Effects of a Community-Based Tai Chi Program on Balance, Functional Outcomes, and Sensorimotor Function in Older Adults

Effects of Tai Chi Chuan on Older Adults' Balance: A Systematic Review With Meta-Analysis

BACKGROUND

Tai Chi Chuan (TCC) is considered a mind and body practice of Chinese origin, considered as an intangible cultural heritage of humanity by UNESCO, and recommended by the World Health Organization as a therapeutic approach to prevent falls.

OBJECTIVE

To assess the effects of TCC on older adult's balance.

METHODS

A systematic review of randomized clinical trials was conducted by two independent reviewers using the ROB2 tool to assess the risk of bias under the following databases: PubMed, SCOPUS, Web of Science, PEDro, Embase, Cochrane, CINAHL, and LILACS. A meta-analysis of the selected articles for the dynamic and static balance criteria was conducted in a population of older adults (over 65 years) with publications from 2010 to 2024.

RESULTS

Eighteen randomized clinical trials fulfilled the criteria. TCC improves dynamic balance in the timed up and go and gait speeds tests, and static balance in the single-leg test and functional reach test when compared with the control group in the meta-analysis. Adverse events were found in only one study, and the training parameters were heterogeneous.

CONCLUSION

TCC improves older adults with both dynamic and static balance. The results of the parameters indicate a direction in which TCC is prescribed for clinical practice with minimal or no risk of adverse effects.

Complementary Health Approaches and Integrative Health in Occupational Therapy

This AOTA Position Statement describes the use of complementary and integrative health approaches in occupational therapy practice and presents ethical and pragmatic matters, including diversity, equity, inclusion, cultural humility, continuing competence, standards of practice, and supporting evidence.

Functional outcomes of Tai Chi exercise prescription in women with knee osteoarthritis

Knee Osteoarthritis (KOA) is the most common type of knee joint injury and also a risk factor for multiple health consequences and is prevalent among older women. The updated clinical guidelines for KOA treatment by the American Rheumatism Association recommend Tai Chi exercise. However, a literature review outlined limitations in Tai Chi intervention implementations. This study aimed to address some of the gaps. This study selected thirty female patients to participate in Tai Chi exercises and undergo relevant tests. The subjects were randomly assigned to Tai Chi or education groups. Independent sample t-tests were conducted to compare the difference in health indicators between the two groups after the intervention. The difference-in-differences (DID) regression was performed to assess the difference in the health outcomes between the two groups at baseline and follow-up and the difference in the differences. After the completion of the intervention, the Tai Chi group reported significantly improved KOA symptoms, physical fitness, and health status indicators than the control group. Specifically, the group differences were significantly larger at the baseline than at the follow-up. Our findings provide compelling evidence of the effects of the innovative Tai Chi exercise prescription specifically designed for KOA patients. The empirical evidence on its effectiveness in alleviating KOA symptoms and improving the overall health of middle-aged and elderly women with KOA suggested that Tai Chi intervention exercise has huge prospects for integration in KOA rehabilitation therapy.

Feasibility trial of an integrated treatment "Activate for Life" for physical and mental well-being in older adults

Background

Pain and fatigue are common chronic conditions faced by older adults. Integrated interventions to address pain and fatigue may therefore be particularly useful for older adults, especially those interventions that target mobility and psychosocial well-being. The present study describes feasibility and participant satisfaction for an integrated eHealth treatment to address pain and fatigue in a sample of older adults living in a low-income independent residence facility and their own homes in the community.

Methods

Three treatment combinations were compared in a randomized repeated measures design to determine if adding components of breathing retraining and behavioral activation to the existing Otago program (for strength and balance) affected feasibility and patient satisfaction. Specifically, 30 older adults were randomly allocated to: Arm1: the Otago alone (n = 10); Arm 2: Otago + Gentle Yoga and Yogic Breathing (n = 10); or Arm 3: Otago + Gentle Yoga and Yogic Breathing + Behavioral Activation (combination was named ‘Activate for Life’ n = 10). Feasibility measures included recruitment rate, session completion characteristics, and satisfaction with the program.

Conclusion

Data from this study provide support for the feasibility of an integrated program to address physical and mental well-being of older adults. Future fully powered studies should now focus on assessment of clinical outcomes and refinement of individual components.

Trial registration

Registered in clinicaltrials.gov with the identifier: NCT03853148.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-022-01000-8.

Home physical exercise improves functional mobility and quality of life in the elderly: A CONSORT-prospective, randomised controlled clinical trial

AIMS

To test the hypothesis of a semi-supervised home physical exercise programme that is likely to improve the functional mobility and quality of life (QOL) of elderly in the community.

METHODS

This trial included elderly adults (88% female) aged 60 years or older and who were sedentary and without cognitive decline. The participants were randomly assigned to an intervention group (IG, home physical exercise and sleep hygiene) and a control group (CG, sleep hygiene). The International Questionnaire on Physical Activity, mental state mini-exam, World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) and the Timed Up and Go (TUG) tests were conducted before and after the 12-week intervention period.

RESULTS

The study was concluded with 125 elderly participants. Anthropometric data were indicative of pre-obesity, with a mean body mass index of 27.3 ± 4, a low-income socio-economic profile (78% ≤ 2 SM) and low schooling rates (76% ≤ 3 years of study). Most of the elderly (87%) were considered physically active with IPAQ > 150 min/week. The group of elderly people who performed the home physical exercise programme showed a significant improvement in functional mobility according to the time of execution of the TUG test before (9.1 ± 2) and after (7.1 ± 1) with an average reduction of 2 ± 1 s (P < .01). The difference in the QOL of the elderly who participated in the exercise protocol was also observed, verified through the WHOQOL-OLD global score, which presented an initial score of 85 ± 10, changing to 90.4 ± 9 after the intervention.

CONCLUSION

Semi-supervised physical home exercise is safe and effective in improving the functional mobility and QOL of sedentary elderly people in the community.

Benefits of tai ji quan practice on neuromuscular functions in older adults: A Systematic Review and meta-analysis

BACKGROUND AND PURPOSE

Tai Ji Quan (TJQ) practice has been recommended for reducing falls in older adults, but a gap exists in our understanding of the neuromuscular mechanisms underlying TJQ practice benefits. This study aims to quantify and validate neuromuscular mechanisms underlying TJQ practice benefits in older adults.

MATERIALS AND METHODS

This review and analysis followed the PRISMA framework. All meta-analyses were performed in R.

RESULTS

For healthy older adults, TJQ practice was found to decrease muscle onset latency. Higher leg muscle activations were found during TJQ gait in comparison to normal gait. A significant interaction between TJQ practice time and age of the cohort was observed in muscle onset latency. For adults with pre-existing health conditions, TJQ practice has similar neuromuscular benefits as conventional rehabilitation methods.

CONCLUSION

Neuromuscular function improvements associated with TJQ practice provide a mechanism for reducing falls in older adults with and without pre-existing health conditions.