Effect of Tai Chi on muscle strength, physical endurance, postural balance and flexibility: a systematic review and meta-analysis

Effects of Tai Chi training on functionality, dynamic balance, kinesiophobia, and quality of life in athletes with functional ankle instability

This study investigated the effects of Tai Chi training on functionality, dynamic balance, kinesiophobia, and quality of life in athletes with Functional Ankle Instability (FAI). Forty-three athletes with FAI were randomly assigned to either a Tai Chi group (n = 21) or a control group (n = 22). The Tai Chi group followed a tailored exercise protocol addressing ankle instability through a three-phase progression, while the control group had no intervention but continued their usual activities. Measurements, including Cumberland Ankle Instability Tool (CAIT), Star Excursion Balance Test (SEBT), Tampa Scale for Kinesiophobia (TSK), Short Form-12 (SF-12), figure-8 hop test, and perceived treatment effect were assessed before and after the intervention. The Tai Chi group showed significant improvements in CAIT score and SEBT reach distance compared to the control group (p < 0.001). Tai Chi exercises also reduced TSK, improved figure-8 hop score, and enhanced the physical component of SF-12 (p < 0.005), with no significant effect on the mental component of SF-12 (p = 0.7). The findings imply that Tai Chi may be a valuable consideration for athletic trainers and sports medicine professionals working with athletes with FAI.

At least 150 min per week of Tai chi practice improves sleep quality in the older people: evidence from a meta-analysis

OBJECTIVE

To conduct a meta-analysis to explore the optimal dosage of Tai chi exercise that positively influences the sleep quality of the older people.

METHODS

A literature search was conducted from 2004 to October 2024 in PubMed, Embase, Web of Science, Google Scholar, Cochrane Library, and Chinese databases (CNKI and Wanfang) for randomised controlled trials in Chinese and English on Tai chi improving sleep quality in the older people. Data extraction and verification were performed by two independent researchers. Additionally, a meta-analysis of the mean difference (MD) and 95% confidence interval (CI) was conducted using RevMan 5.4.

RESULTS

A total of nine randomised controlled trials involving 1,166 older participants were included. Compared with the control group, Tai chi significantly reduced the total Pittsburgh Sleep Quality Index (PSQI) scores in the older people [MD =  - 1.53, 95% CI (- 2.18, - 0.89), p < 0.001], with heterogeneity results Q = 53.63, df = 12, and I2 of 78% (p < 0.001); Total weekly duration of Tai chi exercise: Less than 150 min reduced PSQI scores, but the difference was not statistically significant [MD =  - 1.47, 95% CI (- 3.89, 0.95), p = 0.23]. Between 150-300 min significantly reduced PSQI scores [MD =  - 1.54, 95% CI (- 2.00, - 1.08), p < 0.001]; Duration of Tai chi exercise programme: 8-12 weeks significantly reduced PSQI scores [MD =  - 1.93, 95% CI (- 2.60, - 1.25), p < 0.001]; 16-24 weeks significantly reduced PSQI scores [MD =  - 1.27, 95% CI (- 2.27, - 0.26), p = 0.01]; Single session duration of Tai chi exercise: 60 min significantly reduced PSQI scores [MD =  - 2.17, 95% CI (- 3.15, - 1.18), p < 0.001]; Less than 60 min (25-45 min) significantly reduced PSQI scores [MD =  - 0.92, 95% CI (- 1.63, - 0.20), p = 0.01].

CONCLUSION

Older individuals engaging in at least 150 min per week of Tai chi practice can improve sleep quality. Beyond this threshold, extending the duration of individual practice sessions or the exercise programme does not yield additional benefits for sleep quality.

Gaming-Based Tele-Exercise Program to Improve Physical Function in Frail Older Adults: Feasibility Randomized Controlled Trial

BACKGROUND

Frailty leads to reduced physical activity can cause increased fall risk. This contributes to accelerated aging processes, leading to adverse health outcomes and reduced quality of life. We have developed and piloted the design, usability, safety, and feasibility of a gaming-based cognitive-motor (CogXergaming) tele-exercise protocol in prefrail older adults.

OBJECTIVE

This pilot randomized control trial tested preliminary feasibility and effectiveness of the CogXergaming telehealth protocol for improving physical function.

METHODS

Community-dwelling, prefrail older adults were randomly assigned to CogXergaming (n=13) or a control group (n=14). The CogXergaming group received supervised tele-exercises in a gaming format for 6 weeks (3 sessions per week) comprising 18 sessions lasting 90 minutes each. Control group participants participated in a Matter of Balance (MOB), an 8-week, once-a-week structured 90-minute tele-session that has been shown to reduce the fear of falling and increase physical activity. Feasibility of training was obtained by computing the median duration of training sessions for the CogXergaming group. Effectiveness was assessed using dynamic balance control (Four Square Step Test), subjective self-efficacy (Activities-Specific Balance Confidence scale), gait function (Tinetti Performance Oriented Mobility Assessment), muscle strength (30-second chair stand test), and endurance (2-minute step in-place test).

RESULTS

Of the 45 participants enrolled in the study, 4 participants from CogXergaming group and 5 from MOB group lost contact after signing the consent form and did not receive their respective intervention. Eighteen participants were randomized to each group. In the CogXergaming group, 15 (83%) completed the intervention, with 3 (16%) dropping out in the first week. In the MOB group, 16 (88%) completed the program, with 2 (11%) withdrawing during the first week. In addition, there was a significant time group interaction for Four Square Step Test (F1,21=5.55, P=.03), Tinetti Performance Oriented Mobility Assessment (F1,25=4.16, P=.05), and 30-second chair stand test (F1,21=5.06, P=.03), with a significant improvement in these measures for the CogXergaming group post training, compared with no change observed in the MOB group.

CONCLUSIONS

These pilot findings indicate that CogXergaming is feasible and applicable in prefrail older adults. Such game-based protocols can be beneficial in improving physical function among community-dwelling, prefrail older adults, however, the efficacy of such training requires further investigation.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04534686; https://clinicaltrials.gov/study/NCT04534686.

Effects of different traditional Chinese exercise for knee osteoarthritis patients: A network meta-analysis of randomized controlled trials

BACKGROUND

The most popular traditional Chinese exercise (TCE) techniques include Tai Chi, Yijinjing, Baduanjin, Wuqinxi, and Qigong. Exercise is advised as a primary treatment for knee osteoarthritis (KOA) according to clinical standards. According to several studies, TCE may be an effective way to help people with KOA manage their pain, stiffness, and physical function. Which TCE therapy is the most effective and whose particular usefulness is still debatable. The network meta-analysis (NMA) method is used in this study to evaluate and compare the effects of various TCE therapies on KOA patients.

METHODS

We will search PubMed, Embase, Scopus, Cochrane Library, Web of Science, the China National Knowledge Infrastructure, Wanfang, the Chinese Scientific Journal Database (VIP), and the China Biology Medical Literature Database (CBM) for randomized controlled trials reporting TCE therapy for KOA patients published before October 25, 2023. The Stata 16.0 program will compare the effectiveness of various TCE therapies on KOA patients using conventional pairwise and NMA.

RESULTS

The final 29 studies included 15 articles on Tai Chi, 7 articles on Baduanjin, 4 articles on Wuqinxi, and 3 articles on Yijinjing. Tai Chi was first for the effect sizes of VAS scores, WOMAC pain scores, and WOMAC available scores, while Baduanjin was ranked top for WOMAC stiffness scores. Research should continue to be conducted on the effect of Qigong on KOA intervention.

CONCLUSIONS

This NMA will help determine the best TCE treatment for KOA and offer evidence-based bias for clinical decision-making.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Effects of Tai Chi exercise on pain, functional status, and quality of life in patients with osteoarthritis or inflammatory arthritis

Objectives

This study aims to assess the impact of a Tai Chi exercise program (TCEP) on pain, spinal flexibility, muscle strength, stability and balance, functional status, and quality of life (QoL) among home-dwelling patients with osteoarthritis (OA) or inflammatory arthritis (iA).

Patients and methods

Between October 2018 and April 2019, a total of 28 participants (4 males, 24 females; median age: 62 years; range, 34 to 79 years) who completed the training program participating in at least 18 sessions were included. The TCEP consisted of 50 sessions for 60 min twice a week. The average attendance rate was high (78%, 39 sessions).

Results

Chest mobility (breathing index, p<0.001), sagittal mobility of cervical (p<0.001), thoracic (p=0.009), and lumbar spine (Schober's test, p<0.001) improved significantly in participants with OA and iA. The improvement in functional status was significant only in participants with OA (Lequesne index, p=0.014). Although the change in Lequesne index was statistically significant, the median value remained in the range of severe disability and the change did not reach the minimal clinically important difference. Although the trends were positive, the changes in pain (Visual Analog Scale pain, p=0.599), stability and balance (functional reach test, p=0.341), muscular strength (wall sit test, p=0.069), and health-related QoL (15D, p=0.065) were non-significant in participants with OA and iA.

Conclusion

Our study results suggest that a 25-week TCEP is safe and can improve chest and spinal mobility in home-dwelling individuals with OA or iA.

Motivational Barriers and Facilitators for Older Adults' Engagement in Exercise during Depressive Episodes: A Network Meta-Analysis of Randomized Controlled Trials

This study aims to assess the motivational factors influencing the participation of older adults in various exercise interventions during depressive episodes and to identify which types of exercise are most effective in alleviating depressive symptoms in this population. Therefore, randomized controlled trials (RCTs) focusing on exercise interventions and their impact on depression in older adult patients, identified by the terms "exercise" AND "depression" AND "elderly" OR "geriatric", were selected from primary electronic databases to conduct this network meta-analysis (NMA). The primary outcome was the effect on depressive symptoms, while the secondary outcome was the comparison of dropout rates between the intervention groups and the usual care control groups, as a measure of sustained motivation and engagement. Standardized mean difference (SMD) values and the corresponding 95% confidence intervals (CIs) were computed for effect evaluation. This study protocol has been registered in IPLASY (INPLASY 202460035). The results of 31 RCTs with 3238 participants indicated that qigong (SMD -1.17, -2.28 to -0.06), Otago Exercise (SMD -1.15, -2.29 to -0.01), and yoga (SMD -0.88, -1.55 to -0.21) significantly alleviate depressive symptoms in older adults. Walking (SMD -0.82, -1.34 to -0.31) and strength training (SMD -0.67, -1.05 to -0.30) also showed significant effects. Aerobic, physical training, and tai chi had moderate effects, while multisport showed a weaker impact with no significant improvement. In summary, our research findings demonstrate that exercise can effectively alleviate depressive symptoms in older adults, with low dropout rates likely due to interconnected physiological, psychological, and social mechanisms. This is crucial for enhancing treatment strategies for older adults' depression.

Treating Dystonia in a Soccer Player Through an Integrated Rehabilitative Approach: A Case Report

CONTEXT

Sport-related dystonia is a rare form of activity-specific dystonia that can severely impair an athlete's ability to perform. Due to a lack of data on the condition, it is difficult to diagnose and often overlooked, and no gold standard treatment has yet been defined.

CASE PRESENTATION

We present a rare and challenging case of sport-related dystonia that affected a 24-year-old male professional soccer player. The patient presented with severe rigidity and dystonia of the right lower-extremity, particularly the ankle and foot. The symptoms set on >1 year prior to the presentation to our outpatient clinic. He began to complain of stiffness and difficulty moving his lower limbs, especially his right leg, initially when playing soccer, but then also when walking normally. On presentation, he was unable to run and walked with difficulty, supporting his body weight only on the outside of his right foot. He also reported a motor trick and reverse motor trick involving the oral musculature in order to move his lower limb more freely.

MANAGEMENT AND OUTCOMES

An integrated rehabilitation approach based on postural rehabilitation, neuromuscular rehabilitation, and dental intervention was used to successfully treat this condition. The approach included: (1) postural rehabilitation with the Mézières-Bertelè method to reduce muscular stiffness, (2) neuromuscular re-education with Tai Chi exercises and electromyography-guided biofeedback, and (3) dental intervention and swallowing rehabilitation to limit impaired oral habits (due to the relationship between his impaired lower limb movements and motor tricks of the oral musculature). After 7 months of integrated rehabilitation, the patient returned to professional soccer.

CONCLUSIONS

This case report highlights the potential efficacy of an integrative rehabilitation approach for sports dystonia, particularly in cases where traditional treatments may not be effective. Such an approach could be considered a valuable option in the management of this rare, but debilitating, condition in athletes. Further research is needed to assess the effectiveness of this approach in larger populations.

Responsiveness of respiratory function in Parkinson's Disease to an integrative exercise programme: A prospective cohort study

INTRODUCTION

Respiratory disorders are the most common cause of death in Parkinson's Disease (PD). Conflicting data exist on the aetiology of respiratory dysfunction in PD and few studies examine the effects of exercise-based interventions on respiratory measures. This study was conducted to better understand respiratory dysfunction in PD and to identify measures of dysfunction responsive to an integrative exercise programme.

OBJECTIVES

The objectives were to compare baseline respiratory measures with matched, published population norms and to examine immediate and longer-term effects of a 12-week integrated exercise programme on these measures.

DESIGN

Twenty-three people with mild PD (median Hoehn & Yahr = 2) self-selected to participate in this exploratory prospective cohort study. Evaluation of participants occurred at three time points: at baseline; following the 12-week exercise programme and at 4-month follow-up.

OUTCOME MEASURES

Outcome measures included: Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), FEV1/FVC ratio, Peak Expiratory Flow (PEF), Inspiratory Muscle Strength (MIP), Expiratory Muscle Strength (MEP), Peak Cough Flow (PCF), and Cardiovascular Fitness measures of estimated VO2 max and 6-Minute Walk Test (6MWT).

RESULTS

Compared to published norms, participants had impaired cough, reduced respiratory muscle strength, FEV, FVC, PEF and cardiovascular fitness. Post exercise intervention, statistically significant improvements were noted in MEP, cardiovascular fitness, and PEF. However only gains in PEF were maintained at 4-month follow-up.

CONCLUSIONS

Significant respiratory dysfunction exists, even in the early stages of PD. Metrics of respiratory muscle strength, peak expiratory flow and cardiovascular fitness appear responsive to an integrative exercise programme.

The influence of tai chi on the death anxiety of elderly people living alone: the chain mediating effect of social support and psychological capital

Background

Population aging is a global trend, and the number of older adults living alone is increasing. Tai chi, a traditional Chinese exercise, has been shown to improve the physical and mental health of older adults.

Aim

To investigate the effects of tai chi on death anxiety in older adults living alone and the role of social support and psychological capital in this relationship.

Method

A cross-sectional study of 493 older adults living alone in four cities in southwestern China. Participants were assessed using questionnaires on tai chi practice, social support, psychological capital, and death anxiety.

Results

Tai chi practice significantly reduced death anxiety in older adults living alone. It also positively correlated with social support and psychological capital, both of which negatively correlated with death anxiety. Social support and psychological capital mediated the relationship between tai chi practice and death anxiety, suggesting that tai chi may reduce death anxiety through these factors. These findings encourage older adults living alone to practice tai chi, as it may improve their mental and physical health and reduce their risk of death anxiety.

Conclusion

Tai chi practice may reduce death anxiety in older adults living alone through the chain-mediated effects of social support and psychological capital. This suggests that tai chi may be a beneficial intervention for older adults living alone.

Effects of a self-determination theory-based physical activity programme for postmenopausal women with rheumatoid arthritis: A randomized controlled trial

AIMS

The study aimed to develop and evaluate the effects of a self-determination theory-based, nurse-led, physical activity programme for postmenopausal women with rheumatoid arthritis.

METHODS

Between December 2019 and April 2020, this randomized controlled trial recruited 62 postmenopausal women with rheumatoid arthritis from a university-affiliated hospital in South Korea. The intervention group participated in a self-determination theory-based, nurse-led, physical activity programme that consisted of Tai Chi-based physical activity, a supportive psychosocial strategy, and interactive counselling for 16 weeks, and the control group continued to undergo their usual care.

RESULTS

There were statistically significant group-by-time interactions in physical activity and perceived sarcopenia, which favoured the intervention group. Additionally, the intervention group showed significant improvements in the perceived therapeutic efficacy of physical activity, grip strength, walking speed, disease activity score, and health-related quality of life.

CONCLUSIONS

The programme developed in this study can be an effective and feasible approach for postmenopausal women with rheumatoid arthritis in improving physical activity, selected osteosarcopenic outcomes, and health-related quality of life. Further research is required to investigate the long-term effects of this theory-based programme for postmenopausal women in diverse settings.

The influence of home isolation during COVID-19 on the physical fitness development of college students: a study utilizing repeated measures analysis of variance

BACKGROUND

Research on the impact of COVID-19-induced home isolation on the physical fitness of college students is limited. This study aims to compare and analyze the physical fitness test scores of college students in two groups: those who experienced home isolation and those who did not, over three consecutive years after enrolment, to investigate the effects of home isolation on the physical fitness development of Chinese college students.

METHODS

This comparative study included two longitudinal surveys conducted among medical college students. The participants were divided into an experimental group and a control group. The physical fitness indicators measured included body mass index (BMI), vital capacity (VC), 50-metre run, sit-and-reach, standing long jump, 1000/800-metre runs (males/females), pull-ups (males) and sit-ups (females). Repeated measures analysis of variance (ANOVA) was employed, and the Greenhouse-Geisser correction was applied when Mauchly's assumption of sphericity was violated. Pairwise comparisons were conducted using the Bonferroni method.

RESULTS

A total of 6580 students participated in the study, with 3360 students (1490 males, 1870 females) enrolled in 2019 as the experimental group and 3220 students (1326 males, 1894 females) enrolled in 2017 as the control group. All participants completed the physical fitness tests for three consecutive years. The results showed that the experimental group exhibited decreased performance in the 1000-metre and 800-metre runs, and improved performance in the sit-and-reach test. After the end of home isolation, there was an improvement in the performance of the 1000-metre run and 800-metre run, while no significant differences were observed in the trends of the other tested indicators.

CONCLUSION

The findings of this study indicate that the home isolation environment during COVID-19 had a significant impact on the physical fitness of college students, specifically in terms of endurance and flexibility qualities, as well as male BMI. To better prepare for future public health emergencies and mitigate the effects of isolation, teaching students endurance exercises that can be performed at home should be prioritized. Furthermore, physical education programs should be improved to enhance student flexibility.

The influence of Tai Chi exercise on the subjective well-being in the aged: the mediating role of physical fitness and cognitive function

This study investigated the effects of Tai Chi exercise on subjective well-being in the aged. The participants were randomly assigned to an experimental group or a control group. The experimental group received 12-week Tai Chi exercise while the control group maintain their original living habits. The participants' subjective well-being, physical fitness, self-control, and executive function were measured at baseline and after 12 weeks of Tai Chi exercise. Results: (1) Tai Chi exercise can positively affect the subjective well-being of the aged (F(1,78) = 37.699, p < 0.001); (2) Tai Chi exercise could affect the subjective well-being in the aged through the independent intermediary of physical fitness (95% CI=[0.115, 0.485]) and self-control (95% CI=[0.109, 0.433]); (3) Tai Chi exercise could indirectly affect the subjective well-being in the aged through the chain mediation of executive function and self-control (95% CI=[0.009, 0.104]). This study provides valuable insights into the potential benefits of Tai Chi exercise for subjective well-being in the aged.

Effect of Taichi Chuan on health-related physical fitness in adults: A systematic review with meta-analysis

PURPOSE

Taichi Chuan was previously shown to benefit physical health, but the results were inconsistent. The main reason is that the mechanism is not clear and may be interpreted differently. In this systematic review, we analyzed the data obtained from various randomized controlled trials to identify the effectiveness of Taichi Chuan and the mechanism by which it improves the physical health of adults.

METHODS

We systematically searched various databases, including PubMed, Web of Science, Scopus, Embase, EBSCO Host, Science Direct, CNKI, Wan-Fang, and VPCS, and obtained 1448 articles for review. The articles were selected following the PICO eligibility criteria. We performed a systematic review and meta-analysis to interpret the results of the different studies.

RESULTS

We included 16 studies in the systematic review. Six of them were of very high quality, ten were of acceptable quality. Overall, the results showed that Taichi Chuan is beneficial to physical fitness, but not all indices supported this statement. Specifically, the effects were significant on Balance (ES = - 0.33; P = 0.02), BMI (ES = - 0.83; P < 0.00001), body fat (ES = - 0.45; P < 0.00001), and vital capacity (ES = 23.39; P = 0.01). However, there were no significant effects on systolic blood pressure (ES = 0.07; P = 0.94) and diastolic blood pressure (ES = 0.03; P = 0.97).

CONCLUSION

We found sufficient high-quality evidence to suggest that Taichi Chuan affects balance, BMI, body fat, vital capacity, and flexibility (sit-reach) in adults. The mechanism can be explained by low posture (balance) and moderate intensity of Taichi Chuan. However, no study has explained how to maintain concentration while keeping a dynamic low posture, which made it difficult to validate the finding that Taichi Chuan can reduce sympathetic tension under stress. In this study, we assumed that relaxation methods, which work on the central nervous system that links the body and the mind, might be the key explanation. However, further studies based on scientific, replicable methods need to be performed to confirm our findings.

Effects of Physical Activity Interventions on Strength, Balance and Falls in Middle-Aged Adults: A Systematic Review and Meta-Analysis

BACKGROUND

Weak lower body strength and balance impairments are fundamental risk factors for mobility impairments and falls that can be improved by physical activity (PA). Previous meta-analyses have focused on these risk factors in adults aged ≥ 65 years. Yet, the potential of PA for improving these risk factors in middle-aged populations has not been systematically investigated. This systematic review and meta-analysis aim to examine the effect of general and structured PA on lower limb strength, postural balance and falls in middle-aged adults.

METHODS

A computerized systematic literature search was conducted in the electronic databases MEDLINE, CINAHL, Web of Science and Cochrane Library. PA intervention types were classified according to the ProFaNE taxonomy. Randomized controlled trials exploring the effects of PA on strength (e.g., leg press one-repetition-maximum), balance (e.g., single limb stance) and falls (e.g., fall rates) in adults aged 40-60 years were systematically searched and included in a network analysis. Moderator analyses were performed for specific subgroups (age, sex, low PA). The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale.

RESULTS

Out of 7170 articles screened, 66 studies (median PEDro score 5) with 3387 participants were included. Strong, significant effects on muscle strength were found for strength (SMD = 1.02), strength-aerobic (SMD = 1.41), strength-endurance (SMD = 0.92) and water-based (SMD = 1.08) training (52 studies, I² = 79.3%). Strength training (SMD = 1.16), strength-aerobic (SMD = 0.98) and 3D training (SMD = 1.31) improved postural balance (30 studies, I² = 88.1%). Moderator analyses revealed significant effects of specific intervention types on certain subgroups and subdomains of strength and balance. No studies were found measuring falls.

CONCLUSIONS

Structured PA interventions in middle-aged adults improve strength and balance outcomes related to functional impairments and falls. Strength training increases both strength and balance and can be recommended to prevent age-related functional decline. However, the interpretability of the results is limited due to considerable heterogeneity and the overall low methodological quality of the included studies. Long-term trials are needed to determine the preventive potential of PA on strength, balance and falls. This meta-analysis may inform guidelines for tailored training during middle age to promote healthy aging. Prospero registration: CRD42020218643.

The effects of community-based exercise modalities and volume on musculoskeletal health and functions in elderly people

The effects of different muscle loading exercise (MLEX) modes and volume on musculoskeletal health is not well-studied in older populations. Aim: Therefore, this study aimed to compare the effects of community-based MLEX modalities and volume on musculoskeletal health in elderly people. Methods: Elderly men (n = 86) and women (n = 170), age 50-82 years old, were assigned to the sedentary (SE, n = 60), muscle strengthening exercise (MSE, n = 71), aerobic exercise (AE, n = 62) and Tai Chi exercise (TCE, n = 63) groups, based on > 2 years of exercise history. Exercise volume was compared between "Minimum" ("Min" < 60 min/week), "Low" (60-120 min/week). "Moderate" (121-239 min/week) and "High" (240-720 min/week) volumes. Results: All three modes of MLEX were associated with lower percentage of body fat (BF%) and higher percentage of lean body mass (LBM%, p = 0.003 main effect of group, and p = 0.002 main effect of volume for both BF% and LBM%), but not with higher bone mineral density (BMD, total body, lumbar spine, total hip and neck of femur), than SE. TCE had a distinct advantage in trunk flexibility (p = 0.007 with MSE, p = 0.02 with AE, and p = 0.01 with SE), and both TCE (p = 0.03) and AE (p = 0.03) performed better than SE in the one-leg stand balance test. Isometric strength and throwing speed and peak power with a 2 kg power ball were higher in the MLEX than SE groups (p = 0.01), in the ranking order of MSE, AE and TCE. However, there was no difference in handgrip strength performance between the MLEX groups, which performed better than the SE participants. Accumulating >120 min/week of MLEX can promote body composition health and muscle functions, but 60 min/week of MSE alone may have equal or better outcomes in these parameters. Conclusion: Community-based MLEX classes may be used to mitigate age-related chronic disease that are associated with body composition and muscular functions.

Associations between older adults' physical fitness level and their engagement in different types of physical activity: cross-sectional results from the OUTDOOR ACTIVE study

OBJECTIVES

To describe the prevalence of different types of physical activities and to explore the association between engagement in these physical activities and performance in the physical fitness dimensions among older adults living in Bremen, Germany.

DESIGN

Cross-sectional study.

SETTING

Twelve subdistricts in Bremen, Germany.

PARTICIPANTS

1583 non-institutionalised adults aged 65-75 years residing in one of the 12 subdistricts in Bremen, Germany (53.1% female).

PRIMARY OUTCOME MEASURES

Level of physical fitness in five dimensions: handgrip strength (hand dynamometry), lower muscle strength (30 s-chair stand test), aerobic endurance (2 min-step test), lower body flexibility (sit-and-reach test), and upper body flexibility (back scratch test); classified using normative values.

RESULTS

In this study population, home-based activities (housework, gardening) and activities for transport (walking, cycling) were performed by nearly all the participants, while leisure activities were less prevalent. Logistic regression revealed a positive association between being in or over norm in handgrip strength with cycling (OR: 1.56, 95% CI: 1.13 to 2.15), hiking/running (OR: 1.50, 95% CI: 1.05 to 2.16) and other sports (OR: 3.22, 95% CI: 1.37 to 7.56). Lower muscle strength was positively related to cycling (OR: 1.91, 95% CI: 1.37 to 2.65), gym training (OR: 1.62, 95% CI: 1.16 to 2.26) and dancing (OR: 2.15, 95% CI: 1.00 to 4.61). Aerobic endurance was positively associated with cycling (OR: 1.90, 95% CI: 1.37 to 2.65), gym training (OR: 1.68, 95% CI: 1.20 to 2.36), aerobics (OR: 1.64, 95% CI: 1.19 to 2.26), dancing (OR: 2.62, 95% CI: 1.10 to 6.22) and ball sports (OR: 2.07, 95% CI: 1.30 to 3.29). Apart from housework and upper body flexibility (OR: 0.39, 95% CI: 0.19 to 0.78), flexibility dimensions did not show any significant associations.

CONCLUSIONS

While muscle strength dimensions and aerobic endurance were associated with several physical activities, flexibility dimensions were associated with none of the investigated activities apart from housework. Especially cycling and leisure activities (eg, hiking/ running, gym training, aerobics, dancing) showed great potential for sustaining and increasing physical fitness in older age.

Mitigating effects and mechanisms of Tai Chi on mild cognitive impairment in the elderly

Mild cognitive impairment (MCI) is a major public health concern that endangers health and decreases the quality of life of the elderly around the world. A recent clinical guideline has recommended regular exercise (twice per week) for patients with MCI as part of an overall approach to management. Tai Chi, a form of light-to-moderate-intensity mind-body exercise, is particularly suitable for seniors. This review aims to summarize epidemiological studies related to the effects of Tai Chi on symptom remission in older adults with MCI and reveal the potential mechanisms. Evidence suggested that Tai Chi can improve cognitive functions and alleviate the accompanying symptoms of MCI in the elderly potentially by activating the expression of signals in different brain regions, altering their connectivity, increasing the brain volume, and modulating brain-derived neurotropic and inflammation factors. Studies comparing various types of Tai Chi may contribute to the identification of paradigms that have appropriate intensities and difficulty and exert good effects on older people with MCI. In addition, studies are warranted to determine the frequency and duration of training that can optimize the beneficial effects of Tai Chi on MCI.

Research study on the effects of multi-component exercise on older adults with chronic conditions

BACKGROUND

Multicomponent exercises involving eccentric contraction (ECC) exercise, chair yoga (CY) and tai chi (TC) are practiced extensively to treat older adults with chronic conditions. The study investigated the effect of CY and TC performance after various intensity of ECC exercise induced muscle pain, delayed onset of muscle sores (DOMS), and strength in sedentary older adults.

METHODS

Nine sedentary older adults with chronic condition(s) aged between 60 and 90 performed CY and TC after ECC exercise protocol for 9 weeks. The medical preprotocol, ECC exercise, CY, and TC performance, subjective (health activities of daily living [ADL] difficulty scale; Visual Analog Scale [VAS], and DOMS), objective (pressure pain threshold [PPT]), and medical postprotocol assessments were carried out and compared the physical status before and after the protocol.

RESULTS

Our results show that functional limitations, DOMS, VAS, and PPT levels were improved in the CY and TC performed weeks 3, 4, 7, and 8 compared to ECC exercise weeks 2 and 6. The manual muscle testing (MMT), active range of motion (AROM), and maximal voluntary isometric contraction (MVIC) were improved and showed significant differences on the weak muscle groups. The mean Tinetti balance and gait score, and general endurance showed significant difference.

CONCLUSIONS

Our findings have important implications for clinical exercise prescription as low perceived CY and TC, and ECC exercise might suit well for older adults with chronic conditions. Performing multicomponent exercises can help to reduce the risk of injury from falls and prevent age-related mobility, balance, and physical function decline in older adults.

Design and evaluation of an exergame system to assist knee disorders patients' rehabilitation based on gesture interaction

We designed a knee rehabilitation exercise game (Exergame) for home-based rehabilitation of patients with knee disorders. The system includes three functional components: knee exercise plan formulation, exergame, and exercise feedback. The 3D Human Pose Estimation based on images is used as the gesture interaction to capture the patient's primary joint motion data. We recruited 20 knee osteoarthritis (KOA) to evaluate the system's feasibility and user experience. The physician's group formulated the patient's exercise plans. The average accuracy of motion recognition is 95.2%, indicating that the system can effectively guide rehabilitation training for KOA patients. The results of the UEQ-S questionnaire, namely the practical quality value (1.63 ± 0.85), hedonic quality value (1.75 ± 0.86), and the total value (1.69 ± 0.86) of 20 patients, indicate that the system provides an excellent user experience, which improves the willingness and compliance of the patients for the active exercise. The above evidence confirms that the proposed approach is suitable for Knee disorders rehabilitation exercise and has promising application prospects.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13755-022-00189-5.

Tai Chi for spatiotemporal gait features and dynamic balancing capacity in elderly female patients with non-specific low back pain: A six-week randomized controlled trial

BACKGROUND

Non-specific low back pain (NS-LBP) is a serious public health problem. Tai Chi is promising in reducing the risk of falls and alleviating symptoms in this population.

OBJECTIVE

To investigate the effect of Tai Chi on gait and dynamic balance in elderly women with NS-LBP.

METHODS

20 women (age > 65 yr.) with NS-LBP were randomly assigned to a Tai Chi group (n= 10) or a control group (n= 10). The Tai Chi group practiced Tai Chi exercise 3 times a week for 6 weeks. Each session lasted 60 minutes. Pain, spatiotemporal gait features and dynamic balancing capacity were assessed at 0 and 6 weeks.

RESULTS

Compared to the control group at 6 weeks, the Tai Chi group had a significant decrease in VAS (p= 0.027) and stride width (p= 0.019), significant improvement in gait velocity, stride length (p< 0.001). Regarding dynamic balance capacity, the Tai Chi group had significant improvements in anterior (Left: p= 0.001; Right: p= 0.038), postero-lateral (Left: p< 0.001; Right: p= 0.038), and postero-medial (Left: p= 0.015; Right: p= 0.018).

CONCLUSION

6-week Tai Chi can relieve pain and improve gait and dynamic balance in elderly women with NS-LBP, which suggests Tai Chi could be a promising rehabilitation intervention to reduce the risk of falls in this population.

Effects of qigong exercise on the physical and mental health of college students: a systematic review and Meta-analysis

BACKGROUND

Physical and mental health problems are becoming more serious among college students due to lifestyle changes and increased academic stress. Qigong exercise has been regarded as a potentially effective intervention to improve the physical and mental health of college students.

METHODS

Eleven databases were searched from their respective inception dates to April 2022. Relevant randomized controlled trials (RCTs) were included. Physical and psychological conditions, including limb muscle strength, flexibility, cardiorespiratory endurance, vital capacity, blood pressure and heart rate, as well as depression, anxiety and mood, were evaluated. The risk of bias was assessed with the Cochrane Collaboration tool.

RESULTS

Sixteen randomized controlled trials were included in the meta-analysis. Significant improvements in cardiorespiratory endurance (MD = 3.83, 95% CI: 0.99 to 6.67, P = 0.008) and flexibility (MD = 3.01, 95% CI: 1.21 to 4.81, P = 0.001) were observed. We also observed that Qigong exercise significantly reduced depression and anxiety symptoms (SMD=-0.89, 95% CI: -1.17 to -0.61, P < 0.00001; SMD=-0.78, 95% CI: -1.31 to -0.25, P = 0.004). Nevertheless, no significant effects on muscle strength, vital capacity, blood pressure, heart rate or mood were found.

CONCLUSION

Qigong exercise was advantageous for college students in terms of improving flexibility and cardiorespiratory endurance and alleviating depression and anxiety to some extent. However, due to the limited number of eligible trials and the low methodological quality, more well-designed RCTs are needed in the future.

Emerging Trends and Hotspots in Tai Chi Fall Prevention: Analysis and Visualization

Recently, substantial studies have increased around the topic of the tai chi fall-prevention field. Few studies, however, have revealed the current progress and hotspots under a bibliometric analysis. Therefore, the present study aimed to conduct Citespace, a significant application for bibliometric analysis, to carry out the situation and trend in this field. This study has identified the core countries are the United States, China, Australia, and England, which are also the origins of the core institutions. Besides this, we also have found two large research groups led by Li and Sherrington. Moreover, the result has revealed that J Aging Phys Act and J Am Geriatr Soc are the primary journals. Geriatrics and gerontology, sport sciences, rehabilitation, and gerontology are the leading categories. Furthermore, one of the more important findings to come out in this study are that “elderly”, “Parkinson’s disease”, “vestibular rehabilitation”, “frail patient”, and “community fall prevention” are the research hotspots. “Women”, “proprioception”, “cognitive impairment”, “dementia”, “osteoarthritis”, and “stroke” are the potential research trend in the future. These findings suggest that the tai chi fall-prevention field has a broad research prospect. Although several questions remain uncertain currently, it is worthy for scholars to do further study.

Effectiveness of a Hybrid Exercise Program on the Physical Abilities of Frail Elderly and Explainable Artificial-Intelligence-Based Clinical Assistance

Background: Due to the low physical fitness of the frail elderly, current exercise program strategies have a limited impact. Eight-form Tai Chi has a low intensity, but high effectiveness in the elderly. Inspired by it, we designed an exercise program that incorporates eight-form Tai Chi, strength, and endurance exercises, to improve physical fitness and reverse frailty in the elderly. Additionally, for the ease of use in clinical practice, machine learning simulations were used to predict the frailty status after the intervention. Methods: For 24 weeks, 150 frail elderly people completed the experiment, which comprised the eight-form Tai Chi group (TC), the strength and endurance training group (SE), and a comprehensive intervention combining both TC and SE (TCSE). The comparison of the demographic variables used one-way ANOVA for continuous data and the chi-squared test for categorical data. Two-way repeated measures analysis of variance (ANOVA) was performed to determine significant main effects and interaction effects. Eleven machine learning models were used to predict the frailty status of the elderly following the intervention. Results: Two-way repeated measures ANOVA results before the intervention, group effects of ten-meter maximum walking speed (10 m MWS), grip strength (GS), timed up and go test (TUGT), and the six-minute walk test (6 min WT) were not significant. There was a significant interaction effect of group × time in ten-meter maximum walking speed, grip strength, and the six-minute walk test. Post hoc tests showed that after 24 weeks of intervention, subjects in the TCSE group showed the greatest significant improvements in ten-meter maximum walking speed (p < 0.05) and the six-minute walk test (p < 0.05) compared to the TC group and SE group. The improvement in grip strength in the TCSE group (4.29 kg) was slightly less than that in the SE group (5.16 kg). There was neither a significant main effect nor a significant interaction effect for TUGT in subjects. The stacking model outperformed other algorithms. Accuracy and the F1-score were 67.8% and 71.3%, respectively. Conclusion: A hybrid exercise program consisting of eight-form Tai Chi and strength and endurance exercises can more effectively improve physical fitness and reduce frailty among the elderly. It is possible to predict whether an elderly person will reverse frailty following an exercise program based on the stacking model.

Association of Tai Chi exercise with physical and neurocognitive functions, frailty, quality of life and mortality in older adults: Singapore Longitudinal Ageing Study

BACKGROUND

real-world observations on the long-term benefits of Tai Chi (TC) exercise, in terms of physical and cognitive functioning, frailty, quality of life (QOL) and mortality are lacking.

METHODS

prospective cohort study participants were community-dwelling adults aged 55+, including 5,407 non-frequent TC participants (<1x/week) and 572 frequent TC participants (≥1x/week). Outcome measures at baseline and 3-5 years follow-up included physical performance (Knee Extension Strength, POMA Balance and Gait, Timed-up-and-go, Gait Speed) and neurocognitive performance (attention and working memory, visual-motor tracking and mental flexibility, verbal learning and memory, visual memory, spatial and constructional ability), Frailty Index ≥0.10, impaired QOL (SF12 physical and mental component) and all-cause mortality from mean 13 years follow-up. Effect estimates were adjusted for socio-demographics, other physical activities, nutritional risk and presence of cardiometabolic diseases.

RESULTS

frequent TC participation was associated with 0.7-fold lower prevalence of impaired physical QOL [95% confidence interval (CI) = 0.57-0.91], decreased 0.4-fold odds of incident prefrailty/frailty among robust participants at baseline and 0.7-fold odds of impaired mental QOL at follow-up among participants with normal mental QOL at baseline. Lower odds of mortality risk (HR = 0.89, 95%CI = 0.72-1.09) were not significant after controlling for socioeconomic, behavioural and health factors. Composite indexes of physical functional and neurocognitive performance were maintained at high level or increased at follow-up among frequent TC participants.

CONCLUSION

TC exercise practised among community-dwelling older adults is associated with better physical, cognitive and functional wellbeing.

Thoracolumbar Rotation During Tai Chi Movements—A Biomechanical Analysis of the Entire Peking Style Routine

The impact of spinal mobility and sagittal spinal shape on the development of balance impairment supports the hypothesis that enhancing spine flexibility results in an improvement in postural balance ability. Therefore, the aim of this study was to investigate whether the range of motion of thoracolumbar rotation during the movements of the Tai Chi Peking style routine is sufficient to improve thoracolumbar flexibility. Three-dimensional kinematic and kinetic data were collected from eight athletes of the German Wushu Federation, while performing all movements of the entire Peking style routine (1) in a competition version corresponding to national/international championships and (2) in a health sport version performed with shorter and higher stances (i.e. a smaller distance between the feet and thus less knee flexion). For each movement the total mean and standard deviation values for the total range of motion of thoracolumbar rotation was calculated. Statistical analysis was performed using the Wilcoxon signed-rank test for paired differences. Eight movements showed major differences (10.12–19.73°) between the two versions. For the remaining movements, only minor differences (0.7–9.56°) were observed. All movements performed on both sides showed no significant lateral differences. Most of the Tai Chi movements, regardless of the performed version, cover a range of motion of thoracolumbar rotation that has the potential to lead to an improvement of thoracolumbal spine flexibility with appropriate training. The most effective single movements (25.97–72.22°) are Brush Knee and Step Forward, Step Back and Repulse Monkey, Grasp the Sparrow‘s Tail, Wave Hand in the Clouds, and Fair Lady Weaves with Shuttle.

Comparative Study of the Effects of Tai Chi and Square Dance on Immune Function, Physical Health, and Life Satisfaction in Urban Empty-Nest Older Adults

Objective: To compare the effects of Tai Chi and Square dance on immune function, physical health, and life satisfaction in urban, empty-nest older adults.

Methods: This cross-sectional study included 249 older adults (60–69 years) who were categorized into Tai Chi (n = 81), Square dance (n = 90), and control groups (n = 78). We evaluated immunoglobulin G (IgG) and interleukin-2 (IL-2) levels by enzyme-linked immunosorbent assay (ELISA), natural killer (NK) cell cytotoxicity by MTT assay, physical health indices by physical fitness levels, and life satisfaction by Life Satisfaction Index A (LSIA) scores.

Results: Immune function, physical health, and life satisfaction in older adults in the Tai Chi and Square dance groups were significantly better than those in the control group (P < 0.05). Regarding immune function and physical health, the Tai Chi group exhibited significantly higher levels of IgG (15.41 ± 0.26 g/L vs. 11.99 ± 0.35 g/L, P < 0.05), IL-2 (4.60 ± 0.20 ng/mL vs. 4.45 ± 0.21 ng/mL, P < 0.05), and NK cell cytotoxicity (0.28 ± 0.02 vs. 0.22 ± 0.02, P < 0.05) than the square dance group, significantly lower waist-to-hip ratio (0.87 ± 0.02 vs. 0.89 ± 0.02, P < 0.05), resting pulse (78.4 ± 4.6 beats/min vs. 81.0 ± 3.1 beats/min, P < 0.05), systolic blood pressure (132.0 ± 5.2 mmHg vs. 136.2 ± 3.2 mmHg, P < 0.05), diastolic blood pressure (80.0 ± 2.6 mmHg vs. 83.0 ± 2.7 mmHg, P < 0.05), and significantly higher vital capacity (2978.0 ± 263.0 mL vs. 2628.3 ± 262.8 mL, P < 0.05) and duration of one-leg standing with eyes closed (16.2 ± 1.9 s vs. 12.0 ± 1.7 s). However, there was no significant difference in LSIA scores between the Tai Chi and Square dance groups (12.05 ± 1.96 vs. 13.07 ± 1.51, P > 0.05). Further, there was a significant correlation between LSIA scores and immune function (r = 0.50, P = 0.00) and physical health (r = 0.64, P = 0.00).

Conclusion: (1) Both Tai Chi and square dance practitioners had better health outcomes, compared with sedentary individuals; (2) Tai Chi practitioners had better physical health and immune function than Square dance practitioners. (3) Tai Chi and Square dance exercises had similar effects on life satisfaction among urban empty-nest older adults.

Suggestions: For urban empty-nest older adults who want to have better physical health and immune function, long-term Tai Chi exercise may be a better choice; however, those who are concerned about life satisfaction can choose either Tai Chi or Square dance exercise.