHODS

A databases search (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library, Web of Science, CNKI, and Wangfang) was conducted from the first available date to January 10, 2018. Inclusion criteria include (a) human older adults aged 60 years or above, (b) meditation, Tai Chi, Qigong, or yoga intervention, (c) intervention should be structured, (d) inclusion of a control group, (e) at least one outcome measure of cognition was measured at baseline and post-training, and (f) peer-reviewed journal articles in English or Chinese.

RESULTS

Forty-one studies (N = 3,551) were included in the meta-analysis. In general, meditation and mind-body exercises improve cognition in the elderly people (SMD = 0.34, 95% CI: 0.19 to 0.48), but the cognition-enhancing effects depend on the type of exercise. In addition, cognitive performance is only improved when the length of intervention is longer than 12 weeks, exercise frequency is 3-7 times/week, or duration of an exercise session is 45-60 min/session.

DISCUSSION AND IMPLICATIONS

This study suggests that meditation and mind-body exercises are effective to improve cognition of older adults aged 60 years or above, and exercise parameters should be considered for intervention planning.

Promoting healthy ageing through light volleyball intervention in Hong Kong: study protocol for a randomised controlled trial

Background

Our pilot study has demonstrated improvements in health outcomes through participation in a new sport, light volleyball (LVB), among older adults. In response to the promising results of the LVB pilot study and the priority of allocating resources to the prevention of age-related fitness degradation by the Hong Kong (HKG) government, the present study aims to investigate the effectiveness of a LVB intervention on physical and psychological health attributes among older adults at a larger scale in HKG.

Methods/design

This study will apply both quantitative and qualitative methods with a large sample (approximately 315 participants). We will adopt a randomized controlled trial (RCT) design to further evaluate the effectiveness of a LVB intervention on health outcomes against a comparison group, Tai Chi (TC), and a control group (C). Older adults will be eligible to join the intervention if they are (a) aged 65 years and above; (b) living in the community independently; (c) absent of diagnosed cognitive impairment; (d) not regular participants in a structured PA program for two years preceding the study; and (e) able to achieve a passing score on the Timed-up-and-go test (TUG) and Abbreviated Mental Test (AMT).About 315 participants will be randomly assigned into 3 groups in 1:1:1 ratio. LVB group participants will receive 16-week LVB program; TC group will utilize a simplified 24-form Yang Style TC, and C group participants will be instructed to maintain their normal daily activity and join regular non-exercise social gatherings. Measurements will be collected before and after the intervention, and 6 months and 12 months after completion of the intervention.

Discussion

This intervention, if effective, will enhance older adult's physical and psychological health, and provide the data and evidence to support policymaking in relation to future PA promotion for older adults.

Trial registration number

ChiCTR1900026657.

The efficacy of mind-body (Baduanjin) exercise on self-reported sleep quality and quality of life in elderly subjects with sleep disturbances: a randomized controlled trial

OBJECTIVES

To examine the efficacy of a 24-week Baduanjin exercise program on self-reported sleep quality and quality of life in community-dwelling elderly subjects with sleep disturbances.

METHODS

Community-dwelling elderly men and women meeting criteria for sleep disturbances (i.e., Pittsburgh Sleep Quality of Index (PSQI) score ≥ 5) were recruited and randomized to a Baduanjin exercise intervention group or a control group. Participants in the intervention group completed five 45-min exercise sessions per week for 24 weeks, while those in control group were instructed to maintain their usual lifestyle behaviors.

RESULTS

A total of 139 participants were enrolled and randomized. Sixty-two of 67 participants in the intervention group (response rate of 92.5%) and 57 of 72 participants (response rate of 79.6%) in the control group completed intervention and follow-up. The intervention group reported significant improvements in overall sleep quality after 24 weeks compared with those randomized to control (PSQI endpoint-to-baseline change = - 2.6 ± 4.0 vs. - 0.5 ± 4.2, time × group interaction p = 0.007). Intervention group participants had higher response rates at both week 12 (23.9% vs. 9.7%, p = 0.025) and week 24 (40.3% vs. 15.3%, p = 0.001) when compared with the control group. There was a trend that the intervention group had increased quality of life (The Short Form Health Survey [SF-36] endpoint=tobaseline change 6.3 ± 10.9 vs. 2.2 ± 10.9, time × group interaction p = 0.06) when compared with the control group.

CONCLUSIONS

Baduanjin exercise is an effective and feasible approach to improve self-reported sleep quality but less likely the quality of life in community-dwelling elderly men and women with sleep disturbances.

TRIAL REGISTRATION

Effect of Baduanjin Exercise on the Elderly's Sleep; http://www.chictr.org.cn/listbycreater.aspx; ChiCTR1800014706, registered 1 January 2018.

Cognitive stimulations effects and Taigeiko in elderly women's cognition: an intervention

OBJECTIVE

To evaluate the effectiveness of an intervention through cognitive stimulation associated with Taigeiko practice in memory performance and executive function of elderly women, compared to a group exposed to Taigeiko alone.

METHOD

A quasi-experimental study was performed with 16 elderly women. 10 were allocated to the experimental group (EG) submitted to 16 sessions of cognitive stimulation and Taigeiko, and 6 elderly women in the control group (CG) submitted to Taigeiko alone. Cognition was assessed before and after intervention by the tests: Rey Auditory-Verbal Learning (RAVLT); Rey-Osterrieth Complex Figure Test; Trail-Making Test; Stroop Effect; Digit Span Test and Semantic Verbal Fluency Test.

RESULTS

Both groups presented differences in RAVLT domains (EG p=0.004, CG p=0.005) and Stroop Effect (EG p=0.012; CG p=0.024). However, in EG, better scores were shown in the tests, although not statistically significant.

CONCLUSION

Taigeiko has been shown to be a potential activity in obtaining cognitive gains, independently of the associated cognitive stimulation.

Non-communicable Diseases and Cognitive Impairment: Pathways and Shared Behavioral Risk Factors Among Older Chinese

Population aging has brought about a number of challenges to public health and primary health care systems due to increases in the prevalence of non-communicable diseases (NCDs). As a country with one of the largest populations globally, China is confronting a rising number of chronic NCDs including cardiometabolic related conditions. This mini-review investigates the link between NCDs and cognitive impairment through common risk factors. Identifying risk factors is important for the prevention and management of these chronic conditions. In addition, this review also identifies the role of primary health care services in reducing behavioral risk factors for NCDs and cognitive impairment. Addressing shared determinants and pathways is important in the design of public health interventions and primary health care services in China. Monitoring and management of NCD biomarkers and behavioral risk factors may also be beneficial for cognitive health among older Chinese.

Understanding Levels and Motivation of Physical Activity for Health Promotion among Chinese Middle-Aged and Older Adults: A Cross-Sectional Investigation

Objective

Middle-aged and older Chinese adults (35 to 75) failed to meet the recommendations of physical activity guidelines for health promotion, because of a lack of understanding of their perspective on physical activity. This study considers the physical activity levels and motivation among middle-aged and older Chinese adults partitioned into three different participation groups (sports, exercise, and recreational and cultural activities).

Methods

A cross-sectional analysis was performed on 633 participants, based on two different levels of physical activity levels. The International Physical Activity Questionnaire (IPAQ) and the Exercise Motivation Inventory (EMI-2) with 14 subscales were used to measure the participant's physical activity levels and physical activity motivation for the three different group activities.

Results

Results indicate those participants' physical activity levels and motivation varied significantly among the different groups. The participants who engage in recreational and cultural activities have a higher motivation for physical activity, as compared with those whose primary form of physical activity is sports and exercise, and a higher probability to fulfill the global recommendations concerning physical activity. Participants who used recreational and cultural activities as their major type of physical activities were more motivated by “intrinsic” aspects. In contrast, those who participate in sports and exercise as their main type of physical activity are more motivated by “extrinsic” aspects.

Conclusion

Close friends and family members of one's home and community have potential influence in physical activity and recreational and cultural activity participants are highly motivated and luckier than others to fulfill the goal of physical activity levels.

The Effects of Locus of Control, Agents of Socialization and Sport Socialization Situations on the Sports Participation of Women in Taiwan

Compared to men, the sports participation of women is lower, especially in the East. Not many studies have compared the impacts of locus of control, agents of socialization, and sport socialization situations on the sports participation of women. Hence, the purpose of this study is to explore the contributing factors which may promote the sports participation of women in Taiwan. To do this, 450 structured questionnaires were distributed to women in Chiayi, Taiwan, with an 89.3% return rate. The study found that internal locus of control, agents of socialization, and sport socialization situation had positive impacts on the sports participation of women. In line with these results, the study suggests the strengthening of the internal locus of control of women, making the best use of socialization agents, and improvement of sport socialization situations, in order to promote sports participation in women.

Psychological and social outcomes of sport participation for older adults: a systematic review

Sport participation is well known to promote health outcomes for children and adolescents. Nevertheless, there is insufficient evidence about the psychological and social outcomes of sport participation for older adults. This article provides the results of a systematic review of the psychological and social outcomes of sport participation for older adults. A systematic review of seven electronic databases was conducted and a total of 21 studies published that attended to psychological and/or social health benefits from sport participation of older adults (50 years old and over) were included. The outcomes of older adults’ sport participation included life satisfaction, depression, anxiety, stress, mood state, hedonistic values, socialisation, competition, and personal psychological outcomes such as personal empowerment, self-confidence, self-esteem and resistance to the negative view of ageing. Future studies are needed to conceptualise and operationalise the different levels of involvement of sport participation.

The Neurophysiological and Psychological Mechanisms of Qigong as a Treatment for Depression: A Systematic Review and Meta-Analysis

Objective: An increasing number of studies have shown the anti-depressive effect of qigong. However, its underlying mechanism remains poorly understood. This study aims to systematically review and meta-analyze existing literature on the mechanism of qigong in reducing depression. Method: The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials of qigong were searched from PsycINFO, PubMed, Embase, ScienceDirect, and Academic Search Premier from inception to December 2018. Studies which involved depression and any neurophysiological or psychological mechanisms as outcomes were included. Publication bias was tested before conducting meta-analysis. Two independent raters were involved for the entire review process. Results: A total of nine studies were identified which covered both neurophysiological and psychological mechanisms. Among these selected studies, seven were involved in meta-analysis, which suggested that qigong was effective in alleviating depression (standardized mean difference, SMD = -0.27, p < 0.05, I ² = 27%). A significant effect was also found for diastolic blood pressure (SMD = -1.64, p < 0.05, I ² = 31%). However, no significant effect was found for cortisol level and systolic blood pressure. Conclusions: This review shows that qigong is effective in reducing depression through activating the parasympathetic nervous system. Future studies with higher quality of research methodology with less selection and attrition bias should be conducted to unravel the possible anti-depressive effect of qigong.

Association of traditional Chinese exercises with glycemic responses in people with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

There is increasing evidence showing the health benefits of various forms of traditional Chinese exercises (TCEs) on the glycemic profile in people with type 2 diabetes. However, relatively little is known about the combined clinical effectiveness of these traditional exercises. This study was designed to perform a systematic review and meta-analysis of the overall effect of 3 common TCEs (Tai Ji Quan, Qigong, Ba Duan Jin) on glycemic control in adults with type 2 diabetes.

METHODS

We conducted an extensive database search in Cochrane Library, EMBASE, PubMed, Web of Science, EBSCO, and China National Knowledge Infrastructure on randomized controlled trials published between April 1967 and September 2017 that compared any of the 3 TCEs with a control or comparison group on glycemic control. Data extraction was performed by 2 independent reviewers. Study quality was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions, which assessed the risk of bias, including sequence generation, allocation concealment, blinding, completeness of outcome data, and selective outcome reporting. The resulting quality of the reviewed studies was characterized in 3 grades representing the level of bias: low, unclear, and high. All analyses were performed using random effects models and heterogeneity was quantified. We a priori specified changes in biomarkers of hemoglobin A1c (in percentage) and fasting blood glucose (mmol/L) as the main outcomes and triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein-cholesterol, 2-h plasma glucose, and fasting plasma glucose as secondary outcomes.

RESULTS

A total of 39 randomized, controlled trials (Tai Ji Quan = 11; Qigong = 6; Ba Duan Jin = 22) with 2917 type 2 diabetic patients (aged 41-80 years) were identified. Compared with a control or comparison group, pooled meta-analyses of TCEs showed a significant decrease in hemoglobin A1c (mean difference (MD) = -0.67%; 95% confidence interval (CI): -0.86% to -0.48%; p < 0.00001) and fasting blood glucose (MD = -0.66 mmol/L; 95%CI: -0.95 to -0.37 mmol/L; p < 0.0001). The observed effect was more pronounced for interventions that were medium range in duration (i.e., >3-<12 months). TCE interventions also showed improvements in the secondary outcome measures. A high risk of bias was observed in the areas of blinding (i.e., study participants and personnel, and outcome assessment).

CONCLUSION

Among patients with type 2 diabetes, TCEs were associated with significantly lower hemoglobin A1c and fasting blood glucose. Further studies to better understand the dose and duration of exposure to TCEs are warranted.

A preliminary study of the effects of medical exercise Wuqinxi on indicators of skin temperature, muscle coordination, and physical quality

BACKGROUND

Wuqinxi is a traditional medicinal exercise that is widely practiced in China now. Because of its obvious medical rehabilitation, Wuqinxi has been used in the physical education for more than 1.2 million people in at least 24 Chinese Medicine university campuses in China for many years. This investigation aimed to evaluate whether Wuqinxi has the positive effect on physical improvements for female college students.

METHODS

Infrared scanners were used for real-time monitoring of body calorie dynamics; the electromyography (EMG) was used to detect the iEMG on biceps, brachioradialis, quadriceps, and gastrocnemius; beside, the physical health elements, heart rate and cardiopulmonary function were also taken within the scope of our investigation and records.

RESULTS

Wuqinxi exercise can improve the body function through making the abdominal muscles, back muscles and limbs strength exercise more effectively; Wuqinxi exercise had also made the athletes better control their muscles to have a good way to contraction and keeping balance; Moreover, the performances of speed of 800 m run, setting flexion, set-ups and grip strength had a comprehensive promotion for each of the participants including long-time practitioners and short-term practitioners.

CONCLUSIONS

Therefore, the new gymnastics derived from ancient Chinese Wuqinxi exercise can improve the physical health of female college students so that it can be used as part of the development of higher education's health quality in the future.