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Gathright EC, Hughes JW, Sun S, Storlazzi LE, DeCosta J, Balletto BL, Carey MP, Scott-Sheldon LAJ, Salmoirago-Blotcher E. Effects of stress management interventions on heart rate variability in adults with cardiovascular disease: a systematic review and meta-analysis. J Behav Med 2024; 47:374-388. [PMID: 38478157 DOI: 10.1007/s10865-024-00468-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/15/2024] [Indexed: 04/19/2024]
Abstract
Meta-analysis was used to investigate the potential benefits of stress management interventions (SMIs) on vagally-mediated heart rate variability (HRV) in adults with cardiovascular disease. Electronic bibliographic databases were searched through August 2022. Randomized controlled trials and quasi-experimental studies assessing effects of SMIs on HRV were included. Methodological quality was assessed with a standardized checklist. A pooled effect size was calculated for vagally-mediated HRV indices (standard deviation of normal-to-normal intervals, root mean square of the successive differences, and high frequency power) using random effects models. Fourteen studies (1202 participants, Mage: 59 ± 6.25 years; 25% ± 16% women; 61% ± 22% White) were included. Ten studies (11 effects) reported short-term HRV assessment; a small between-group difference emerged for vagally-mediated HRV (d+ = .27, 95% confidence interval [CI] 0.01-0.52, k = 11). Most interventions examined biofeedback; these studies yielded a small between-group difference on vagally-mediated HRV (d+ = 0.31, 95% CI 0.09-0.53, k = 7, Q [6] = 3.82, p = .70, I2 = 11%). This is the first systematic examination of the effect of SMIs on HRV in adults with CVD. Findings suggest a small effect of SMIs on vagally-mediated HRV, with biofeedback likely driving the effect. More research is required to fully understand whether this benefit on vagally-mediated HRV applies to other SMIs.
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Affiliation(s)
- Emily C Gathright
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA.
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.
| | - Joel W Hughes
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Laurie E Storlazzi
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
| | - Julie DeCosta
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
| | - Brittany L Balletto
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
| | - Michael P Carey
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Lori A J Scott-Sheldon
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Elena Salmoirago-Blotcher
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Medicine, Alpert School of Medicine, Brown University, Providence, RI, USA
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El-Malahi O, Mohajeri D, Mincu R, Bäuerle A, Rothenaicher K, Knuschke R, Rammos C, Rassaf T, Lortz J. Beneficial impacts of physical activity on heart rate variability: A systematic review and meta-analysis. PLoS One 2024; 19:e0299793. [PMID: 38578755 PMCID: PMC10997132 DOI: 10.1371/journal.pone.0299793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 02/16/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) are the leading causes of morbidity and mortality. Heart rate variability (HRV) represents the modulatory capacity of the autonomous nervous system and influences mortality. By surveying this meta-analysis, we investigated the impact of physical activity on HRV. METHODS Databases, online journal libraries and clinical trial registries were searched for publications of randomized controlled and non-randomized controlled trials concerning adults with coronary artery disease (CAD)/ischemic heart disease (IHD), congestive heart failure (CHF), peripheral arterial disease (PAD) or after acute coronary syndrome (ACS) joining an intervention group with physical activity or a control group with usual care or no intervention. Extracted time-domain and frequency-domain parameter of HRV were analyzed in a meta-analysis using a random effect model. Subgroup analyses concerning intervention type, study design and type of heart disease and sensitivity analysis were performed. RESULTS Significant results were obtained for RR-Interval (p = 0.05) and standard deviation of Normal-to-Normal intervals (SDNN) (p = 0.01) for short-term assessment and for the ratio of low-frequency power (LF) to high-frequency power (HF) (p = 0.05) for 24-hour assessment. Subgroup analyses also resulted significant: root-mean-square difference of successive normal R-R intervals (RMSSD) (p = 0.01), SDNN (p = 0.02) and HF (p < 0.01) concerning CHF. CONCLUSION We were able to demonstrate the positive impact of physical activity on HRV, especially in patients with CHF. Cardiac rehabilitation exercise programs need to be individualized to identify the most beneficial method of training for improving the prognosis of patients with CVD.
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Affiliation(s)
- Ouahiba El-Malahi
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Darya Mohajeri
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Raluca Mincu
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Korbinian Rothenaicher
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Ramtin Knuschke
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
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Zhou Y, Wang Q, Larkey L, James D, Cui H. Tai Chi Effects on Heart Rate Variability: A Systematic Review and Meta-Analysis. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:121-132. [PMID: 37695835 DOI: 10.1089/jicm.2022.0682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Background: Tai Chi, originating in China, is a mind-body exercise that integrates mind training, Qi training, and body training. While Tai Chi practice has demonstrated beneficial physical and psychological health benefits, how it achieves effects has been less studied. In recent years, some researchers have begun to explore the potential of heart rate variability (HRV) changes as balancing the autonomic nervous system (ANS) to achieve results, but only a few studies have directly tested how Tai Chi impacts HRV, and results have been mixed. Objective: This study systematically evaluates the effects of Tai Chi on HRV. Methods: Electronic databases including Web of Science, PubMed, Scopus, Cochrane Library, and EBSCOhost direct from inception until December 2020 were searched to obtain eligible studies. The primary outcomes examined were HRV parameters (time domain and frequency domain), and secondary analysis was whether breathing was emphasized during Tai Chi interventions. Results: Based on the 11 randomized controlled trials included comparing Tai Chi with non-active control condition, meta-analyses showed significantly beneficial effects on HRV parameters (low-frequency power [LF], mean difference [MD] = -200.40, 95% confidence interval [CI]: 365.31 to -35.49, p = 0.02; normalized low-frequency power [nLF], MD = -7.39, 95% CI: -12.48 to -2.29, p = 0.004; total power [TP], MD = -649.82, 95% CI: -1180.54 to -119.11, p = 0.02; very low-frequency power [VLF], MD = -200.55, 95% CI: -349.63 to -51.46, p = 0.008; root mean square of the square sum of the difference between adjacent normal heartbeat intervals [RMSSD], MD = 2.59, 95% CI: -7.23 to 12.41, p < 0.0001; standard deviation of the heartbeat interval [SDNN], MD = 8.33, 95% CI: 0.69 to 15.98, p = 0.03). The effect of Tai Chi on certain HRV parameters compared with active control conditions was less favorable (nLF, MD = 6.42, 95% CI: 3.74 to 9.09, p < 0.00001; normalized high-frequency power [nHF], MD: -6.13, 95% CI: -8.76 to -3.50, p < 0.00001; low-frequency/high-frequency power ratio [LF/HF], MD = 1.00, 95% CI: 0.68 to 1.33, p < 0.00001). In addition, studies describing an emphasis on breathing in the Tai Chi intervention showed positive impact on HRV (nLF, MD = -3.22, 95% CI: -5.32 to -1.12, p = 0.003; nHF, MD = 3.80, 95% CI: 0.80 to 6.81, p = 0.01; SDNN, MD = 5.55, 95% CI: 4.85 to 6.25, p < 0.00001). Conclusions: Meta-analysis results showed that Tai Chi compared with non-active control conditions has a positive impact on key HRV parameters associated with the ANS balance. However, active control condition comparisons showed greater HRV improvements than for Tai Chi. Considering the limited number of studies and their heterogeneity, further robust studies are necessary to verify findings and investigate differential effects of Tai Chi on HRV.
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Affiliation(s)
- Yujiao Zhou
- Department of Wushu, Beijing Sport University, Beijing, China
| | - Qiuyu Wang
- Department of Foreign Languages, Beijing Sport University, Beijing, China
| | - Linda Larkey
- Center for Health Promotion and Disease Prevention, Edson College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Dara James
- Center for Health Promotion and Disease Prevention, Edson College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Hua Cui
- Department of Wushu, Beijing Sport University, Beijing, China
- Sport Information Research and Teaching Center, Beijing Sport University, Beijing, China
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Wang F, Cai J, Liu J, Duan B, Yang Y, Yang Q. Effects of traditional Chinese exercise on physiological indicators and quality of life in patients with coronary heart disease: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34233. [PMID: 37390231 PMCID: PMC10313288 DOI: 10.1097/md.0000000000034233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND The efficacy of traditional Chinese exercise (TCE)-based intervention in the improvement of physiological indicators and quality of life in patients with coronary heart disease (CHD) is controversial. METHOD Five databases were systematically searched for relevant articles published from inception to February 2023. Controlled trials examining TCE intervention in patients with CHD. The treatment effects were estimated using a random-effect meta-analysis model with standardized mean differences (Hedges g). The categorical and continuous variables were used to conduct moderator analyses. Two investigators independently screened abstracts and full-text articles and graded the certainty of evidence based on the Grading of Recommendations Assessment, Development and Evaluation approach. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42023401934). RESULT Ten studies involving a total of 718 participants were included in the final analysis. In the physiological indicators outcomes, the meta-analytic findings revealed large and significant improvements in systolic blood pressure (g = 0.78, 95% confidence interval [CI] = 0.51-1.05, P = .00, I2 = 98%), diastolic blood pressure (g = 0.90, 95% CI = 0.61-1.20, P = .00, I2 = 98%) and body mass index (g = 1.05, 95% CI = 0.75-1.34, P = .00, I2 = 99%), small and significant improvements in heart rate (g = 0.28, 95% CI = 0.01-0.54, P = .04, I2 = 98%) and ventilatory equivalents/carbon dioxide (g = -1.10, 95% CI = -1.47 to -0.74, P = .00, I2 = 96%).In the quality of life outcomes, the findings revealed small and significant improvements in physical functioning (g = -3.01, 95% CI = -3.45 to -2.57, P = .00, I2 = 96%), bodily pain (g = -2.16, 95% CI = -2.57 to -1.74, P = .00, I2 = 98%), vitality (g = -3.67, 95% CI = -4.16 to -3.16, P = .00, I2 = 97%) and mental health (g = -1.23, 95% CI = -1.771 to -0.692, P = .00, I2 = 99%). The moderator shows that the effects of TCE on physiological indicators and quality of life were moderated by PEDro score, type of exercise, exercise frequency, exercise duration, and number of sessions. CONCLUSION TCE intervention is a beneficial nonpharmacological approach to improving physiological indicators in patients with CHD, especially in systolic blood pressure, diastolic blood pressure, and body mass index. However, there was no significant effect on quality of life. Our findings require broader clinical trials and higher-quality study designs to strengthen the evidence.
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Affiliation(s)
- Fan Wang
- Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Jingjing Cai
- Shiyan Hospital of Integrated Traditional Chinese and Western Medicine, Shiyan, Hubei Province, China
| | - Jihong Liu
- Shiyan Hospital of Integrated Traditional Chinese and Western Medicine, Shiyan, Hubei Province, China
| | - Banyan Duan
- Shiyan Hospital of Integrated Traditional Chinese and Western Medicine, Shiyan, Hubei Province, China
| | - Yingying Yang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Qianfang Yang
- Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang Province, China
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Du Z, Zhang X, Qin H, Wang R, Bai Y, Yao X. META analysis on the effect of taijiquan on improving negative psychological symptoms of college students and the optimal dose. Front Public Health 2022; 10:1032266. [PMID: 36589943 PMCID: PMC9800891 DOI: 10.3389/fpubh.2022.1032266] [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: 08/30/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Background Taijiquan, as a physical and mental exercise, can improve the negative psychology of college students. However, it is still controversial, and the optimal exercise dose of taijiquan to interfere with negative psychology has not been evaluated. Objective This study is aimed at systematically evaluating the effect of taijiquan therapy on improving negative psychological symptoms of college students and its optimal intervention dose. Methods Search databases such as Web of Science, Embase, PubMed, CNKI, WFSD, etc. Collect high-quality relevant RCT studies. After screening, extracting, coding and counting the data, a META analysis is done through Review Manage 5.3 and Stata 15.0 software. PICOS established the eligibility criteria to select the studies as follows: (i) population - non-clinical of college students; (ii) intervention - taijiquan intervention; (iii) comparison - taijiquan intervention group and regular physical activity group; (iv) outcomes - depression, anxiety; and (v) study design - randomized controlled trial. Results A total of 12 articles and 1,000 samples were included. All of the participants are college students. Taijiquan therapy can significantly reduce the depression and anxiety symptoms of college students [SMD = -0.53, 95% CI (-0.82, -0.23)], [SMD = -0.49, 95% CI (-0.90, -0.09)], with statistical significance (P < 0.05). Subgroup analysis shows that: there is a precise focus on depression and anxiety symptoms. The intervention period is more than 12 weeks, and the best effect appears when people practice 3 times a week. The best single intervention time for depression symptoms is 60 min, and for anxiety symptoms 80-90 min. It is found that taijiquan combined with mindfulness intervention can significantly reduce negative psychological symptoms like depression and anxiety of college students than single taijiquan intervention. Funnel plot combined with sensitivity analysis, Begg, Egger test showed no publication bias. Conclusion Taijiquan intervention can effectively improve the negative psychological symptoms of college students, and it has great promotion value in colleges and universities. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022314071.
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Affiliation(s)
- Zhihao Du
- School of Physical Education and Exercise, Beijing Normal University, Beijing, China
| | - Xiuli Zhang
- School of Physical Education (School Headquarters), Sports and Medical Integration Development Research Center, Zhengzhou University, Zhengzhou, China,*Correspondence: Xiuli Zhang ;
| | - Hao Qin
- School of Physical Education and Exercise, Beijing Normal University, Beijing, China
| | - Ruiqi Wang
- School of Physical Education and Exercise, Beijing Normal University, Beijing, China
| | - Yunxia Bai
- School of Computer Science, Baotou Medical College, Baotou, China
| | - Xiaonan Yao
- School of Sociology, Sanya University, Sanya, China
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6
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Mou T, Brown O, Hua Y, Simon M, Dong X, Kenton K, Bretschneider CE. Gender differences of lower urinary tract symptoms in older Chinese Americans. Asian J Urol 2021. [DOI: 10.1016/j.ajur.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Perloff J, Thomas CP, Macklin E, Gagnon P, Tsai T, Isaza I, Wayne PM, Lipsitz L. The Impact of Tai Chi Exercise on Health Care Utilization and Imputed Cost in Residents of Low-Income Senior Housing. Glob Adv Health Med 2021; 10:2164956120985479. [PMID: 33598365 PMCID: PMC7841657 DOI: 10.1177/2164956120985479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study was designed to test the impact of Tai Chi (TC) on healthcare utilization and cost in older adults living in low-income senior housing. We hypothesized that TC would improve overall health enough to reduce the use of emergency department (ED) and inpatient services. DESIGN Cluster randomized controlled trial with randomization at the housing site level. SETTING Greater Boston, Massachusetts. PARTICIPANTS The study includes 6 sites with 75 individuals in the TC treatment condition and 6 sites with 67 individuals in the health education control condition. INTERVENTION Members of the treatment group received up to a year-long intervention with twice weekly, in-person TC exercise sessions along with video-directed exercises that could be done independently at home. The comparison group received monthly, in-person healthy aging education classes (HE). Study recruitment took place between August, 2015 and October, 2017. Key outcomes included acute care utilization (inpatient stays, observation stays and emergency department visits). In addition, the cost of utilization was estimated using the age, sex and race adjusted allowed amount from Medicare claims for a geographically similar population aged ≥ 65. RESULTS The results suggested a possible reduction in the rate of ED visits in the TC group vs. controls (rate ratio = 0.476, p-value = 0.06), but no findings achieved statistical significance. Adjusted estimates of imputed costs of ED and hospital care were similar between TC and HE, averaging approximately $3,000 in each group. CONCLUSION ED utilization tended to be lower over 6 to 12 months of TC exercises compared to HE in older adults living in low-income housing, although estimated costs of care were similar.
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Affiliation(s)
- Jennifer Perloff
- The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Cindy Parks Thomas
- The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Eric Macklin
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Peggy Gagnon
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
| | - Timothy Tsai
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
| | - Ilean Isaza
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
| | - Peter M Wayne
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Lewis Lipsitz
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Beth Israel Deaconess Medical Center Division of Gerontology, Boston, Massachusetts
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Lo OY, Conboy LA, Rukhadze A, Georgetti C, Gagnon MM, Manor B, Lachman ME, Lipsitz LA, Wayne PM. In the Eyes of Those Who Were Randomized: Perceptions of Disadvantaged Older Adults in a Tai Chi Trial. THE GERONTOLOGIST 2020; 60:672-682. [PMID: 30544227 DOI: 10.1093/geront/gny165] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Older adults living in subsidized housing have typically been excluded from exercise intervention studies. We conducted a qualitative study to explore the perceived physical, psychological, social, and economic factors that influenced participation in and adherence to a year-long Tai Chi intervention within an ongoing cluster-randomized controlled trial (RCT) for older adults living within subsidized housing facilities. RESEARCH DESIGN AND METHODS Focus groups were held with participants of the RCT who were allocated to the trial's Tai Chi intervention. Individual phone interviews were conducted with those allocated to Tai Chi who had low adherence or who had withdrawn their participation from the study. Emergent themes were extracted using grounded-theory methods. RESULTS In this qualitative study, we enrolled 41 participants who were allocated to the RCT's Tai Chi intervention: 38 completed and 3 withdrew from the study. Average Tai Chi class attendance was 64.3%. Pragmatic factors that led to higher adherence and retention included: locating classes within each facility; providing programs at no cost; and deployment of a skilled research support team. In addition, the use of an accessible, simplified Tai Chi program improved confidence, social support, self-efficacy, and self-reported improvements in physical and psychological well-being. DISCUSSION AND IMPLICATIONS Perceived physical, psychological, social benefits, and self-efficacy likely enhance adherence and retention to research-based Tai Chi interventions for older adults. Delivering an on-site, no cost, and supportive program appears critical to overcoming financial and environmental barriers to participation for those living within subsidized housing.
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Affiliation(s)
- On-Yee Lo
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Lisa A Conboy
- New England School of Acupuncture, Newton, Massachusetts
| | | | - Caroline Georgetti
- New England School of Acupuncture at Massachusetts College of Pharmacy and Health Sciences, Worcester, Massachusetts
| | - Margaret M Gagnon
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Margie E Lachman
- Department of Psychology, Brandeis University, Waltham, Massachusetts
| | - Lewis A Lipsitz
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Peter M Wayne
- Harvard Medical School, Boston, Massachusetts.,Osher Center for Integrative Medicine at Brigham and Women's Hospital, Boston, Massachusetts
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Meier-Girard D, Ribi K, Gerstenberg G, Ruhstaller T, Wolf U. Eurythmy therapy versus slow movement fitness in the treatment of fatigue in metastatic breast cancer patients: study protocol for a randomized controlled trial. Trials 2020; 21:612. [PMID: 32631427 PMCID: PMC7336433 DOI: 10.1186/s13063-020-04542-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is the most taxing symptom for many breast cancer patients during and after therapy. In patients with metastatic disease, the prevalence of CRF exceeds 75%. Currently, there is no gold standard for the treatment of CRF. Physical activity can reduce CRF and is recommended during and after cancer treatment, but may be too burdensome for patients with metastatic breast cancer. The aim of this study is to assess the effect on fatigue of eurythmy therapy (ERYT) compared to slow movement fitness (CoordiFit) in metastatic breast cancer patients. METHODS The ERYT/CoordiFit study is a randomized controlled, open-label, two-arm, multi-center Swiss clinical trial. A sample of 196 patients presenting with CRF will be recruited by oncologists from the departments of clinical oncology at each local study site. All participants will be randomly allocated to the intervention or control group in a 1:1 ratio. The control group is an active control intervention (CoordiFit) in order to control for potential non-intended effects such as therapist-patient interaction and participation in a program. Both ERYT and CoordiFit exercises are easy to learn, and the training sessions will follow the same frequency and duration schedule, i.e., 13 standardized therapy sessions of 45 min (once a week for 6 weeks and then once every second week) during the total intervention period of 20 weeks. The primary endpoint of the study is the change from baseline over the whole intervention period (i.e., including measurements at baseline, weeks 8, 14, and 20) in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) subscale score. DISCUSSION This study is the first-known randomized clinical trial assessing eurythmy therapy in the treatment of fatigue in metastatic breast cancer patients. Given the distress that fatigue causes patients, it is important to validate treatment options. If eurythmy therapy proves beneficial in CRF as part of this randomized controlled clinical trial, the study may be very impactful with implications not only for metastatic breast cancer patients but also for other cancer patients, health care personnel, scientists, and funding and regulatory bodies. TRIAL REGISTRATION The ERYT/CoordiFit trial was registered at the US National Institutes of Health (ClinicalTrials.gov) on July 18, 2019, #NCT04024267 , and in the portal for human research in Switzerland on December 3, 2019, #SNCTP000003525 .
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Affiliation(s)
- Delphine Meier-Girard
- Institute of Complementary and Integrative Medicine, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Karin Ribi
- International Breast Cancer Study Group, Coordinating Center, Bern, Switzerland
| | - Gisa Gerstenberg
- Institute of Complementary and Integrative Medicine, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | | | - Ursula Wolf
- Institute of Complementary and Integrative Medicine, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
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Ma J, Zhang JW, Li H, Zhao LS, Guo AY, Chen ZH, Yuan W, Gao TM, Li YM, Li CH, Wang HW, Song B, Lu YL, Cui MZ, Wei QY, Lyu SJ, Yin HC. Safety and effectiveness of a Tai Chi-based cardiac rehabilitation programme for chronic coronary syndrom patients: study protocol for a randomised controlled trial. BMJ Open 2020; 10:e036061. [PMID: 32624473 PMCID: PMC7337900 DOI: 10.1136/bmjopen-2019-036061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Preliminary evidence from clinical observations suggests that Tai Chi exercise may offer potential benefits for patients with chronic coronary syndrom (CCS). However, the advantages for CCS patients to practice Tai Chi exercise as rehabilitation have not been rigorously tested and there is a lack of consensus on its benefits. This study aims to develop an innovative Tai Chi Cardiac Rehabilitation Program (TCCRP) for CCS patients and to assess the efficacy, safety and acceptability of the programme. METHODS AND ANALYSIS We propose to conduct a multicentre randomised controlled clinical trial comprising of 150 participants with CCS. The patients will be randomly assigned in a 1:1 ratio into two groups. The intervention group will participate in a supervised TCCRP held three times a week for 3 months. The control group will receive supervised conventional exercise rehabilitation held three times a week for 3 months. The primary and secondary outcomes will be assessed at baseline, 1 month, 3 months after intervention and after an additional 3-month follow-up period. Primary outcome measures will include a score of 36-Item Short Form Survey and Chinese Perceived Stress Scale. The secondary outcome measures will include body composition, cardiopulmonary exercise test, respiratory muscle function, locomotor skills, echocardiogram, New York Heart Association classification, heart rate recovery time and laboratory examination. Other measures also include Seattle Angina Scale, Pittsburgh Sleep Quality Index, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and Berg Balance Scale. All adverse events will be recorded and analysed. ETHICS AND DISSEMINATION This study conforms to the principles of the Declaration of Helsinki and relevant ethical guidelines. Ethical approval has been obtained from the Ethics Committee of Chinese People's Libration Army General Hospital (approval number: S2019-060-02). Findings from this study will be published and presented at conferences for widespread dissemination of the results. TRIAL REGISTRATION NUMBER NCT03936504.
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Affiliation(s)
- Jing Ma
- Department of Cardiology, First Medical Center of Chinese People's Libration Army General Hospital, Beijing, China
| | - Jian Wei Zhang
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Hua Li
- Department of Cardiovascular Medicine, Anzhen Community Health Service Center, Chaoyang District, Beijing, China
| | - Lian Shan Zhao
- Department of Cardiovascular Medicine, Beijing Shuili Hospital, Beijing, China
| | - Ai Ying Guo
- Department of Cardiovascular Medicine, Anzhen Community Health Service Center, Chaoyang District, Beijing, China
| | - Zai Hao Chen
- College of Wushu, Beijing Sport University, Beijing, China
| | - Wen Yuan
- College of Wushu, Beijing Sport University, Beijing, China
| | - Tian Ming Gao
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Ya Meng Li
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Cui Han Li
- College of Wushu, Beijing Sport University, Beijing, China
| | - Hong Wei Wang
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Bo Song
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Yu Long Lu
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Mei Ze Cui
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Qiu Yang Wei
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Shao Jun Lyu
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Heng Chan Yin
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
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Complexity-Based Measures of Heart Rate Dynamics in Older Adults Following Long- and Short-Term Tai Chi Training: Cross-sectional and Randomized Trial Studies. Sci Rep 2019; 9:7500. [PMID: 31097732 PMCID: PMC6522618 DOI: 10.1038/s41598-019-43602-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/27/2019] [Indexed: 12/19/2022] Open
Abstract
Measures characterizing the complexity of heart rate (HR) dynamics have been informative in predicting age- and disease-related decline in cardiovascular health, but few studies have evaluated whether mind-body exercise can impact HR complexity. This study evaluated the effects of long-term Tai Chi (TC) practice on the complexity of HR dynamics using an observational comparison of TC experts and age- and gender-matched TC-naïve individuals. Shorter-term effects of TC were assessed by randomly assigning TC-naïve participants to either TC group to receive six months of TC training or to a waitlist control group. 23 TC experts (age = 63.3 ± 8.0 y; 24.6 ± 12.0 y TC experience) and 52 TC-naïve (age = 64.3 ± 7.7 y) were enrolled. In cross-sectional analyses, TC experts had a higher overall complexity index (CI, p = 0.004) and higher entropy at multiple individual time scales (p < 0.05); these findings persisted in models accounting for age, gender, body mass index (BMI), and physical activity levels. Longitudinal changes in complexity index did not differ significantly following random assignment to six months of TC vs. a waitlist control; however, within the TC group, complexity at select time scales showed statistically non-significant trends toward increases. Our study supports that longer-term TC mind-body training may be associated with increased complexity of HR dynamics.
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12
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Silva V, Grande AJ, Peccin MS. Physical activity for lower urinary tract symptoms secondary to benign prostatic obstruction. Cochrane Database Syst Rev 2019; 4:CD012044. [PMID: 30953341 PMCID: PMC6450803 DOI: 10.1002/14651858.cd012044.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Lower urinary tract symptoms caused by benign prostatic obstruction (LUTS/BPO) represents one of the most common clinical complaints in men. Physical activity might represent a viable first-line intervention for treating LUTS/BPO. OBJECTIVES To assess the effects of physical activity for lower urinary tract symptoms caused by benign prostatic obstruction (LUTS/BPO). SEARCH METHODS We performed a comprehensive search of multiple databases (CENTRAL, MEDLINE, Embase, Web of Science, LILACS, ClinicalTrials.gov, and WHO ICTRP); checked the reference lists of retrieved articles; and handsearched abstract proceedings of conferences with no restrictions on the language of publication or publication status from database inception to 6 November 2018. SELECTION CRITERIA We included published and unpublished randomised controlled and controlled clinical trials that included men diagnosed with LUTS/BPO. We excluded studies in which medical history suggested non-BPO causes of LUTS or prior invasive therapies to physical activity or that used electrical stimulation. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, extracted data, and assessed the risk of bias of included studies. We assessed primary outcomes (symptom score for LUTS; response rate, defined as 20% improvement in symptom score; withdrawal due to adverse events) and secondary outcomes (change of medication use; need for an invasive procedure; postvoid residual urine). We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS We included six studies that randomised 652 men over 40 years old with moderate or severe LUTS. The four different comparisons were as follows:Physical activity versus watchful waitingTwo RCTs randomised 119 participants. The interventions included tai chi and pelvic floor exercise. The evidence was overall of very low quality, and we are uncertain about the effects of physical activity on symptom score for LUTS (mean difference (MD) -8.1, 95% confidence interval (CI) -13.2 to -3.1); response rate (risk ratio (RR) 1.80, 95% CI 0.81 to 4.02; 286 more men per 1000, 95% CI 68 fewer to 1079 more); and withdrawal due to adverse events (RR 1.00, 95% CI 0.59 to 1.69; 0 fewer men per 1000, 95% CI 205 fewer to 345 more).Physical activity as part of self-management programme versus watchful waitingTwo RCTs randomised 362 participants. Pelvic floor exercise was one of multiple intervention components. The evidence was of very low quality, and we are uncertain about the effects of physical activity for symptom score for LUTS (MD -6.2, 95% CI -9.9 to -2.5); response rate (RR 2.36, 95% CI 1.32 to 4.21; 424 more men per 1000, 95% CI 100 more to 1000 more); and withdrawal due to adverse events (risk difference 0.00, 95% CI -0.05 to 0.06; 65 fewer men per 1000, 95% CI 65 fewer to 65 fewer).Physical activity as part of weight reduction programme versus watchful waitingOne RCT randomised 130 participants. An unclear type of intense exercise was one of multiple intervention components. The evidence was of very low quality, and we are uncertain about the effects for symptom score for LUTS (MD -1.1, 95% CI -3.5 to 1.3); response rate (RR 1.20, 95% CI 0.74 to 1.94; 67 more men per 1000, 95% CI 87 fewer to 313 more); and withdrawal due to adverse events (RR 1.63, 95% CI 1.03 to 2.57; 184 more men per 1000, 95% CI 9 more to 459 more).Physical activity versus alpha-blockersOne RCT randomised 41 participants to pelvic floor exercise or alpha-blockers. The evidence was of very low quality, and we are uncertain about the effects for symptom score for LUTS (MD 2.8, 95% CI -0.9 to 6.4) and response rate (RR 0.80, 95% CI 0.55 to 1.15; 167 fewer men per 1000, 95% CI 375 fewer to 125 more). The evidence was of low quality for withdrawal due to adverse events; the effects for this outcome may be similar between interventions (RR 0.86, 95% CI 0.06 to 12.89; 7 fewer men per 1000, 95% CI 49 fewer to 626 more). AUTHORS' CONCLUSIONS We rated the quality of the evidence for most of the effects of physical activity for LUTS/BPO as very low. We are therefore uncertain whether physical activity affects symptom scores for LUTS, response rate, and withdrawal due to adverse events. Our confidence in the estimates was lowered due to study limitations, inconsistency, indirectness, and imprecision. Additional high-quality research is necessary.
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Affiliation(s)
- Valter Silva
- Centro Universitário Tiradentes (UNIT/AL)Postgraduate Program on Society, Technology and Public Policies (SOTEPP); Department of MedicineAv. Comendador Gustavo Paiva, 5017Cruz das AlmasMaceióALBrazil57038‐000
| | - Antonio Jose Grande
- Universidade Estadual de Mato Grosso do SulLaboratory of Evidence‐Based PracticeAv. Dom Antônio Barbosa, 4155Vila Santo AmaroCampo GrandeMato Grosso do SulBrazil79115‐898
| | - Maria S Peccin
- Universidade Federal de São PauloDepartment of Human Movement SciencesR. Silva Jardim, 136 ‐ Vl. Mathias ‐SantosSão PauloBrazil11015‐020
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Zou L, Sasaki JE, Wei GX, Huang T, Yeung AS, Neto OB, Chen KW, Hui SSC. Effects of Mind⁻Body Exercises (Tai Chi/Yoga) on Heart Rate Variability Parameters and Perceived Stress: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. J Clin Med 2018; 7:jcm7110404. [PMID: 30384420 PMCID: PMC6262541 DOI: 10.3390/jcm7110404] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 10/23/2018] [Accepted: 10/29/2018] [Indexed: 11/16/2022] Open
Abstract
Background: Heart rate variability (HRV) as an accurate, noninvasive measure of the Autonomous Nervous System (ANS) can reflect mental health (e.g., stress, depression, or anxiety). Tai Chi and Yoga (Tai Chi/Yoga), as the most widely practiced mind–body exercises, have shown positive outcomes of mental health. To date, no systematic review regarding the long-lasting effects of Tai Chi/Yoga on HRV parameters and perceived stress has been conducted. Objective: To critically evaluate the existing literature on this topic. Methods: Five electronic databases (Web of Science, PubMed, Scopus, SportDiscus and Cochrane Library) were searched from the start of the research project to July 2018. Study selection, data extraction, and study quality assessment were independently carried out by two reviewers. The potentially identified randomized controlled trials (RCT) reported the useful quantitative data that were included only for meta-analysis. Results: meta-analysis of 17 medium-to-high quality RCTs showed significantly beneficial effects on HRV parameters (normalized low-frequency, Hedge’s g = −0.39, 95% CI −0.39 to −0.56, p < 0.001, I2 = 11.62%; normalized high-frequency, Hedge’s g = 0.37, 95% CI 0.22 to −0.52, p < 0.001, I2 = 0%; low-frequency to high-frequency ratio, Hedge’s g = −0.58, 95% CI −0.81 to −0.35, p < 0.001, I2 = 53.78%) and stress level (Hedge’s g = −0.80, 95% CI −1.17 to −0.44, p < 0.001, I2 = 68.54%). Conclusions: Stress reduction may be attributed to sympathetic-vagal balance modulated by mind–body exercises. Tai Chi/Yoga could be an alternative method for stress reduction for people who live under high stress or negative emotions.
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Affiliation(s)
- Liye Zou
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Jeffer Eidi Sasaki
- Department of Sport Sciences, Institute of Health Sciences, Federal University of Triangulo Mineiro, Uberaba, MG 38025-440, Brazil.
| | - Gao-Xia Wei
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Tao Huang
- Department of Physical Education, Shanghai Jiaotong University, Shanghai 200240, China.
| | - Albert S Yeung
- Depression Clinical and Research Program, Harvard Medical School, Boston, MA 02114, USA.
| | - Octávio Barbosa Neto
- Department of Sport Sciences, Institute of Health Sciences, Federal University of Triangulo Mineiro, Uberaba, MG 38025-440, Brazil.
| | - Kevin W Chen
- Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
| | - Stanley Sai-Chuen Hui
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
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Effectiveness of Tai Chi on Cardiac Autonomic Function and Symptomatology in Women With Fibromyalgia: A Randomized Controlled Trial. J Aging Phys Act 2018; 26:214-221. [PMID: 28657825 DOI: 10.1123/japa.2017-0038] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The present study examined the effects of a 12-week Tai Chi (TC) training regimen on heart rate variability (HRV), symptomatology, muscle fitness and body composition in women with fibromyalgia. Participants were randomly assigned to either a TC training group (n = 18) or a control group (n = 19). HRV, symptomatology, muscle fitness and body composition were measured before and after 12 weeks. There were significant decreases (p < 0.05) in sympathovagal balance (LnLF/LnHF), sympathetic tone (LnLF, nLF), pain, and fatigue, and significant increases (p < 0.05) in parasympathetic tone (LnHF, nHF), strength and flexibility following TC compared with no changes after control. The changes in LnLF and LnLF/LnHF were correlated with changes in pain. There were no significant changes in HR, sleep quality and body composition after TC or control. TC may be an effective therapeutic intervention for improving sympathovagal balance, pain, fatigue, strength and flexibility in women with fibromyalgia.
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15
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Liu T, Chan AW, Liu YH, Taylor-Piliae RE. Effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being, and cardiovascular risk reduction among patients with coronary heart disease: A systematic review and meta-analysis. Eur J Cardiovasc Nurs 2017; 17:368-383. [PMID: 29256626 DOI: 10.1177/1474515117749592] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Tai Chi is an attractive exercise to improve cardiovascular health. This review aimed to synthesize articles written both in Chinese and in English to evaluate the effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being and cardiovascular diseases risk reduction for coronary heart diseases patients. METHODS PRISMA guidelines were used to search major health databases to identify randomized controlled trials or non-randomized controlled clinical trials that evaluated Tai Chi intervention compared with active or non-active control groups in coronary heart disease patients. When suitable, data were pooled using a random-effects meta-analysis model. RESULTS Thirteen studies met the inclusion criteria. Tai Chi groups showed a large and significant improvement in aerobic endurance compared with both active and non-active control interventions (standard mean difference (SMD) 1.12; 95% confidence interval (CI): 0.58-1.66; p <0.001). Tai Chi groups also showed a significantly lower level of anxiety (SMD=9.28; CI: 17.46-1.10; p=0.03) and depression (SMD=9.42; CI: 13.59-5.26; p <0.001), and significantly better quality of life (SMD=0.73; 95% CI: 0.39-1.08; p <0.001) compared with non-active control groups. CONCLUSION Significant effects of Tai Chi have been found in improving aerobic endurance and psychosocial well-being among coronary heart disease patients. Tai Chi could be a cost-effective and safe exercise option in cardiac rehabilitation. However, the effect of Tai Chi on cardiovascular disease risk reduction has not been amply investigated among coronary heart disease patients. Caution is also warranted in view of a small number of studies for this meta-analysis and potential heterogeneity in differences in the varied designs of Tai Chi intervention.
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Affiliation(s)
- Ting Liu
- 1 Faculty of Medicine, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Aileen Wk Chan
- 1 Faculty of Medicine, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yun Hong Liu
- 1 Faculty of Medicine, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Wayne PM, Gagnon MM, Macklin EA, Travison TG, Manor B, Lachman M, Thomas CP, Lipsitz LA. The Mind Body-Wellness in Supportive Housing (Mi-WiSH) study: Design and rationale of a cluster randomized controlled trial of Tai Chi in senior housing. Contemp Clin Trials 2017; 60:96-104. [PMID: 28694204 PMCID: PMC5639896 DOI: 10.1016/j.cct.2017.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/28/2017] [Accepted: 07/03/2017] [Indexed: 02/08/2023]
Abstract
Supporting the health of growing numbers of frail older adults living in subsidized housing requires interventions that can combat frailty, improve residents' functional abilities, and reduce their health care costs. Tai Chi is an increasingly popular multimodal mind-body exercise that incorporates physical, cognitive, social, and meditative components in the same activity and offers a promising intervention for ameliorating many of the conditions that lead to poor health and excessive health care utilization. The Mind Body-Wellness in Supportive Housing (Mi-WiSH) study is an ongoing two-arm cluster randomized, attention-controlled trial designed to examine the impact of Tai Chi on functional indicators of health and health care utilization. We are enrolling participants from 16 urban subsidized housing facilities (n=320 participants), conducting the Tai Chi intervention or education classes and social calls (attention control) in consenting subjects within the facilities for one year, and assessing these subjects at baseline, 6months, and 1year. Physical function (quantified by the Short Physical Performance Battery), and health care utilization (emergency visits, hospitalizations, skilled nursing and nursing home admissions), assessed at 12months are co-primary outcomes. Our discussion highlights our strategy to balance pragmatic and explanatory features into the study design, describes efforts to enhance site recruitment and participant adherence, and summarizes our broader goal of post study dissemination if effectiveness and cost-effectiveness are demonstrated, by preparing training and protocol manuals for use in housing facilities across the U.S.
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Affiliation(s)
- Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States.
| | - Margaret M Gagnon
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States.
| | - Eric A Macklin
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
| | - Thomas G Travison
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States.
| | - Bradley Manor
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States.
| | - Margie Lachman
- Department of Psychology, Brandeis University, Waltham, MA, United States.
| | - Cindy P Thomas
- The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States.
| | - Lewis A Lipsitz
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States.
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Effects of Tai Chi exercise on heart rate variability. Complement Ther Clin Pract 2016; 23:59-63. [DOI: 10.1016/j.ctcp.2016.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 03/23/2016] [Indexed: 02/05/2023]
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Silva V, Grande AJ, Stanton KR, Peccin MS. Physical activity for lower urinary tract symptoms secondary to benign prostatic obstruction. Hippokratia 2016. [DOI: 10.1002/14651858.cd012044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Valter Silva
- Universidade Federal de São Paulo; Department of Human Movement Sciences; Santos Brazil
| | - Antonio Jose Grande
- Universidade do Extremo Sul Catarinense; Laboratory of Evidence-Based Practice; Av. Universitária, 1105 Predio S, LABEPI Criciuma Santa Catarina Brazil 88806-000
| | | | - Maria S Peccin
- Universidade Federal de São Paulo; Department of Human Movement Sciences; Santos Brazil
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Kang R, Wu Y, Li Z, Jiang J, Gao Q, Yu Y, Gao K, Yan Y, He Y. Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study. Psychopathology 2016; 49:345-355. [PMID: 27584836 DOI: 10.1159/000448195] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 06/25/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Antipsychotic drugs are limited in their ability to improve negative symptoms, quality of life, and medication adherence in patients with schizophrenia. The addition of nonpharmacological interventions like social skills training has a positive effect on medication adherence and decreases rehospitalization rates but is limited in improving patients' symptoms, aggressive behaviors, and quality of life. Aerobic exercise, especially Tai-chi, can potentially reduce psychopathological and negative symptoms, decrease aggressive behaviors, and improve quality of life. It is an ideal rehabilitation intervention for patients with schizophrenia. However, no study has investigated the effects of social skills training plus Tai-chi on outcomes among outpatients with schizophrenia. This study analyzes the effect of antipsychotics combined with community-based integrated interventions on outcomes of schizophrenia. METHODS In this study, a 24-session social skills training plus Tai-chi was used in community settings among patients with schizophrenia. A total of 244 patients were randomly assigned to medication treatment alone (MTA group) or community-based integrated intervention (CBII group), which accepted social skills training plus Tai-chi in addition to medication treatment. Generalized linear mixed models were used to evaluate the intervention effect (group effect), intervention effect over time (time effect), and interaction effect (group × time effect). t tests were used to evaluate between-group differences on clinical variables. Multiple linear regression analysis was used to analyze the differences between the intervention at 12 months and baseline for the Positive and Negative Syndrome Scale (PANSS) negative symptoms and quality of life-social domain. RESULTS Compared with the MTA group, the CBII group had lower scores on PANSS (F = 17.312, p < 0.001) and negative symptoms (F = 44.909, p < 0.001), a lower risk for aggressive behavior (F = 12.382, p < 0.001), and a greater improvement in adherence to medication (F = 12.391, p < 0.001) after 1 year of intervention. The changes in PANSS total scores, negative scores, and social domain of the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF) from baseline to 12 months were significant between the two groups (PANSS total score: t = 4.839, p < 0.001; negative symptoms: t = 8.250, p < 0.001, and quality of life-social domain: t = -2.171, p = 0.031). Multiple linear regression analysis also showed that the intervention was significantly effective for changes from baseline to 12 months on PANSS total score (B = 0.804, p < 0.001), negative score (B = 0.709, p < 0.001), and social domain of quality of life (B = -0.673, p = 0.044). CONCLUSIONS This study suggested that the community-based integrated intervention such as social skills training plus Tai-chi should be part of a rehabilitation effort for patients with schizophrenia in order to improve clinical symptoms, quality of life, and medication adherence.
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Affiliation(s)
- Ruiying Kang
- Department of Epidemiology and Biostatics, School of Public Health, Capital Medical University, Beijing, China
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Wei GX, Li YF, Yue XL, Ma X, Chang YK, Yi LY, Li JC, Zuo XN. Tai Chi Chuan modulates heart rate variability during abdominal breathing in elderly adults. Psych J 2015; 5:69-77. [PMID: 26377754 DOI: 10.1002/pchj.105] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/10/2015] [Indexed: 11/10/2022]
Abstract
Tai Chi Chuan (TCC) practice is currently intentionally applied in clinical populations, especially those with cardiovascular diseases because of its potential benefits on the autonomic nervous system. The long-term effect of TCC practice on heart rate variability (HRV) remains largely unknown. In this study, we recruited 23 TCC practitioners whose experience averaged approximately 21 years and 19 controls matched by age, sex and education to examine the effect of TCC practice on the autonomic nervous system during a resting state and during an abdominal breathing state. HRV was measured by traditional electrocardiogram (ECG) recording. The results showed that the low frequency, total power frequency, and normalized low frequency components and the low-frequency/high-frequency ratio were significantly higher, whereas the normalized high frequency was significantly lower in the TCC practitioners relative to controls during the abdominal breathing state. However, we did not detect any significant difference in the HRV measures during the resting state between the two groups. Additionally, TCC experience did not correlate with HRV components either in the abdominal state or the resting state in the TCC group. Considering all of these findings, we suggest that TCC improves vagal activity and the balance between sympathetic and parasympathetic activity during the relaxation state. This study also provides direct physiological evidence for the role of TCC practice in relaxation.
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Affiliation(s)
- Gao-Xia Wei
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - You-Fa Li
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing, China
| | - Xiao-Lin Yue
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Xiao Ma
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing, China.,Department of Psychology, Beijing Normal University, Beijing, China
| | - Yu-Kai Chang
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Long-Yan Yi
- Sport Science Research Center, Beijing Sport University, Beijing, China
| | - Jing-Cheng Li
- Capital University of Physical Education and Sports, Beijing, China
| | - Xi-Nian Zuo
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Garland EL, Franken IH, Howard MO. Cue-elicited heart rate variability and attentional bias predict alcohol relapse following treatment. Psychopharmacology (Berl) 2012; 222:17-26. [PMID: 22203318 PMCID: PMC3346884 DOI: 10.1007/s00213-011-2618-4] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 12/10/2011] [Indexed: 11/30/2022]
Abstract
RATIONALE Identification of malleable neurocognitive predictors of relapse among alcohol-dependent individuals is important for the optimization of health care delivery and clinical services. OBJECTIVES Given that alcohol cue-reactivity can predict relapse, we evaluated cue-elicited high-frequency heart rate variability (HFHRV) and alcohol attentional bias (AB) as potential relapse risk indices. METHOD Alcohol-dependent patients in long-term residential treatment who had participated in mindfulness-oriented therapy or an addiction support group completed a spatial cueing task as a measure of alcohol AB and an affect-modulated alcohol cue-reactivity protocol while HFHRV was assessed. RESULTS Post-treatment HFHRV cue-reactivity and alcohol AB significantly predicted the occurrence and timing of relapse by 6-month follow-up, independent of treatment condition and after controlling for alcohol dependence severity. Alcohol-dependent patients who relapsed exhibited a significantly greater HFHRV reactivity to stress-primed alcohol cues than patients who did not relapse. CONCLUSIONS Cue-elicited HFHRV and alcohol AB can presage relapse and may therefore hold promise as prognostic indicators in clinical settings.
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Tai chi for lower urinary tract symptoms and quality of life in elderly patients with benign prostate hypertrophy: a randomized controlled trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2012:624692. [PMID: 21977055 PMCID: PMC3185236 DOI: 10.1155/2012/624692] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 07/30/2011] [Indexed: 11/23/2022]
Abstract
Tai chi exercise has been recommended as suitable for the improvement of health in the elderly. The purpose of this study was to investigate the effects of tai chi on lower urinary tract symptoms (LUTSs), quality of life (QoL), and sex hormone levels in patients with benign prostate hypertrophy (BPH). The elderly patients with BPH were randomized to receive tai chi or usual care. Fifty-six participants were randomized into either the tai chi group (n = 28) or the control group (n = 28). After 12 weeks of treatment, the tai chi group showed significant improvement in LUTS and QoL. There was a significant effect of tai chi on testosterone but no significant effect on insulin or glucose. No serious adverse events were observed during the study period. In conclusion, our results suggest that 12 weeks of tai chi may improve LUTS and QoL in elderly patients with BPH.
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Huang CM, Chang HC, Kao ST, Li TC, Wei CC, Chen CC, Chen FJ, Tsou SS. Radial Pressure Pulse and Heart Rate Variability in Normotensive and Hypertensive Subjects. J Altern Complement Med 2011; 17:945-52. [DOI: 10.1089/acm.2010.0326] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Chin-Ming Huang
- School of Chinese Medicine, China Medical University, Taichung, Taiwan, Republic of China
| | - Hsien-Cheh Chang
- School of Chinese Medicine, China Medical University, Taichung, Taiwan, Republic of China
| | - Shung-Te Kao
- School of Chinese Medicine, China Medical University, Taichung, Taiwan, Republic of China
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan, Republic of China
| | - Ching-Chuan Wei
- Department of Information and Communication Engineering, Chaoyang University of Technology, Taichung, Taiwan, Republic of China
| | - Chia Chung Chen
- Department of Bio-industrial Mechatronics Engineering, National ChungHsing University, Taichung, Taiwan, Republic of China
| | - Fun-jou Chen
- Institute of Integrated Medicine, China Medical University, Taichung, Taiwan, Republic of China
| | - Shi-Sheng Tsou
- Division of Cardiology, China Medical University Hospital, Taichung, Taiwan, Republic of China
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Seifert G, Kanitz JL, Pretzer K, Henze G, Witt K, Reulecke S, Voss A. Improvement of heart rate variability by eurythmy therapy after a 6-week eurythmy therapy training. Integr Cancer Ther 2011; 11:111-9. [PMID: 21733984 DOI: 10.1177/1534735411413263] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Eurythmy therapy (EYT) is a mind-body therapy used in anthroposophic medicine. Recently, the authors were able to show that at comparable workloads, EYT stimulated heart rate variability (HRV) whereas conventional ergometer training attenuated HRV. Furthermore, a long-term improvement of quality of life (QoL) and stress coping strategies by EYT could be shown. OBJECTIVE This study aimed to evaluate the long-term effects of EYT training on HRV. DESIGN A total of 23 healthy women (mean age = 44.57 ± 8.04 years) performed 10 hours of EYT over a period of 6 weeks. Electrocardiograms were recorded before and after the EYT trial. HRV was quantified by the extent of high (HF), low (LF), very low (VLF), and ultra low frequency (ULF) oscillations of heart rate. RESULTS Autonomic regulation was significantly changed following the EYT training compared with baseline. Especially the proportion referring to the total power (P) of HF/P and LF/P increased, whereas ULF/P and (ULF+VLF)/P decreased after the training period. CONCLUSION EYT shifted the autonomic regulation proportionally referring to the total power mainly caused by changes of ULF and VLF components of HRV. The LF and HF spectral components were also decreased following EYT while their proportion in relation to the total variance of the power spectrum was increased. The proportional enhancement of the higher frequency and the decrease of the ULF and VLF components are probably an indicator of an improvement of autonomic regulation processes by more relaxed physical activity after the EYT training, thus supporting the plausibility of the improved QoL and better stress coping strategies.
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Affiliation(s)
- Georg Seifert
- Department of Pediatric Oncology and Hematology, Otto Heubner Center for Pediatric and Adolescent Medicine, Charité, Universitätsmedizin Berlin, Germany.
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Dalusung-Angosta A. The impact of Tai Chi exercise on coronary heart disease: a systematic review. ACTA ACUST UNITED AC 2011; 23:376-81. [PMID: 21696487 DOI: 10.1111/j.1745-7599.2011.00597.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE (a) To explore current studies on Tai Chi and its impact on coronary heart disease (CHD), (b) provide critique of existing studies, and (c) provide recommendations for clinical practice and future research. DATA SOURCES Comprehensive review of literature. CONCLUSIONS Tai Chi is a safe alternative exercise for patients who are at risk of CHD or with existing CHD. Implementing Tai Chi exercise may improve serum lipids, blood pressure, and heart rate. IMPLICATIONS FOR PRACTICE Nurse practitioners (NPs) are in an ideal position to facilitate health promotion and disease prevention. NPs may prescribe Tai Chi as an alternative exercise therapy for their patients who are at risk for developing CHD and even for those with existing CHD. Tai Chi exercise may help prevent and even reverse the progression of cardiac disease.
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Garland EL, Fredrickson B, Kring AM, Johnson DP, Meyer PS, Penn DL. Upward spirals of positive emotions counter downward spirals of negativity: insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. Clin Psychol Rev 2010; 30:849-64. [PMID: 20363063 PMCID: PMC2908186 DOI: 10.1016/j.cpr.2010.03.002] [Citation(s) in RCA: 439] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Revised: 02/09/2010] [Accepted: 03/05/2010] [Indexed: 12/28/2022]
Abstract
This review integrates Fredrickson's broaden-and-build theory of positive emotions with advances in affective neuroscience regarding plasticity in the neural circuitry of emotions to inform the treatment of emotion deficits within psychopathology. We first present a body of research showing that positive emotions broaden cognition and behavioral repertoires, and in so doing, build durable biopsychosocial resources that support coping and flourishing mental health. Next, by explicating the processes through which momentary experiences of emotions may accrue into self-perpetuating emotional systems, the current review proposes an underlying architecture of state-trait interactions that engenders lasting affective dispositions. This theoretical framework is then used to elucidate the cognitive-emotional mechanisms underpinning three disorders of affect regulation: depression, anxiety, and schizophrenia. In turn, two mind training interventions, mindfulness and loving-kindness meditation, are highlighted as means of generating positive emotions that may counter the negative affective processes implicated in these disorders. We conclude with the proposition that positive emotions may exert a countervailing force on the dysphoric, fearful, or anhedonic states characteristic of psychopathologies typified by emotional dysfunctions.
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Affiliation(s)
- Eric L Garland
- College of Social Work, Florida State University, University Center, Building C, Tallahassee, Fl 32306-2570, USA.
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Chang RY, Koo M, Ho MY, Lin ZZ, Yu ZR, Lin YF, Wang BJ. Effects of Tai Chi on adiponectin and glucose homeostasis in individuals with cardiovascular risk factors. Eur J Appl Physiol 2010; 111:57-66. [DOI: 10.1007/s00421-010-1628-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2010] [Indexed: 12/30/2022]
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Sato S, Makita S, Uchida R, Ishihara S, Masuda M. Effect of Tai Chi Training on Baroreflex Sensitivity and Heart Rate Variability in Patients With Coronary Heart Disease. Int Heart J 2010; 51:238-41. [DOI: 10.1536/ihj.51.238] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Shinji Sato
- Department of Sport and Health Science, Osaka Sangyo University
| | - Shigeru Makita
- Department of Cardiac Rehabilitation Medicine, Saitama Medical University International Medical Center
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