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Chang CL, Lin TK, Pan CY, Wang TC, Tseng YT, Chien CY, Tsai CL. Distinct effects of long-term Tai Chi Chuan and aerobic exercise interventions on motor and neurocognitive performance in early-stage Parkinson's disease: a randomized controlled trial. Eur J Phys Rehabil Med 2024; 60:621-633. [PMID: 38888734 PMCID: PMC11403633 DOI: 10.23736/s1973-9087.24.08166-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
BACKGROUND Parkinson's disease (PD) is a neurodegenerative condition characterized by movement disorders and probable cognitive impairment. Exercise plays an important role in PD management, and recent studies have reported improvement in motor symptoms and cognitive function following aerobic and Tai Chi Chuan exercise. AIM To explore the different effects of Tai Chi Chuan and aerobic exercise on the clinical motor status and neurocognitive performance of patients with early-stage PD. DESIGN A randomized controlled trial. SETTING Parkinson's Disease Center at Kaohsiung Chang Gung Memorial Hospital and National Cheng Kung University Hospital. POPULATION Patients with idiopathic PD. METHODS Fifty-six patients with PD were recruited and divided into three groups: aerobic exercise (AE, N.=14), Tai Chi Chuan exercise (TE, N.=16), and control (CG, N.=13). Before and after a 12-week intervention period, we used unified Parkinson's disease rating scale Part III (UPDRS-III) scores and neuropsychological (e.g., accuracy rates [ARs] and reaction times [RTs]) and neurophysiological (e.g., event-related potential [ERP] N2 and P3 latencies and amplitudes) parameters to respectively assess the patients' clinical motor symptoms and neurocognitive performance when performing a working memory (WM) task. RESULTS Compared to baseline, UPDRS-III scores were significantly lower in the AE and TE groups after the intervention period, whereas those for the CG group were higher. In terms of the neurocognitive parameters, when performing the WM task after the intervention period, the AE group exhibited significantly faster RTs and larger ERP P3 amplitudes, the TE group exhibited an improvement only in ERP P3 amplitude, and the CG group exhibited a significantly reduced ERP P3 amplitude. However, neither the TE nor the AE group exhibited improved ARs and ERP N2 performance. CONCLUSIONS The present study supported the distinct effectiveness of Tai Chi Chuan and aerobic exercise for improving motor symptoms and providing neurocognitive benefits in PD patients. CLINICAL REHABILITATION IMPACT These results have important implications regarding the use of these exercise interventions for managing PD, particularly in the early stages.
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Affiliation(s)
- Cheng-Liang Chang
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan (ROC)
| | - Tsu-Kung Lin
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (ROC)
- Center for Parkinson's Disease, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (ROC)
- Center for Mitochondrial Research and Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (ROC)
| | - Chien-Yu Pan
- Department of Physical Education, National Kaohsiung Normal University, Kaohsiung, Taiwan (ROC)
| | - Tsai-Chiao Wang
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan (ROC)
- General Research Service Center, National Pingtung University of Science and Technology, Pingtung, Taiwan (ROC)
| | - Yu-Ting Tseng
- Department of Kinesiology, National Tsing Hua University, Hsinchu, Taiwan (ROC)
| | - Chung-Yao Chien
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan (ROC)
| | - Chia-Liang Tsai
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan (ROC) -
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Hu Y, Huang M, Cerna J, Kaur R, Hernandez ME. Tai Chi Expertise Classification in Older Adults Using Wrist Wearables and Machine Learning. SENSORS (BASEL, SWITZERLAND) 2024; 24:4955. [PMID: 39124002 PMCID: PMC11314743 DOI: 10.3390/s24154955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/17/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024]
Abstract
Tai Chi is a Chinese martial art that provides an adaptive and accessible exercise for older adults with varying functional capacity. While Tai Chi is widely recommended for its physical benefits, wider adoption in at-home practice presents challenges for practitioners, as limited feedback may hamper learning. This study examined the feasibility of using a wearable sensor, combined with machine learning (ML) approaches, to automatically and objectively classify Tai Chi expertise. We hypothesized that the combination of wrist acceleration profiles with ML approaches would be able to accurately classify practitioners' Tai Chi expertise levels. Twelve older active Tai Chi practitioners were recruited for this study. The self-reported lifetime practice hours were used to identify subjects in low, medium, or highly experienced groups. Using 15 acceleration-derived features from a wearable sensor during a self-guided Tai Chi movement and 8 ML architectures, we found multiclass classification performance to range from 0.73 to 0.97 in accuracy and F1-score. Based on feature importance analysis, the top three features were found to each result in a 16-19% performance drop in accuracy. These findings suggest that wrist-wearable-based ML models may accurately classify practice-related changes in movement patterns, which may be helpful in quantifying progress in at-home exercises.
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Affiliation(s)
- Yang Hu
- Department of Kinesiology, College of Health and Human Science, San José State University, San Jose, CA 95129, USA;
| | - Mengyue Huang
- School of Information Sciences, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA;
| | - Jonathan Cerna
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA;
| | - Rachneet Kaur
- Department of Industrial and Enterprise Systems Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA;
| | - Manuel E. Hernandez
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA;
- Department of Biomedical and Translational Sciences, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
- Beckman Institute, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
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Liu H, Chen X, Li Y, Gao Z, Huang W, Jiang Z. Neuromuscular control strategies of the lower limb during a typical Tai Chi brush knee and twist step in practitioners with and without knee pain: a pilot study. Res Sports Med 2024; 32:679-694. [PMID: 37246805 DOI: 10.1080/15438627.2023.2219799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Abstract
As a complex movement, Tai Chi (TC) could be challenging for knee control, and the compensatory changes in TC biomechanics of knee pain patients are unknown. The Brush Knee and Twist Step (BKTS) is a typical TC movement that involves basic leg motion repeated in the whole TC. This pilot study examined electromyography and retro-reflective marker trajectory data to investigate neuromuscular control strategies of the lower extremity during BKTS in TC practitioners with and without knee pain. Twelve experienced TC practitioners with (n = 6) and without knee pain (n = 6) participated. Our results revealed that knee pain practitioners presented muscle imbalance in the vastus medialis-vastus lateralis and vastus lateralis-biceps femoris, and poor alignment of the knee with the toes in TC lunge. Additionally, they adaptively developed rigid coordination strategies, showing higher levels of lower limb muscle co-contraction and activity compared to controls. Training programs for TC practitioners with knee pain should be designed to modify both abnormal muscle synergy patterns and incorrect lunge during TC, which may improve exercise safety.
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Affiliation(s)
- Hong Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaolin Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yaping Li
- Department of Rehabilitation, Fujian Provincial Hospital, Fuzhou, China
| | - Zhen Gao
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- The First Clinical Medical College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Wujie Huang
- Department of Rehabilitation, Shenzhen Children's Hospital, Shenzhen, China
| | - Zheng Jiang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Law NY, Li JX. Effects of a 12-week online Tai Chi intervention on gait and postural stability in individuals with Parkinson's disease. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:239-244. [PMID: 37753420 PMCID: PMC10518795 DOI: 10.1016/j.smhs.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 06/08/2023] [Accepted: 07/08/2023] [Indexed: 09/28/2023] Open
Abstract
Parkinson's disease (PD) affects gait and postural stability. Tai Chi (TC) is recommended for PD for management of the condition, however biomechanical understanding to its effects on gait and postural stability is limited. This study aimed to examine the effects of an online 12-week biomechanical-based TC intervention on gait and posture in people with PD. Fifteen individuals in early-stage PD were recruited (Hoehn & Yahr stages 1-2). The TC intervention program was 60 min session, three times weekly for 12 weeks. The pre- and post-intervention test in obstacle crossing, timed-up-and-go (TUG) test, and single leg standing (SLS) with eyes open (EO) and closed (EC) were conducted. Gait speed, crossing stride length, clearance height of the heel and toe, anterior-posterior (AP) and medial-lateral (ML) displacement and velocity of the center of mass (COM) and separation of the COM-center of pressure (COP) were analyzed. The participants significantly improved their pre-vs. post-TC intervention performance on TUG test (p = 0.002). During obstacle crossing, the participants significantly increased crossing stride length of the trailing foot, increased AP COM displacement and decreased ML COM-COP separation (p < 0.05); the maximal dorsiflexion angle of the leading limb significantly increased and maximal plantarflexion angle of the trailing limb significantly decreased (p < 0.05). A 12-week biomechanical-based online TC training was effective towards improvement of gait and postural stability among people in the early-stage of PD. The TC program and online training could be applied for management of PD.
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Affiliation(s)
- Nok-Yeung Law
- School of Human Kinetics, University of Ottawa, Canada
| | - Jing Xian Li
- School of Human Kinetics, University of Ottawa, Canada
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Yu H, Wang J, Mao M, Song Q, Zhang C, Fong DTP, Sun W. Muscle co-contraction and pre-activation in knee and ankle joint during a typical Tai Chi brush-knee twist-step. Res Sports Med 2023; 31:628-637. [PMID: 34957881 DOI: 10.1080/15438627.2021.2020788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
Abstract
This study aimed to investigate the co-contraction and pre-activation of agonistic and antagonistic muscles in experienced Tai Chi (TC) practitioners during normal walking (NW) and brush-knee twist-step (BKTS). The electromyographic activities of rectus femoris, biceps femoris, and tibialis anterior and lateral gastrocnemius muscles were collected during BKTS and NW in 28 TC practitioners. The pre-activation of knee and ankle joints before initial landing of left foot, and the co-contraction of knee and ankle joint in double-stance phase I (DSI), single-stance phase (SS), double-stance phase II (DSII), and swing phase (SW) were calculated during BKTS and NW. Ankle co-contraction significantly increased during DSI and SS in BKTS movements than compared with that in NW. For DSI and SW, SS and DSII, and DSII and SW, a significant difference was found in BKTS. The pre-activation of knee joint significantly decreased in BKTS and NW. This study indicated greater ankle joint muscle co-contraction in DSI and SS of stance phase and lower knee joint muscle co-contraction and pre-activation than in NW in BKTS movement. In addition, greater ankle joint muscle co-contraction was observed in the DSI, SS, and DSII of stance phase than those of swing phase in BKTS movement.
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Affiliation(s)
- Hao Yu
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - JiangNa Wang
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Min Mao
- School of Nursing and Rehabilitation Shandong University, Jinan, China
| | - QiPeng Song
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Cui Zhang
- Lab of Biomechanics, Shandong Institute of Sport Science, Jinan, China
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Wei Sun
- College of Sports and Health, Shandong Sport University, Jinan, China
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Law NY, Li JX, Zhu Q, Nantel J. Effects of a biomechanical-based Tai Chi program on gait and posture in people with Parkinson's disease: study protocol for a randomized controlled trial. Trials 2023; 24:241. [PMID: 37386473 DOI: 10.1186/s13063-023-07146-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 02/08/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is associated with changes in gait and posture, which increases the rate of falls and injuries in this population. Tai Chi (TC) training enhances the movement capacity of patients with PD. However, the understanding of the effect of TC training on gait and postural stability in PD is lacking. This study aims to examine the effect of biomechanical-based TC training on dynamic postural stability and its relationship with walking performance. METHODS/DESIGN A single-blind, randomized control trial of 40 individuals with early-stage PD was conducted (Hoehn and Yahr stages 1 to 3). Patients with PD will be randomly assigned to either the TC or control group. The TC group will participate in a biomechanical-based TC training program that is formed based on the movement analysis of TC and will be practiced thrice a week for 12 weeks. The control group will be required to engage in at least 60 min of regular physical activity (PA) on their own for three times per week for 12 weeks. The primary and secondary outcomes will be assessed at baseline and at 6 and 12 weeks after commencing the study protocol. The primary outcome measures will include dynamic postural stability indicated by the center of mass and center of pressure separation distance and clearance distance of the heel and toe measured during fixed-obstacle crossing. The secondary measures are gait speed, cadence, step length during level surface walking (simple task), and fixed-obstacle crossing (challenging task). The Unified Parkinson's Disease Rating Scale, single leg-stance test with eyes open and closed, and three cognitive scores (Stroop Test, Trail Making Test Part B, and the Wisconsin Card Sorting Test) were also employed. DISCUSSION This protocol could lead to the development of a biomechanics TC training program for the improvement of gait and postural stability among individuals with PD. The program could enhance the understanding of the effect of TC training on gait and postural stability and could help improve or preserve the postural stability, self-confidence, and active participation in social activities of the participants, thus enhancing their overall quality of life. TRIAL REGISTRATION ClinicalTrials.gov NCT04644367. Registered on 25 November 2020.
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Affiliation(s)
- Nok-Yeung Law
- Schools of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| | - Jing Xian Li
- Schools of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| | - Qingguang Zhu
- Research Institute of Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Julie Nantel
- Schools of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Li H, Peng F, Lyu S, Ji Z, Li X, Liu M. Newly compiled Tai Chi (Bafa Wubu) promotes lower extremity exercise: a preliminary cross sectional study. PeerJ 2023; 11:e15036. [PMID: 36935910 PMCID: PMC10019341 DOI: 10.7717/peerj.15036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/20/2023] [Indexed: 03/14/2023] Open
Abstract
Background Tai Chi (Bafa Wubu) is a new type of simplified Tai Chi widely practiced by Tai Chi enthusiasts that has developed and perfected simplified Tai Chi movement and enriched Tai Chi practice methods. When practicing, Tai Chi athletes and enthusiasts can choose the Bafa Wubu movements to practice according to their physical conditions. The purpose of this article is to discuss the mechanism by which Bafa Wubu promotes lower extremity exercise from the perspective of exercise biomechanics. Objectives This article aims to explore the scientific training methods and technical characteristics of Bafa Wubu, and its contribution to comprehensive exercise of the lower extremities, by analyzing the biomechanical characteristics of the lower extremities of participants who practice Bafa Wubu at different levels and by comparing their ground reaction force, lower limb joints, and muscles during Bafa Wubu. Methods A total of 16 male participants were recruited and divided into an amateur group (N = 8) and a professional group (N = 8). The data were collected by a BTS 3D infrared-based motion capture system, and Kistler 3D force plate. The lower extremity joint forces and muscle strength were calculated by anybody simulation software with inverse dynamics. Results During elbowing and leaning sideways with steps sideways (ELS), the ground reaction force of the professional group was significantly higher than that of the amateur group in the sagittal, vertical, and frontal axes (P < 0.01). While stepping forward, backward, and sideways, the professional group's joints loading at the hip, knee, and ankle was always higher in the vertical direction (P < 0.01). Furthermore, during warding off with steps forward (WOF), laying with steps forward (LF), and rolling back with steps backward (RBB), hip joint loading increased in the med-lat direction. During actions with steps backward and sideways, the professional group's ankle flexion/extension torque and hip abduction/rotation torque were significantly larger than those of the amateur group (P < 0.01). Different actions in Bafa Wubu activate muscles to different degrees, whereas the iliacus is mainly responsible for stabilizing postures when practitioners perform standing knee lifting motions. Conclusions Professional groups who have been practicing Tai Chi (Bafa Wubu) for a long time have higher ground reaction force, and the force on the three joints of the lower extremities is different for various movements, which has positive significance for exercising the joints of the lower extremities. In addition, various motions activate muscles of different types at different levels. For amateurs to practice different movements to stimulate the muscles, targeted areas of practice promote the lower extremity muscles' synergistic force. In summary, the muscles and joints of the lower extremity can obtain comprehensive and balanced exercise through Bafa Wubu.
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Affiliation(s)
- Haojie Li
- School of P.E and Sports, Beijing Normal University, Beijing, Haidian, China
| | - Fang Peng
- Department of PE, Peking University, Beijing, Haidian, China
| | - Shaojun Lyu
- School of P.E and Sports, Beijing Normal University, Beijing, Haidian, China
| | - Zhongqiu Ji
- School of P.E and Sports, Beijing Normal University, Beijing, Haidian, China
| | - Xiongfeng Li
- School of P.E and Sports, Beijing Normal University, Beijing, Haidian, China
| | - Mingyu Liu
- School of P.E and Sports, Beijing Normal University, Beijing, Haidian, China
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Li H, Peng F, Lyu S, Ji Z, Li Y. Study on Two Typical Progressive Motions in Tai Chi (Bafa Wubu) Promoting Lower Extremity Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2264. [PMID: 36767630 PMCID: PMC9915851 DOI: 10.3390/ijerph20032264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND By comparatively investigating the joints, muscles and bones of the lower extremity during two progressive motions in Bafa Wubu and normal walking, this paper aims to enrich the diversity of walking exercise and scientifically provide theoretical guidance for primary practitioners. The scientific training methods and technical characteristics of Bafa Wubu, as well as its contribution to comprehensive exercise of the lower extremities, are further explored. METHODS A total of eight professional athletes of Tai Chi at the national level were recruited. The kinetic parameters of the lower extremity were calculated using AnyBody 7.2 musculoskeletal modeling. Stress analysis of the iliac bone was performed using an ANSYS 19.2 workbench. RESULTS In Bafa Wubu, the ground reaction force during two progressive motions was significantly smaller than that noted during normal walking. During warding off with steps forward and laying with steps forward, the load at the three joints of the lower extremity was significantly smaller than that during normal walking in the frontal plane, but significantly greater than that noted during normal walking in the vertical axis. In addition, the lower limb joint torque was higher than that of normal walking in both progressive movements, and lower limb muscle activation was higher. The iliac bone loads during the two progressive motions were larger than those during normal walking, and the maximum loading point differed. CONCLUSIONS This is the first study to demonstrate the biomechanical performance of Bafa Wubu in professional athletes of Tai Chi. Two progressive motions of Bafa Wubu require the lower extremity to be slowly controlled, thereby resulting in a smaller ground reaction force. In addition, the loads of the three joints at the lower extremity all increase in the vertical direction and decrease in the lateral direction, reducing the possibility of lateral injury to the joints. In addition, the two progressive motions significantly enhance the muscle strength of the plantar flexion muscles, dorsiflexor, and muscles around the thigh, and effectively stimulate the bones of the lower extremity. Therefore, progressive motion training contributes to improving the controlling and supporting capabilities of the lower extremities during normal walking.
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Affiliation(s)
- Haojie Li
- School of Physical Education and Sports, Beijing Normal University, Beijing 100875, China
| | - Fang Peng
- Department of Physical Education, Peking University, Beijing 100871, China
| | - Shaojun Lyu
- School of Physical Education and Sports, Beijing Normal University, Beijing 100875, China
| | - Zhongqiu Ji
- School of Physical Education and Sports, Beijing Normal University, Beijing 100875, China
| | - Yameng Li
- School of Physical Education and Sports, Beijing Normal University, Beijing 100875, China
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Zhao J, Han W, Tang H. Lower limbs inter-joint coordination and variability during typical Tai Chi movement in older female adults. Front Physiol 2023; 14:1164923. [PMID: 37200836 PMCID: PMC10187885 DOI: 10.3389/fphys.2023.1164923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/14/2023] [Indexed: 05/20/2023] Open
Abstract
Purpose: This study aimed to investigate the lower limb inter-joint coordination and variability during Tai Chi movements compared with normal walking in older adults. Methods: A total of 30 female Tai Chi practitioners (70.9 ± 5.2 years) were recruited in this study. Herein, each participant performed three trials of the normal walking and Tai Chi movements. The lower limb kinematics data were collected with Vicon 3D motion capture system. The continuous relative phase (CRP) includes both spatial and temporal information of two adjacent joints, which was calculated to assess the inter-joint coordination of lower limbs. Coordination amplitude and coordination variability were assessed with mean absolute relative phase (MARP) and deviation phase (DP). MANOVOA was used to analyze inter-joint coordination parameters between different movements. Results: The CRP values of hip-knee and knee-ankle segments in the sagittal plane of the Tai Chi movements changed frequently. The MARP values of the hip-knee (p < 0.001) and knee-ankle segments (p = 0.032) as well as the DP values of the hip-knee segment (p < 0.001) were significantly lower in Tai Chi than in normal walking. Conclusion: More consistent and stable inter-joint coordination patterns of Tai Chi movements found in this study may be one of the critical factors that Tai Chi could be a suitable coordinated exercise for older adults.
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Affiliation(s)
- Jianmin Zhao
- School of Competitive Sport, Shandong Sport University, Jinan, China
- Digital-Based Performance Training Laboratory, Shandong Sport University, Jinan, China
| | - Wei Han
- School of Competitive Sport, Shandong Sport University, Jinan, China
- Digital-Based Performance Training Laboratory, Shandong Sport University, Jinan, China
- *Correspondence: Huiru Tang, ; Wei Han,
| | - Huiru Tang
- Child Rehabilitation Department, Linyi Maternal and Child Healthcare Hospital, Linyi, China
- *Correspondence: Huiru Tang, ; Wei Han,
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Fong SSM, Chung LMY, Schooling CM, Lau EHY, Wong JYH, Bae YH, Chung JWY. Tai chi-muscle power training for children with developmental coordination disorder: a randomized controlled trial. Sci Rep 2022; 12:22078. [PMID: 36543796 PMCID: PMC9769475 DOI: 10.1038/s41598-022-25822-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
This study compared the effectiveness of tai chi (TC) muscle power training (MPT), TC alone, MPT alone, and no training for improving the limits of stability (LOS) and motor and leg muscular performance and decreasing falls in children with developmental coordination disorder (DCD). One hundred and twenty-one children with DCD were randomly assigned to the TC-MPT, TC, MPT, or control group. The three intervention groups received TC-MPT, TC, or MPT three times per week for 3 months. Measurements were taken before and after the intervention period. The primary outcomes were the LOS completion time and dynamic LOS scores. The secondary outcomes included the Movement Assessment Battery for Children-Second Edition total test score and percentile rank, knee muscle peak force and time to peak force, and the number of falls. None of the interventions affected the LOS test scores. Improvements in the peak forces of the knee extensors and flexors were demonstrated in the TC (p = 0.006) and MPT groups (p = 0.032), respectively. The number of falls also decreased in these two groups (p < 0.001). Thus, clinicians may prescribe TC or MPT for children with DCD to increase their knee muscle strength and reduce their risk of falls.
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Affiliation(s)
- Shirley S. M. Fong
- grid.419993.f0000 0004 1799 6254Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, N.T, Hong Kong S.A.R. China ,grid.194645.b0000000121742757School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong S.A.R. China
| | - Louisa M. Y. Chung
- grid.419993.f0000 0004 1799 6254Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, N.T, Hong Kong S.A.R. China
| | - Catherine Mary Schooling
- grid.194645.b0000000121742757School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong S.A.R. China ,grid.212340.60000000122985718Graduate School of Public Health and Health Policy, City University of New York, New York, USA
| | - Eric H. Y. Lau
- grid.194645.b0000000121742757School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong S.A.R. China
| | - Janet Y. H. Wong
- grid.194645.b0000000121742757School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong S.A.R. China
| | - Young-Hyeon Bae
- grid.419707.c0000 0004 0642 3290Korea National Rehabilitation Center, Department of Healthcare and Public Health, Rehabilitation Research Institute, Seoul, 01022 Korea
| | - Joanne W. Y. Chung
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Homantin, Hong Kong S.A.R. China
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Law NY, Li JX. Biomechanics analysis of seven Tai Chi movements. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:245-252. [PMID: 36600972 PMCID: PMC9806716 DOI: 10.1016/j.smhs.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 01/07/2023] Open
Abstract
This study examined the maximum joint angles and moments, and electromyography (EMG) activity of the lower limbs in an experienced Tai Chi (TC) practitioner in performing four dynamic (Repulse Monkey, Wave-hand in Clouds, Brush Knee Twist Step, and Lateral Forward Step) and three static TC movements (Starting Form, Hero Touch Sky, and Push Hand Back) and compared them with the measures from walking. Integrated EMG (iEMG) and peak EMG of the rectus femoris, adductor longus, tibialis anterior, semitendinosus, erector spinae, gluteus medius, tensor fasciae latae, medial and lateral gastrocnemius muscles were analyzed. One-way analysis of variance showed that compared with walking, TC presented 1) significantly larger hip flexion (71.4° vs. 42.2°) and abduction angles (11.9° vs. 5.3°), smaller knee flexion (45.2° vs. 71.1°) and abduction angles (13.0° vs. 27.7°), larger ankle dorsiflexion (41.4° vs. 11.3°) and abduction angles (8.8° vs. 7.2°); 2) hip flexion moment and knee flexion and abduction moment were significantly larger. Ankle dorsiflexion moment were significantly smaller, whereas ankle abduction moment was significantly larger in two TC movements; and 3) the EMG activity of the muscles in TC varied from 10% to 610% of walking. The knee extensors, hip adductors and abductors had significantly higher peak EMG (430% ± 40%, 240% ± 30%, and 320% ± 90%) and iEMG values (610% ± 30%, 311% ± 30%, and 1.4% ± 20%), respectively. The findings suggested that these TC movements could be a good option for the improvement of muscle strength and range of motion of the lower limbs.
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Affiliation(s)
| | - Jing Xian Li
- Corresponding author. School of Human Kinetics, University of Ottawa, Ottawa, K1N 6N5, Canada.
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Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review. Neural Plast 2022; 2022:3895514. [PMID: 35309256 PMCID: PMC8926482 DOI: 10.1155/2022/3895514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/27/2022] [Accepted: 02/23/2022] [Indexed: 12/12/2022] Open
Abstract
Background Tai chi (TC) has received increased attention in stroke rehabilitation, yet services are greatly underutilized. An increasing number of systematic reviews and meta-analyses (SRs/MAs) have begun to investigate the effects of TC on balance function in stroke patients. The aim of this current study was to systematically collate, appraise, and synthesize the results of these SRs/MAs using a systematic overview. Methods Eight databases were searched: PubMed, Cochrane Library, Embase, Web of Science, CNKI, SinoMed, Chongqing VIP, and Wanfang Data. SRs/MAs of TC on balance function in stroke patients were included. Literature selection, data extraction, and assessment of the review quality were performed by two independent reviewers. Methodological quality was assessed by the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), reporting quality by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and evidence quality by Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results Nine SRs/MAs were included in this study. For methodological quality, what resulted in unsatisfactory methodological quality was noncompliance with critical item 4 (using a comprehensive literature search strategy) and critical item 7 (providing the list of excluded research literature). For reporting quality, what resulted in unsatisfactory reporting quality was inadequate reporting of Q1 (protocol and registration), Q8 (search), Q15 (risk of bias across studies), Q16 (additional analyses), Q22 (risk of bias across studies), Q23 (additional analysis), and Q27 (funding). For GRADE, the evidence quality was high in 0, moderate in 3, low in 11, and very low in 6. Risk of bias was the most common factor leading to downgrading of evidence, followed by inconsistency, imprecision, publication bias, and indirectness. Conclusions TC may have beneficial effects on balance function in stroke survivors; however, this finding is limited by the generally low methodology, reporting quality, and evidence quality for published SRs/MAs.
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Research on Knee Joint Load and Influencing Factors of Typical Tai Chi Movements. Appl Bionics Biomech 2022; 2022:6774980. [PMID: 35310685 PMCID: PMC8924602 DOI: 10.1155/2022/6774980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background Tai chi is recognized worldwide for its rehabilitation abilities and healthcare benefits. However, in recent years, some movements associated with tai chi have been shown to damage the lower limb joints. The purpose of this study was to investigate and compare the effects of different movements, postures, center of mass (COM) movements, and range of knee movement of tai chi exercises on knee joint load. Methods Fourteen professional tai chi practitioners in two postures (high and low) were enrolled to perform the following four typical tai chi movements: wild horse's mane (WHM), repulse monkey (RM), wave-hand in cloud (WHIC), and grasp the bird's tail (GBT). Kinematic and kinetics data were synchronously collected using the Vicon infrared high-speed motion capture system and a three-dimensional (3D) force measurement platform. Variance analysis and partial correlation analysis were performed to investigate factors influencing peak knee joint moment and vertical ground reaction force (VGRF). Results The results showed that the peak knee extension and abduction moment were larger in WHM and RM than those in WHIC and GBT (p < 0.05). WHM was associated with greater rotation moment than the other typical movements (p < 0.05). VGRF and joint moment among different poses were significantly different. Low-pose tai chi typical movements were associated with greater VGRF, knee joint extension and abduction, and rotation moments than high-pose movements (p < 0.05). The anteroposterior and mediolateral COM displacements were strongly and positively associated with VGRF (p < 0.001), while the mediolateral COM displacement was negatively associated with knee extension moment (p < 0.001). The knee internal-external rotation ROM and anteroposterior and mediolateral COM displacements were positively associated with knee abduction moment (p < 0.01). Conclusion For long-term tai chi exercises, choosing a suitable posture based on an individual exercise level and reasonable control of knee ROM and COM displacement can reduce the risk of knee injury during exercise.
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Zhuang SZ, Chen PJ, Han J, Xiao WH. Beneficial Effects and Potential Mechanisms of Tai Chi on Lower Limb Osteoarthritis: A Biopsychosocial Perspective. Chin J Integr Med 2021; 29:368-376. [PMID: 34921649 DOI: 10.1007/s11655-021-3529-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2021] [Indexed: 01/15/2023]
Abstract
Lower limb osteoarthritis (OA) is a chronic, multifactorial disease characterized by impaired physical function, chronic pain, compromised psychological health and decreased social functioning. Chronic inflammation plays a critical role in the pathophysiology of OA. Tai Chi is a type of classical mind-body exercise derived from ancient Chinese martial arts. Evidence supports that Tai Chi has significant benefits for relieving lower limb OA symptoms. Using a biopsychosocial framework, this review aims to elucidate the beneficial effects of Tai Chi in lower limb OA and disentangle its potential mechanisms from the perspective of biology, psychology, and social factors. Complex biomechanical, biochemical, neurological, psychological, and social mechanisms, including strengthening of muscles, proprioception improvement, joint mechanical stress reduction, change of brain activation and sensitization, attenuation of inflammation, emotion modulation and social support, are discussed.
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Affiliation(s)
- Shu-Zhao Zhuang
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Pei-Jie Chen
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Jia Han
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Wei-Hua Xiao
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China.
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Zhu Q, Zhou X, Zhang S, Fang M, Li JX. Joint Angles and Joint Moments of the Lower Limbs in Four Typical Tai Chi Movements: Consideration for Management of Knee Osteoarthritis. Res Sports Med 2021; 29:586-592. [PMID: 34477036 DOI: 10.1080/15438627.2021.1975118] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
This study examined the biomechanics of the lower limbs during four typical Tai Chi (TC) movements: wave hand in cloud, leaning fly side, repulse monkey, and brush knee and twist step, in order to provide biomechanical evidence-based recommendations for patients with knee osteoarthritis (OA) practicing TC. Joint angles and joint moments of the hip, knee, and ankle in frontal and sagittal plane as well as ground reaction forces were examined while performing TC and regular walking in an experienced 38 years old TC master. The results showed that relative to walking, the four TC movements are characterized by a wide motion range of lower limbs, slow increase in joint loading, and strong muscle activity during performance. Therefore, these TC movements could be suitable for patients with knee OA to practice for improving the muscle strength of their lower limbs and functional ability.
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Affiliation(s)
- Qingguang Zhu
- Department of Tuina, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Tuina Research, Shanghai Research Institute of Traditional Chinese Medicine, Shanghai, China
| | - Xin Zhou
- Department of Tuina, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shuaipan Zhang
- Department of Tuina, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Fang
- Department of Tuina, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Tuina Research, Shanghai Research Institute of Traditional Chinese Medicine, Shanghai, China
| | - Jing Xian Li
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Wang SJ, Xu DQ, Su LN, Li JX. Effect of long-term exercise training on static postural control in older adults: a cross-sectional study. Res Sports Med 2020; 28:553-562. [DOI: 10.1080/15438627.2020.1795661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Shao-Jun Wang
- Institute of Physical Education, North Minzu University, Yinchuan, China
- Graduate School, Tianjin University of Sport, Tianjin, China
| | - Dong-Qing Xu
- Graduate School, Tianjin University of Sport, Tianjin, China
| | - Li-Na Su
- Institute of Physical Education, North Minzu University, Yinchuan, China
| | - Jing Xian Li
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
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Duan J, Wang K, Chang T, Wang L, Zhang S, Niu W. Tai Chi Is Safe and Effective for the Hip Joint: A Biomechanical Perspective. J Aging Phys Act 2020; 28:415-425. [PMID: 31756718 DOI: 10.1123/japa.2019-0129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 08/10/2019] [Accepted: 09/20/2019] [Indexed: 11/18/2022]
Abstract
There is little research related to the biomechanical effects of Tai Chi on the hip joint. This study was aimed to analyze the biomechanical characteristic of a typical Tai Chi movement, Brush Knee and Twist Step. A total of 12 experienced older men voluntarily participated in this study. Each participant was requested to perform standard Brush Knee and Twist Step and normal walking. The scaled-generic musculoskeletal model of each participant was developed. A finite element model of the hip joint and pelvis was established and validated. Data from each trail were input to the model for simulation, and the biomechanics were compared between Brush Knee and Twist Step and walking. Compared with walking, Tai Chi may have better improvement in the range of motion of the hip joint and the coordination of the neuromuscular system under safer condition. It is suitable for patients with hip osteoarthritis and the older adults with severe muscle loss, and clinical studies are required to confirm it further.
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Zhao Z, Watanabe K, Asaka T, Wang Y. Postural control in preparation to a step during support surface perturbation. Res Sports Med 2020; 28:588-593. [PMID: 32268804 DOI: 10.1080/15438627.2020.1745802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We investigated changes in the anticipatory activity of the leg and trunk muscles in preparation for a step during support surface perturbation. Eight healthy subjects performed stepping tasks under three conditions: normal, forward perturbation, and backward perturbation. R and C indices were calculated for the reciprocal and co-activation patterns of muscle pairs within the time intervals typical of anticipatory postural adjustments. When the support surface perturbation occurred, anticipatory muscle activations were predominantly in the C indices in the leg muscles. Significant differences in the maximum displacement of the centre of pressure were seen between conditions (FS vs NS; BS vs FS). The results suggest that activation of the leg muscles rather than the trunk muscles was modified to ensure equilibrium for taking a step in response to support surface perturbation.
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Affiliation(s)
- Zhuoyue Zhao
- Tianjin Key Lab of Exercise Physiology and Sports Medicine, College of Social Sport and Health Science, Tianjin University of Sport , Tianjin, China.,Department of Rehabilitation, Tianjin Union medical Center , Tianjin, China
| | | | - Tadayoshi Asaka
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University , Sapporo, Japan
| | - Yun Wang
- Tianjin Key Lab of Exercise Physiology and Sports Medicine, College of Social Sport and Health Science, Tianjin University of Sport , Tianjin, China
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Ko BJ, Hsu TY, Huang CF. The effects of tai chi chuan exercise training on countermovement jump performance in the elderly. Res Sports Med 2020; 28:563-571. [PMID: 32050791 DOI: 10.1080/15438627.2020.1727478] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study sought to compare the biomechanical parameters of the lower extremities during a countermovement jump in elderly people who are engaged in frequent practice of tai chi chuan (TCG) and in the general population of healthy elderly people (HG). Each group included 12 participants. Ten Vicon Motion System infrared cameras and two Kistler force plates were employed for measurement. The jump height, duration, centre of mass (COM) displacement, joint ROM, and upward velocity were analysed in this study. Motion analysis and force platform data were combined to calculate joint moments and powers during the takeoff phase. The data were analysed using independent sample t-tests. The results showed that the tai chi chuan practitioner group (0.13 m) achieved 44% higher jump heights (p < 0.05). The COM displacement during squatting was lower in the TCG (0.25 m) than in the HG (0.19 m) (p < 0.05). The knee and ankle ROMs of the TCG were higher than those of the HG (p < 0.05). Peak knee moment 23% and peak knee power 32% higher in TCG compared to the HG (p < 0.05), suggesting that frequent practice of tai chi chuan may slow the rate of knee degeneration.
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Affiliation(s)
- Bo-Jen Ko
- Department of Physical Education, National Taichung University of Education , Taichung, Taiwan
| | - Tai-Yen Hsu
- Department of Physical Education, National Taichung University of Education , Taichung, Taiwan
| | - Chen-Fu Huang
- Department of Physical Education, National Taiwan Normal University , Taipei, Taiwan
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Hu X, Lai Z, Wang L. Effects of Taichi exercise on knee and ankle proprioception among individuals with knee osteoarthritis. Res Sports Med 2019; 28:268-278. [PMID: 31524502 DOI: 10.1080/15438627.2019.1663520] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The study aimed to investigate the effects of 24 weeks Taichi intervention on knee and ankle proprioception amongst individuals with knee osteoarthritis (KOA). Ninety-two patients with KOA were included in the current study, involving 52 participants in the intervention group and 40 participants in the control group. The intervention group performed Taichi exercise for 24 weeks, the control group accepted the health education lectures. The main outcome of this study was the proprioception of the knee and ankle which was measured by an electric-driven movable frame. Between- and within-group differences were evaluated through the repeated-measurement ANOVA. For the Taichi group, the differences in the changes in ankle proprioception were significant on ankle plantarflexion (p = 0.03), ankle dorsiflexion (p = 0.043), ankle varus (p = 0.019) and knee flexion (p = 0.01) between the baseline and post-test measures. Twenty-four weeks Taichi exercise may improve the ankle and knee proprioception of patients with KOA.
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Affiliation(s)
- Xiaoyue Hu
- Key Laboratory of Exercise and Health Science of the Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Zhangqi Lai
- Key Laboratory of Exercise and Health Science of the Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Science of the Ministry of Education, Shanghai University of Sport, Shanghai, China
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Lyu D, Lyu X, Zhang Y, Ren Y, Yang F, Zhou L, Zou Y, Li Z. Tai Chi for Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Physiol 2018; 9:983. [PMID: 30090071 PMCID: PMC6068268 DOI: 10.3389/fphys.2018.00983] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 07/04/2018] [Indexed: 11/28/2022] Open
Abstract
Background: Stroke is a major cause of poor health and has numerous complications. Tai Chi (TC) may have positive effects on the rehabilitation of stroke survivors, but recent clinical findings have not been included in previously published reviews. Objectives: We conducted this systematic review and meta-analysis to determine the effectiveness of all types of TC vs. conventional rehabilitation therapy for all aspects of stroke survivors' rehabilitation that have been studied. Method: We searched seven electronic literature databases (three in English, four in Chinese) and one clinical registry platform using established strategies to identify randomized controlled trials performed up to October 2017. Screening, quality assessment, and data collection were performed by two researchers separately, using the same standard. The results were analyzed using RevMan 5.3.0. The quality of evidence was evaluated with GRADEpro. Results: A total of 21 studies with 1,293 stroke survivors met inclusion criteria; 14 were included in the quantitative synthesis to evaluate four aspects and five outcomes. Nine studies indicated that TC was able to improve independent activities of daily living (ADL), especially TC vs. conventional rehabilitation therapy [mean difference (MD) [95% confidence interval (CI)] = 9.92 [6.82, 13.02], P < 0.00001]. Five studies reported significant effects of TC plus conventional rehabilitation therapy in increasing scores on the Fugl-Meyer Assessment for the upper limb [MD (95%CI) = 8.27 [4.69, 11.84], P < 0.0001], lower limb [MD (95%CI) = 2.75 [0.95, 4.56], P = 0.003], and overall [MD (95%CI) = 4.49 [1.92, 7.06], P = 0.0006]. The Berg Balance Scale revealed significant improvements according to pooled estimates for TC vs. conventional rehabilitation therapy [MD (95%CI) = 5.23 [3.42, 7.05], P < 0.00001]. TC plus conventional rehabilitation therapy also improved walking ability as measured by the Holden scale [MD (95%CI) = 0.61 [0.38, 0.85], P < 0.00001] and up-and-go time [MD (95%CI) = 2.59 [1.76, 3.43], P < 0.00001]. Conclusion: TC has an overall beneficial effect on ADL, balance, limb motor function, and walking ability among stroke survivors, based on very low-quality evidence, and may also improve sleep quality, mood, mental health, and other motor function. Well-designed, higher-quality trials with longer-term follow-up periods are needed to develop better-quality evidence.
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Affiliation(s)
- Diyang Lyu
- Neurological Rehabilitation Center, Beijing Rehabilitation Hospital, The Affiliated Hospital of Capital Medical University, Beijing, China
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Xuanxin Lyu
- Neurological Rehabilitation Center, Beijing Rehabilitation Hospital, The Affiliated Hospital of Capital Medical University, Beijing, China
| | - Yong Zhang
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Yi Ren
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Fan Yang
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Li Zhou
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Yihuai Zou
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Zongheng Li
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
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