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Kraft J, Waibl PJ, Meissner K. Stress reduction through taiji: a systematic review and meta-analysis. BMC Complement Med Ther 2024; 24:210. [PMID: 38831412 PMCID: PMC11149313 DOI: 10.1186/s12906-024-04493-3] [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: 11/06/2023] [Accepted: 05/08/2024] [Indexed: 06/05/2024] Open
Abstract
PURPOSE In light of the mounting prevalence of stress in contemporary society and the growing interest in stress reduction methods, this review investigates the potential of taiji as a viable strategy for alleviating stress. METHODS MEDLINE, EMBASE, the Cochrane Controlled Trials Register (CENTRAL), PsycINFO, and Web of Science were searched up to April 2023 to identify randomized controlled trials of taiji. Studies in both patients and healthy populations were considered. They had to provide a measure of perceived stress and include a no treatment or placebo control group. Data were extracted by two reviewers. Pooled standardized mean differences (SMD) were calculated for perceived stress, biological stress markers, anxiety, depression, and quality of life (QoL). Meta-regression analyses were performed to identify sources of heterogeneity. RESULTS Eleven trials with a total of 1323 patients comparing taiji to no intervention met the inclusion criteria. The included studies varied strongly with regard to patient characteristics, taiji intervention, and methodological quality. The overall SMD for perceived stress was significant at -0.41 (95% confidence interval, CI, -0.63 to -0.19; I2 = 63%). Exclusion of studies with less than 100 participants yielded a diminished SMD at -0.26 (95% CI, -0.45 to -0.06). The SMD for perceived stress at follow-up was significant (-0.25, 95% CI -0.46 to -0.05). Secondary outcomes highlighted improvements in anxiety and physical QoL, while depression, mental QoL, and biological stress markers remained unchanged. CONCLUSIONS Results underscore taiji's potential in mitigating perceived stress in both patients and healthy populations, paralleled by enhancements in depressive symptoms, anxiety levels, and physical QoL.
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Affiliation(s)
- Jana Kraft
- Department of Applied Natural Sciences and Health, Programs in Health Promotion, Coburg University of Applied Sciences, Friedrich-Streib-Str. 2, Coburg, 96450, Germany
| | - Paula J Waibl
- Department of Applied Natural Sciences and Health, Programs in Health Promotion, Coburg University of Applied Sciences, Friedrich-Streib-Str. 2, Coburg, 96450, Germany
| | - Karin Meissner
- Department of Applied Natural Sciences and Health, Programs in Health Promotion, Coburg University of Applied Sciences, Friedrich-Streib-Str. 2, Coburg, 96450, Germany.
- Institute of Medical Psychology, Medical Faculty, LMU Munich, Munich, Germany.
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Ibañez GE, Ahmed S, Hu N, Larkey L, Fennie KP, Lembo M, Huertas L. Acceptability and Feasibility of a Tai Chi/Qigong Intervention for Older People Living With HIV. AIDS Behav 2024; 28:1291-1300. [PMID: 37597056 DOI: 10.1007/s10461-023-04158-1] [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] [Accepted: 08/10/2023] [Indexed: 08/21/2023]
Abstract
Tai chi/qigong (TCQ) is a low impact, meditative movement with breathwork that may benefit people with HIV (PWH) over 50 years old. This study is a feasibility clinical trial of a remote TCQ intervention for older PWH. Participants (n = 48) were recruited via clinic sites and social media and randomized to a TCQ, sham qigong, or wait-list control group. The 12-week intervention included fourteen 45-60-minute sessions. Acceptability (satisfaction, attitudes, practice, attendance) and feasibility (retention rate, adverse events, remote delivery) data were surveyed. Overall retention rate was 72.9%, but 81.2% for the TCQ group. Most TCQ participants attended at least 10 sessions (62.5%) and were practicing TCQ after 2 weeks (72.7%). Over 92% of TCQ participants reported satisfaction and positive attitudes and preferred remote versus in person delivery (63.6%). Two mild intervention related adverse events occurred. Findings suggest that a remote TCQ intervention is acceptable, feasible, and safe among older PWH.
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Affiliation(s)
- Gladys E Ibañez
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA.
- Natural Sciences Division, New College of Florida, Sarasota, Fl, 34243, USA.
| | - Shyfuddin Ahmed
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
| | - Nan Hu
- Department of Biostatistics, Florida International University, Miami, Fl, 33199, USA
| | - Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, 85004, USA
| | - Kristopher P Fennie
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
| | - Micaela Lembo
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
| | - Laura Huertas
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
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Cheng L, Chang S, Wang B, He B, Tan Y. Cross-sectional study of depression tendency and sleep quality in 1352 people practicing Tai Chi. Res Sports Med 2023; 31:650-662. [PMID: 34994259 DOI: 10.1080/15438627.2021.2024832] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/28/2021] [Indexed: 10/19/2022]
Abstract
This cross-sectional study aimed to analyse the relationship between Tai Chi exercise habits and depression tendency and sleep quality in people practicing Tai Chi in Chengdu, China. A total of 1352 Tai Chi practitioners aged 50-79 years old were divided into six groups according to age and gender for Tai Chi exercise habits, depression tendency and sleep quality. The frequency of weekly Tai Chi practice and duration of single Tai Chi practice have a significant positive correlation with the exercise years. For female subjects who had long-term Tai Chi exercise, depression decreased with the duration and weekly frequency of a single exercise. Tai Chi exercise habits reduced sleep disturbance scores (in the male group aged 60-69 years old, exercise years, r = -0.242, p = 0.004) and sleep duration (in the male and female group aged 70-79 years old, duration of single Tai Chi practice, r = -0.334, p = 0.035; r = -0.235, p = 0.029), suggesting that long-term Tai Chi exercise may reduce the trend of poor sleep quality due to increased ageing.
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Affiliation(s)
- Liang Cheng
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Shuwan Chang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Bingcheng Wang
- Jinling Hospital, General Hospital of Eastern Theater Command, Nanjing, China
| | - Benxiang He
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Yajun Tan
- Sport Hospital, Chengdu Sport University, Chengdu, China
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Xie Y, Cai K, Dai J, Wei G. Enhanced Integrity of White Matter Microstructure in Mind-Body Practitioners: A Whole-Brain Diffusion Tensor Imaging Study. Brain Sci 2023; 13:brainsci13040691. [PMID: 37190656 DOI: 10.3390/brainsci13040691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023] Open
Abstract
Tai Chi Chuan (TCC) is an increasingly popular multimodal mind-body practice with potential cognitive benefits, yet the neurobiological mechanisms underlying these effects, particularly in relation to brain white matter (WM) microstructure, remain largely unknown. In this study, we used diffusion tensor imaging (DTI) and the attention network test (ANT) to compare 22 TCC practitioners and 18 healthy controls. We found extensive differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) between the two groups. Specifically, TCC practitioners had significantly different diffusion metrics in the corticospinal tract (CST), fornix (FX)/stria terminalis (ST), and cerebral peduncle (CP). We also observed a significant correlation between increased FA values in the right CP and ANT performance in TCC practitioners. Our findings suggest that optimized regional WM microstructure may contribute to the complex information processing associated with TCC practice, providing insights for preventing cognitive decline and treating neurological disorders with cognitive impairment in clinical rehabilitation.
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Affiliation(s)
- Yingrong Xie
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Kelong Cai
- College of Physical Education, Yangzhou University, Yangzhou 225127, China
| | - Jingang Dai
- Experimental Research Center, China Academy of Chinese Medical Sciences, National Chinese Medicine Experts Inheritance Office of Song Jun, Beijing 100700, China
| | - Gaoxia Wei
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China
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Effects of 12-week Tai Chi program on physical function, depression, and quality of life among cognitively impaired older adults: a feasibility study. BMC Geriatr 2023; 23:118. [PMID: 36869290 PMCID: PMC9983256 DOI: 10.1186/s12877-023-03840-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Older adults with cognitive decline need physical activity for maintaining brain health and mitigating cognitive decline. Tai Chi is a safe and gentle aerobic exercise and has been recommended for people with various health conditions to improve their physical functioning, well-being, and quality of life (QoL). This study aimed to determine the feasibility of a 12-week program of Tai Chi for memory (TCM) among older adults with mild cognitive impairment (MCI) or dementia; and to determine the pilot effects of TCM on physical functioning, depression, and health-related QoL. METHODS A quasi-experimental design was used with two groups: MCI and dementia. The feasibility of the 12-week TCM program was assessed after it finished in terms of its acceptability, demand, implementation, practicality, adaptation, integration, expansion, and limited-efficacy testing. Other health-related outcomes, physical functioning, depression, and health-related QoL were measured before and after the TCM program. Outcome measures consist of a digital hand dynamometer for grip strength, the standard sit-and-reach test, the one-leg-standing balance test, timed up and go (TUG) test, the Korean version of the Geriatric Depression Scale, and the 12-item Short Form survey (SF-12). Paired and independent t-tests were used to compare the effects of TCM within and between groups. RESULTS The TCM program was completed by 41 participants with MCI (n = 21) or dementia (n = 20), and its accepted feasibility was assessed. After TCM, the MCI group exhibited significant enhancements in right-hand grip strength (t = - 2.13, p = .04) and physical-health-related QoL (t = - 2.27, p = .03). TUG scores improved in both groups (MCI, t = 3.96 p = .001; dementia, t = 2.54 p = .02). The adopted form of the TCM program was effectively and safely applied to those with various levels of cognitive impairment. The program was well accepted by the participants with a mean attendance rate of 87%. No adverse events were reported during the program. CONCLUSION TCM has the potential to improve physical functioning and QoL. Since there was no comparison group to control for confounding factors and low statistical power in the present study, further studies are warranted with a stronger design that includes longer follow-up periods. This protocol was retrospectively registered on Dec 1, 2022 (NCT05629650) at ClinicalTrials.gov.
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Kohn JN, Lobo JD, Troyer EA, Wilson KL, Ang G, Walker AL, Pruitt C, Pung MA, Redwine LS, Hong S. Tai chi or health education for older adults with hypertension: effects on mental health and psychological resilience to COVID-19. Aging Ment Health 2023; 27:496-504. [PMID: 35311437 PMCID: PMC9489818 DOI: 10.1080/13607863.2022.2053836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/04/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To compare the effectiveness of 12 weeks of community-based, in-person, group Tai Chi (TC) and Health Education (HAP-E) in improving health and wellbeing in older adults with hypertension and in promoting psychological resilience during COVID-19. METHODS A 12-week randomized controlled trial (RCT) in San Diego County, USA. Self-reported depressive symptoms, anxiety, sleep disturbances, gratitude, resilience, mental and physical health were assessed in-person pre- and post-intervention, and by long-term follow-up surveys during COVID-19. Linear mixed-effects models were used to assess study arm differences over time and logistic regression to identify predictors of positive intervention response. RESULTS Of 182 randomized participants (72.6 ± 7.9 yrs; 72% female), 131 completed the intervention. Modest improvements in health and wellbeing occurred post-intervention in both arms (Cohen's d: TC = 0.38, 95% CI: 0.25-0.51; HAP-E = 0.24, 0.11-0.37), though positive intervention responses were more than twice as likely in TC (OR = 2.29, 1.07-4.57). Younger age, higher anxiety, and poorer mental health at baseline predicted greater odds of response. Small declines in health and wellbeing were reported at the first COVID-19 follow-up, with smaller declines in the TC arm (Cohen's d: TC = -0.15, -0.31-0.00; HAP-E = -0.34, -0.49 to -0.19). Health and wellbeing stabilized at the second COVID-19 follow-up. Most participants (>70%) reported that the interventions benefitted their health and wellbeing during COVID-19. CONCLUSION TC and HAP-E improved health and wellbeing, though TC conferred greater odds of an improved mental health response. Declines in health and wellbeing were observed at pandemic follow-up, with smaller declines in the TC arm, suggesting increased resilience.
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Affiliation(s)
- Jordan N. Kohn
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA 92093
| | - Judith D. Lobo
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
| | - Emily A. Troyer
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
| | - Kathleen L. Wilson
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA 92093
| | - Gavrila Ang
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
| | - Amanda L. Walker
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA 92093
| | - Christopher Pruitt
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA 92093
| | - Meredith A. Pung
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA 92093
| | - Laura S. Redwine
- College of Behavioral and Community Sciences, University of South Florida, Tampa, FL
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL
| | - Suzi Hong
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA 92093
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García-Muñoz C, González-García P, Casuso-Holgado MJ, Martínez-Calderón J, Heredia-Rizo AM. Are movement-based mindful exercises (QIGONG, TAI CHI, AND YOGA) beneficial for stroke and Parkinson's disease? A scoping review. Complement Ther Med 2023; 72:102912. [PMID: 36565791 DOI: 10.1016/j.ctim.2022.102912] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/04/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To synthesize evidence from systematic reviews on the effects of qigong, tai chi, and yoga in people with neurological diseases. METHODS A systematic search was conducted in PubMed, PsycINFO, Embase, CINAHL and Cochrane Library until September 2022. Methodological quality was assessed using the AMSTAR 2 tool. A qualitative synthesis of included reviews and meta-analyses was performed. Citation matrices and the corrected covered area were used to explore the overlap of randomized controlled trials among reviews. RESULTS Nineteen systematic reviews (containing 74 trials and 80 meta-analyses) in people with Parkinson's disease (PD) or stroke were included. The critical domains of the AMSTAR 2 were not satisfied in more than half of the reviews, and only 4 evaluated the certainty of the evidence. The overlap was very high (21.7%) and high (11%) for tai chi studies in PD and stroke, respectively. In people with PD, qigong, yoga, and tai chi can improve balance, with tai chi being beneficial to increase functional mobility. For stroke patients, tai chi was better than controls to enhance motor function and independence, but not for health-related quality of life and quality of sleep. Findings on balance, walking ability and depression were inconclusive in stroke population. CONCLUSIONS Qigong, tai chi, and yoga appear to be effective to improve balance performance in people with PD. Tai chi practice enhances motor function and independency in stroke patients.
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Affiliation(s)
- Cristina García-Muñoz
- Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Cádiz, Avda. Ana de Viya 52, 11009 Cádiz, Spain; Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, Sevilla, Spain
| | - Paula González-García
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/ Avicena s/n, 41009 Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain..
| | - María Jesús Casuso-Holgado
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/ Avicena s/n, 41009 Sevilla, Spain; Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, Sevilla, Spain
| | - Javier Martínez-Calderón
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/ Avicena s/n, 41009 Sevilla, Spain; Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, Sevilla, Spain
| | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/ Avicena s/n, 41009 Sevilla, Spain; Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, Sevilla, Spain
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Luo X, Zhao M, Zhang Y, Zhang Y. Effects of baduanjin exercise on blood glucose, depression and anxiety among patients with type II diabetes and emotional disorders: A meta-analysis. Complement Ther Clin Pract 2023; 50:101702. [PMID: 36423358 DOI: 10.1016/j.ctcp.2022.101702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) is a group of metabolic disorders reflected by high blood glucose levels and lack of hormone insulin. Notably, T2DM patients are three times more likely to report depression than the general population. Conventional exercise training programs have been shown to be beneficial for T2DM, but less is known regarding the effects of Baduanjin exercise on hemoglobin A1c (HbA1c) and psychological measures among this unique group. Therefore, this systematic review and meta-analysis aimed to investigate the effects of Baduanjin exercise on HbA1c, depression, and anxiety among type 2 diabetes mellitus (T2DM) patients with emotional disorders. METHODS The potential literature was searched from six electronic databases (PubMed, MEDLINE, CINAHL, Scopus, Wanfang, and CNKI) from their inception to July 2022. The randomized controlled studies that investigated the effects of Baduanjin on HbA1c, depression , and anxiety in T2DM with emotional disorders were included. The effect sizes were calculated using the random-effect models with a 95% confidence interval (CI). The Physiotherapy Evidence Database (PEDro) scale was employed to assess the study quality. RESULTS Eleven studies involving 755 T2DM participants with emotional disorders were analyzed in this study. The pooled results showed that Baduanjin had significant improvements in HbA1c (SMD = 0.75, 95% CI 0.46 to 1.04, p < 0.001), depression (SMD = 0.69, 95% CI 0.30 to 1.08, p < 0.01) and anxiety (SMD = 0.98, 95% CI 0.44 to 1.53, p < 0.01) compared to the control group. CONCLUSION Findings suggest that Baduanjin exercise may effectively alleviate HbA1c, depression, and anxiety among T2DM patients with emotional disorders. However, more well-designed studies are required to further substantiate the promising findings.
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Affiliation(s)
- Xiwen Luo
- College of Physical Education, Faculty of Teacher Education, Taizhou University, China
| | - Mengxian Zhao
- School of Physical Education, Shenzhen University, Shenzhen, China
| | - Yulong Zhang
- Hunan Judicial Police Vocational College, Changsha, China
| | - Yanjie Zhang
- Physical Education Unit, School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, China; The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health.
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Laczkó T, Ács P, Morvay-Sey K, Cselik B, Stocker M. The Role of Sports in the Subjective Psychological Well-Being of Hungarian Adult Population in Three Waves of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:660. [PMID: 36612976 PMCID: PMC9819107 DOI: 10.3390/ijerph20010660] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: In this study, sport and subjective psychological well-being is investigated in three waves of the COVID-19 pandemic. (2) Methods: We have conducted three different representative sample surveys (n = 3600 altogether) on the Hungarian adult population and investigated the sample's subjective psychological well-being with the WHO-5 Well-Being Index, as well as changes in their subjective well-being through the different waves of the pandemic. Sporting habits and socio-economic variables were also surveyed, and OLS regression models were created focused on the WHO-5 measures. (3) Results: The subjective psychological well-being of the Hungarian adult population decreased significantly, but in the second and third wave of pandemic restrictions, an increase in subjective psychological well-being has been measured. The relationships between the time spent on doing sports and subjective psychological well-being were significant in each pandemic waves. The highest subjective psychological well-being and its highest increase were reported by those who could increase their time spent on doing sports as well. (4) Conclusions: The relationships between the sports activities, physical health, size of settlement, changes in income and subjective psychological well-being of the Hungarian adult population were significant in all three waves of the COVID-19 pandemic.
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Affiliation(s)
- Tamás Laczkó
- Institute of Health Insurance, Faculty of Health Sciences, University of Pécs, Vörösmarty u.3, 7621 Pécs, Hungary
| | - Pongrác Ács
- Physical Activity Research Team, Szentágothai Research Centre, University of Pécs, Ifjúság útja 20, 7624 Pécs, Hungary
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty u.3, 7621 Pécs, Hungary
| | - Kata Morvay-Sey
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty u.3, 7621 Pécs, Hungary
| | - Bence Cselik
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty u.3, 7621 Pécs, Hungary
| | - Miklós Stocker
- Institute of Strategy and Management, Corvinus University of Budapest, Fővám tér 8, 1093 Budapest, Hungary
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10
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Yang GY, Hunter J, Bu FL, Hao WL, Zhang H, Wayne PM, Liu JP. Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials. Syst Rev 2022; 11:260. [PMID: 36463306 PMCID: PMC9719113 DOI: 10.1186/s13643-022-02100-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/14/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND This overview summarizes the best available systematic review (SR) evidence on the health effects of Tai Chi. METHODS Nine databases (PubMed, Cochrane Library, EMBASE, Medline, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Sino-Med, and Wanfang Database) were searched for SRs of controlled clinical trials of Tai Chi interventions published between Jan 2010 and Dec 2020 in any language. Effect estimates were extracted from the most recent, comprehensive, highest-quality SR for each population, condition, and outcome. SR quality was appraised with AMSTAR 2 and overall certainty of effect estimates with the GRADE method. RESULTS Of the 210 included SRs, 193 only included randomized controlled trials, one only included non-randomized studies of interventions, and 16 included both. Common conditions were neurological (18.6%), falls/balance (14.7%), cardiovascular (14.7%), musculoskeletal (11.0%), cancer (7.1%), and diabetes mellitus (6.7%). Except for stroke, no evidence for disease prevention was found; however, multiple proxy-outcomes/risks factors were evaluated. One hundred and fourteen effect estimates were extracted from 37 SRs (2 high, 6 moderate, 18 low, and 11 critically low quality), representing 59,306 adults. Compared to active and/or inactive controls, 66 of the 114 effect estimates reported clinically important benefits from Tai Chi, 53 reported an equivalent or marginal benefit, and 6 an equivalent risk of adverse events. Eight of the 114 effect estimates (7.0%) were rated as high, 43 (37.7%) moderate, 36 (31.6%) low, and 27 (23.7%) very low certainty evidence due to concerns with risk of bias (92/114, 80.7%), imprecision (43/114, 37.7%), inconsistency (37/114, 32.5%), and publication bias (3/114, 2.6%). SR quality was often limited by the search strategies, language bias, inadequate consideration of clinical, methodological, and statistical heterogeneity, poor reporting standards, and/or no registered SR protocol. CONCLUSIONS The findings suggest Tai Chi has multidimensional effects, including physical, psychological and quality of life benefits for a wide range of conditions, as well as multimorbidity. Clinically important benefits were most consistently reported for Parkinson's disease, falls risk, knee osteoarthritis, low back pain, cerebrovascular, and cardiovascular diseases including hypertension. For most conditions, higher-quality SRs with rigorous primary studies are required. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021225708.
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Affiliation(s)
- Guo-Yan Yang
- grid.1029.a0000 0000 9939 5719NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | | | - Fan-Long Bu
- grid.411609.b0000 0004 1758 4735National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, 100045 China
| | - Wen-Li Hao
- grid.410612.00000 0004 0604 6392Public Health School, Inner Mongolia Medical University, Hohht, 010000 Inner Mongolia China
| | - Han Zhang
- grid.24695.3c0000 0001 1431 9176School of Acupuncture and Massage, Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Peter M. Wayne
- grid.38142.3c000000041936754XOsher Center for Integrative Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215 USA
| | - Jian-Ping Liu
- grid.24695.3c0000 0001 1431 9176Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029 China
- grid.10919.300000000122595234The Faculty of Health Science, Department of Community Medicine, UiT The Arctic University of Norway, The National Research Center in Complementary and Alternative Medicine – NAFKAM, Hansine Hansens veg 19, 9037 Tromsø, Norway
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Leung LYL, Tam HL, Ho JKM. Effectiveness of Tai Chi on older adults: A systematic review of systematic reviews with re-meta-analysis. Arch Gerontol Geriatr 2022; 103:104796. [PMID: 36058045 DOI: 10.1016/j.archger.2022.104796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/14/2022] [Accepted: 08/24/2022] [Indexed: 11/22/2022]
Abstract
This overview study examined and synthesized the effect of Tai Chi (TC) on the physical conditions, psychological conditions, cognitive abilities, and quality of life (QoL) of older adults. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Using Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register, PubMed, Scopus, and Web of Science, English-language systematic reviews (SRs) published within the latest decade (2010-2020) were included. SRs with meta-analysis were selected if TC was the examined intervention and older adults was the targeted population. A total of 16 SRs covering 89 original studies were included. A number of the pooled results of the included SRs were inconclusive. Taking into consideration of the new meta-analyses of this study, TC significantly improved most outcomes, including the mobility, pain level, physical function, psychological distress, depressive symptoms, anxiety, global cognitive function, mental speed and attention, learning ability, verbal fluency, executive function, and QoL of older adults. TC can be an effective intervention for older adults for improving physical and psychological conditions, cognitive abilities, and QoL. Additional high-quality studies with larger samples investigating the effectiveness of TC in older adults are warranted.
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Affiliation(s)
- Leona Yuen Ling Leung
- The Ronin Institute, Montclair, NJ 07043-2314, USA; Canadian Academy of Independent Scholar, Vancouver, Canada
| | - Hon Lon Tam
- Kiang Wu Nursing College of Macau, Macau; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
| | - Jonathan Ka Ming Ho
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong
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Pauleen D, Intezari A, Küpers W. Wise relational management: Tai Chi Chuan as an exemplar of embodied and balanced responsiveness. SCANDINAVIAN JOURNAL OF MANAGEMENT 2022. [DOI: 10.1016/j.scaman.2022.101218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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Düpjan S, Dawkins MS. Animal Welfare and Resistance to Disease: Interaction of Affective States and the Immune System. Front Vet Sci 2022; 9:929805. [PMID: 35774975 PMCID: PMC9237619 DOI: 10.3389/fvets.2022.929805] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 05/16/2022] [Indexed: 11/29/2022] Open
Abstract
Good management and improved standards of animal welfare are discussed as important ways of reducing the risk of infection in farm animals without medication. Increasing evidence from both humans and animals suggests that environments that promote wellbeing over stress and positive over negative emotions can reduce susceptibility to disease and/or lead to milder symptoms. We point out, however, that the relationship between welfare, immunity, and disease is highly complex and we caution against claiming more than the current evidence shows. The accumulating but sometimes equivocal evidence of close links between the brain, the gut microbiome, immunity, and welfare are discussed in the context of the known links between mental and physical health in humans. This evidence not only provides empirical support for the importance of good welfare as preventative medicine in animals but also indicates a variety of mechanisms by which good welfare can directly influence disease resistance. Finally, we outline what still needs to be done to explore the potential preventative effects of good welfare.
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Affiliation(s)
- Sandra Düpjan
- Institute of Behavioural Physiology, Research Institute for Farm Animal Biology (FBN), Dummerstorf, Germany
| | - Marian Stamp Dawkins
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- *Correspondence: Marian Stamp Dawkins
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Fogaça LZ, Portella CFS, Ghelman R, Abdala CVM, Schveitzer MC. Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map. Front Public Health 2022; 9:659075. [PMID: 34988045 PMCID: PMC8722380 DOI: 10.3389/fpubh.2021.659075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 11/08/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes. Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects. Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia. Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.
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Affiliation(s)
| | | | - Ricardo Ghelman
- Brazilian Academic Consortium for Integrative Health (CABSIn), São Paulo, Brazil
| | - Carmen Verônica Mendes Abdala
- BIREME (Latin American and Caribbean Center on Health Sciences Information) - Pan American Health Organization/World Health Organization (PAHO/WHO), São Paulo, Brazil
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Yang G, Li W, Klupp N, Cao H, Liu J, Bensoussan A, Kiat H, Karamacoska D, Chang D. Does tai chi improve psychological well-being and quality of life in patients with cardiovascular disease and/or cardiovascular risk factors? A systematic review. BMC Complement Med Ther 2022; 22:3. [PMID: 34983493 PMCID: PMC8725570 DOI: 10.1186/s12906-021-03482-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 12/08/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Psychological risk factors have been recognised as potential, modifiable risk factors in the development and progression of cardiovascular disease (CVD). Tai Chi, a mind-body exercise, has the potential to improve psychological well-being and quality of life. We aim to assess the effects and safety of Tai Chi on psychological well-being and quality of life in people with CVD and/or cardiovascular risk factors. METHODS We searched for randomised controlled trials evaluating Tai Chi for psychological well-being and quality of life in people with CVD and cardiovascular risk factors, from major English and Chinese databases until 30 July 2021. Two authors independently conducted study selection and data extraction. Methodological quality was evaluated using the Cochrane Risk of Bias tool. Review Manager software was used for meta-analysis. RESULTS We included 37 studies (38 reports) involving 3525 participants in this review. The methodological quality of the included studies was generally poor. Positive effects of Tai Chi on stress, self-efficacy, and mood were found in several individual studies. Meta-analyses demonstrated favourable effects of Tai Chi plus usual care in reducing anxiety (SMD - 2.13, 95% confidence interval (CI): - 2.55, - 1.70, 3 studies, I2 = 60%) and depression (SMD -0.86, 95% CI: - 1.35, - 0.37, 6 studies, I2 = 88%), and improving mental health (MD 7.86, 95% CI: 5.20, 10.52, 11 studies, I2 = 71%) and bodily pain (MD 6.76, 95% CI: 4.13, 9.39, 11 studies, I2 = 75%) domains of the 36-Item Short Form Survey (scale from 0 to 100), compared with usual care alone. Tai Chi did not increase adverse events (RR 0.50, 95% CI: 0.21, 1.20, 5 RCTs, I2 = 0%), compared with control group. However, less than 30% of included studies reported safety information. CONCLUSIONS Tai Chi seems to be beneficial in the management of anxiety, depression, and quality of life, and safe to practice in people with CVD and/or cardiovascular risk factors. Monitoring and reporting of safety information are highly recommended for future research. More well-designed studies are warranted to determine the effects and safety of Tai Chi on psychological well-being and quality of life in this population. SYSTEMATIC REVIEW REGISTRATION International Prospective Register for Systematic Reviews (PROSPERO), CRD42016042905. Registered on 26 August 2016.
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Affiliation(s)
- Guoyan Yang
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Wenyuan Li
- Hospital of Traditional Chinese Medicine Affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, 610036, Sichuan, China
| | - Nerida Klupp
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Huijuan Cao
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Jianping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Alan Bensoussan
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Hosen Kiat
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, 2109, Australia
- Cardiac Health Institute, Sydney, NSW, 2122, Australia
| | - Diana Karamacoska
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Dennis Chang
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
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Yang G, Li X, Peel N, Klupp N, Liu JP, Bensoussan A, Kiat H, Chang D. Perceptions of Participants on Trial Participation and Adherence to Tai Chi: A Qualitative Study. Patient Prefer Adherence 2022; 16:2695-2707. [PMID: 36196067 PMCID: PMC9527000 DOI: 10.2147/ppa.s380780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/02/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Trial participation and adherence to interventions can directly influence the evaluation of outcomes in clinical trials for real world applications. The factors that influence trial participation and adherence to Tai Chi interventions in people with cardiovascular diseases remains unknown. This study aimed to explore participants' perceptions of influential factors on their trial participation and adherence to a Tai Chi intervention within a trial setting. PATIENTS AND METHODS Participants had coronary heart disease and/or hypertension in a randomized controlled trial comparing Tai Chi with a waitlist control. Data were collected via face-to-face, semi-structured interviews and analyzed using thematic analysis. RESULTS Thirty-four participants from the Tai Chi group who completed the randomized trial were interviewed. Six dominating themes and four sub-themes are discussed under the facilitators of internal and external motivation, positive feelings, benefits of Tai Chi and future practice with an overall internal motivation to improve health. Positive feelings had three sub-themes: positive feelings toward Tai Chi, the project, and the learning experience. The Tai Chi instructor(s) was found to be a crucial element in motivating participants' adherence to Tai Chi. CONCLUSION From the perception of participants, the facilitators to their trial participation and adherence to a Tai Chi intervention included internal and external motivation, positive feelings towards Tai Chi, the project and the learning experience, and perceived benefits of Tai Chi. Perceived barriers included concerns about the safety and complexity of Tai Chi practice, lack of group atmosphere outside of class, and scheduling conflicts. Future researchers can address these factors to improve trial recruitment and implementation of Tai Chi and other mind-body interventions in research and for real world applications.
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Affiliation(s)
- Guoyan Yang
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Xun Li
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Nicole Peel
- School of Health and Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Nerida Klupp
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
- School of Health and Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Jian-Ping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Alan Bensoussan
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Hosen Kiat
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
- Faculty of Medicine, Human and Health Sciences, Macquarie University, Macquarie, NSW, 2109, Australia
- ANU College of Health and Medicine, Australian National University, Canberra, ACT, 2600, Australia
- Cardiac Health Institute, Sydney, NSW, 2122, Australia
| | - Dennis Chang
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
- Correspondence: Dennis Chang; Guoyan Yang, NICM Health Research Institute, Western Sydney University, Locked Bag, 1797, Penrith, NSW, 2751, Australia, Tel +61 2 9685 4725, Fax +61 2 9685 4760, Email ;
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Stroke Survivors' Personal Efficacy Beliefs and Outcome Expectations of Tai Chi Exercise: A Qualitative Descriptive Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413001. [PMID: 34948610 PMCID: PMC8701141 DOI: 10.3390/ijerph182413001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
Prior qualitative research conducted among stroke survivors to explore the potential benefits and challenges of participating in tai chi exercise during stroke recovery is limited to those without depression. A qualitative descriptive approach was used. Social Cognitive Theory and Complex Systems Biology provided the theoretical framework, with focus group interview data collected from stroke survivors after participation in a tai chi intervention. Due to COVID-19, the focus group interview was conducted via online video conferencing. Content analysis of the de-identified transcript was conducted with a-priori codes based on the theoretical framework and inductive codes that were added during the analysis process. Lincoln and Guba's criteria were followed to ensure trustworthiness of the data. Community-dwelling stroke survivors (n = 7) participating in the focus group interviews were on average 68 years old, mainly retired (71%, n = 5), married women (57%, n = 4) with >13 years education (86%, n = 6). The three major themes were: personal efficacy beliefs, tai chi intervention active ingredients, and outcome expectations. Social Cognitive Theory underscored stroke survivors' personal efficacy beliefs, behavior, and outcome expectations, while Complex Systems Biology highlighted the active ingredients of the tai chi intervention they experienced. Participation in the 8-week tai chi intervention led to perceived physical, mental, and social benefits post stroke.
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Dibben G, Faulkner J, Oldridge N, Rees K, Thompson DR, Zwisler AD, Taylor RS. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2021; 11:CD001800. [PMID: 34741536 PMCID: PMC8571912 DOI: 10.1002/14651858.cd001800.pub4] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Coronary heart disease (CHD) is the most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people living with CHD may need support to manage their symptoms and prognosis. Exercise-based cardiac rehabilitation (CR) aims to improve the health and outcomes of people with CHD. This is an update of a Cochrane Review previously published in 2016. OBJECTIVES To assess the clinical effectiveness and cost-effectiveness of exercise-based CR (exercise training alone or in combination with psychosocial or educational interventions) compared with 'no exercise' control, on mortality, morbidity and health-related quality of life (HRQoL) in people with CHD. SEARCH METHODS We updated searches from the previous Cochrane Review, by searching CENTRAL, MEDLINE, Embase, and two other databases in September 2020. We also searched two clinical trials registers in June 2021. SELECTION CRITERIA We included randomised controlled trials (RCTs) of exercise-based interventions with at least six months' follow-up, compared with 'no exercise' control. The study population comprised adult men and women who have had a myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), or have angina pectoris, or coronary artery disease. DATA COLLECTION AND ANALYSIS We screened all identified references, extracted data and assessed risk of bias according to Cochrane methods. We stratified meta-analysis by duration of follow-up: short-term (6 to 12 months); medium-term (> 12 to 36 months); and long-term ( > 3 years), and used meta-regression to explore potential treatment effect modifiers. We used GRADE for primary outcomes at 6 to 12 months (the most common follow-up time point). MAIN RESULTS: This review included 85 trials which randomised 23,430 people with CHD. This latest update identified 22 new trials (7795 participants). The population included predominantly post-MI and post-revascularisation patients, with a mean age ranging from 47 to 77 years. In the last decade, the median percentage of women with CHD has increased from 11% to 17%, but females still account for a similarly small percentage of participants recruited overall ( < 15%). Twenty-one of the included trials were performed in low- and middle-income countries (LMICs). Overall trial reporting was poor, although there was evidence of an improvement in quality over the last decade. The median longest follow-up time was 12 months (range 6 months to 19 years). At short-term follow-up (6 to 12 months), exercise-based CR likely results in a slight reduction in all-cause mortality (risk ratio (RR) 0.87, 95% confidence interval (CI) 0.73 to 1.04; 25 trials; moderate certainty evidence), a large reduction in MI (RR 0.72, 95% CI 0.55 to 0.93; 22 trials; number needed to treat for an additional beneficial outcome (NNTB) 75, 95% CI 47 to 298; high certainty evidence), and a large reduction in all-cause hospitalisation (RR 0.58, 95% CI 0.43 to 0.77; 14 trials; NNTB 12, 95% CI 9 to 21; moderate certainty evidence). Exercise-based CR likely results in little to no difference in risk of cardiovascular mortality (RR 0.88, 95% CI 0.68 to 1.14; 15 trials; moderate certainty evidence), CABG (RR 0.99, 95% CI 0.78 to 1.27; 20 trials; high certainty evidence), and PCI (RR 0.86, 95% CI 0.63 to 1.19; 13 trials; moderate certainty evidence) up to 12 months' follow-up. We are uncertain about the effects of exercise-based CR on cardiovascular hospitalisation, with a wide confidence interval including considerable benefit as well as harm (RR 0.80, 95% CI 0.41 to 1.59; low certainty evidence). There was evidence of substantial heterogeneity across trials for cardiovascular hospitalisations (I2 = 53%), and of small study bias for all-cause hospitalisation, but not for all other outcomes. At medium-term follow-up, although there may be little to no difference in all-cause mortality (RR 0.90, 95% CI 0.80 to 1.02; 15 trials), MI (RR 1.07, 95% CI 0.91 to 1.27; 12 trials), PCI (RR 0.96, 95% CI 0.69 to 1.35; 6 trials), CABG (RR 0.97, 95% CI 0.77 to 1.23; 9 trials), and all-cause hospitalisation (RR 0.92, 95% CI 0.82 to 1.03; 9 trials), a large reduction in cardiovascular mortality was found (RR 0.77, 95% CI 0.63 to 0.93; 5 trials). Evidence is uncertain for difference in risk of cardiovascular hospitalisation (RR 0.92, 95% CI 0.76 to 1.12; 3 trials). At long-term follow-up, although there may be little to no difference in all-cause mortality (RR 0.91, 95% CI 0.75 to 1.10), exercise-based CR may result in a large reduction in cardiovascular mortality (RR 0.58, 95% CI 0.43 to 0.78; 8 trials) and MI (RR 0.67, 95% CI 0.50 to 0.90; 10 trials). Evidence is uncertain for CABG (RR 0.66, 95% CI 0.34 to 1.27; 4 trials), and PCI (RR 0.76, 95% CI 0.48 to 1.20; 3 trials). Meta-regression showed benefits in outcomes were independent of CHD case mix, type of CR, exercise dose, follow-up length, publication year, CR setting, study location, sample size or risk of bias. There was evidence that exercise-based CR may slightly increase HRQoL across several subscales (SF-36 mental component, physical functioning, physical performance, general health, vitality, social functioning and mental health scores) up to 12 months' follow-up; however, these may not be clinically important differences. The eight trial-based economic evaluation studies showed exercise-based CR to be a potentially cost-effective use of resources in terms of gain in quality-adjusted life years (QALYs). AUTHORS' CONCLUSIONS This updated Cochrane Review supports the conclusions of the previous version, that exercise-based CR provides important benefits to people with CHD, including reduced risk of MI, a likely small reduction in all-cause mortality, and a large reduction in all-cause hospitalisation, along with associated healthcare costs, and improved HRQoL up to 12 months' follow-up. Over longer-term follow-up, benefits may include reductions in cardiovascular mortality and MI. In the last decade, trials were more likely to include females, and be undertaken in LMICs, increasing the generalisability of findings. Well-designed, adequately-reported RCTs of CR in people with CHD more representative of usual clinical practice are still needed. Trials should explicitly report clinical outcomes, including mortality and hospital admissions, and include validated HRQoL outcome measures, especially over longer-term follow-up, and assess costs and cost-effectiveness.
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Affiliation(s)
- Grace Dibben
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
| | - James Faulkner
- Faculty Health and Wellbeing, School of Sport, Health and Community, University of Winchester, Winchester, UK
| | - Neil Oldridge
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Karen Rees
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Ann-Dorthe Zwisler
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Chau JPC, Leung LYL, Liu X, Lo SHS, Choi KC, Zhao J, Chiang HCY. Effects of Tai Chi on health outcomes among community-dwelling adults with or at risk of metabolic syndrome: A systematic review. Complement Ther Clin Pract 2021; 44:101445. [PMID: 34260997 DOI: 10.1016/j.ctcp.2021.101445] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/04/2021] [Accepted: 07/09/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This systematic review evaluated the effects of Tai Chi on health outcomes among community-dwelling adults with or at risk of metabolic syndrome (MetS). METHODS Randomized controlled trials (RCTs) were searched in 10 databases. Data were statistically pooled for meta-analysis. RESULTS Twenty RCTs were included. One study involved adults with MetS, and the other 19 studies involved adults with at least one risk factor for MetS. Tai Chi was found to reduce waist circumference and increase high-density lipoprotein cholesterol in obese adults. Tai Chi also reduces waist circumference, body mass index, blood glucose level, insulin resistance, and increases the quality of life (QoL) in adults with elevated blood glucose/type 2 diabetes (T2DM). Among participants with hypertension, Tai Chi improves blood pressure, lipid profiles, anxiety, depression, and physical QoL. CONCLUSIONS Tai Chi may be effective for enhancing the physiological and psychosocial wellbeing of community-dwelling adults at risk of MetS. Further RCTs are needed to examine its effects in adults with MetS and identify optimal regimes.
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Affiliation(s)
- Janita Pak Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Leona Yuen Ling Leung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xu Liu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Suzanne Hoi Shan Lo
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jie Zhao
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Helen Chung Yan Chiang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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You Y, Min L, Tang M, Chen Y, Ma X. Bibliometric Evaluation of Global Tai Chi Research from 1980-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116150. [PMID: 34200236 PMCID: PMC8201343 DOI: 10.3390/ijerph18116150] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 12/24/2022]
Abstract
While studies on the health benefits of Tai Chi have sprung up over the past four decades, few have engaged in collecting global data, estimating the developing trends, and conducting reviews from the perspective of visualization and bibliometric analysis. This study aimed to provide a summary of the global scientific outputs on Tai Chi research from 1980 to 2020, explore the frontiers, identify cooperation networks, track research trends and highlight emerging hotspots. Relevant publications were downloaded from the Web of Science Core Collection (WoSCC) database between 1980 and 2020. Bibliometric visualization and comparative analysis of authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords were systematically conducted using CiteSpace software. A total of 1078 publications satisfied the search criteria, and the trend of annual related publications was generally in an upward trend, although with some fluctuations. China (503) and Harvard University (74) were the most prolific country and institution, respectively. Most of the related researches were published in the journals with a focus on sport sciences, alternative medicine, geriatrics gerontology, and rehabilitation. Our results indicated that the current concerns and difficulties of Tai Chi research are “Intervention method”, “Targeted therapy”, “Applicable population”, “Risk factors”, and “Research quality”. The frontiers and promising domains of Tai Chi exercise in the health science field are preventions and rehabilitations of “Fall risk”, “Cardiorespiratory related disease”, “Stroke”, “Parkinson’s disease”, and “Depression”, which should receive more attention in the future.
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Affiliation(s)
- Yanwei You
- Division of Sport Science & Physical Education, Tsinghua University, Beijing 100084, China; (Y.Y.); (L.M.)
| | - Leizi Min
- Division of Sport Science & Physical Education, Tsinghua University, Beijing 100084, China; (Y.Y.); (L.M.)
| | - Meihua Tang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China;
| | - Yuquan Chen
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China;
| | - Xindong Ma
- Division of Sport Science & Physical Education, Tsinghua University, Beijing 100084, China; (Y.Y.); (L.M.)
- Correspondence:
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21
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A Randomized Trial of Tai Chi on Preventing Hypertension and Hyperlipidemia in Middle-Aged and Elderly Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105480. [PMID: 34065454 PMCID: PMC8160700 DOI: 10.3390/ijerph18105480] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 01/22/2023]
Abstract
In our randomized controlled trial, we investigated whether Wu-style Tai Chi (Tai Chi combined with Daoyin) as a potential exercise prescription is more effective than simplified Tai Chi in the prevention and treatment of hypertension and hyperlipidemia in the middle-aged and elderly. We randomly assigned 66 patients with hypertension and hyperlipidemia to one of the two groups: the Wu-style Tai Chi group or the simplified Tai Chi group; the simplified Tai Chi group only exercised simplified Tai Chi three times a week for 6 weeks. The Wu-style Tai Chi group participated in 60 min of Wu-style Tai Chi three times a week for 6 weeks. Serum biochemical tests were conducted at baseline and at the end of the study. Measurements of blood pressure were performed at the same time. Primary outcomes were compared within and between groups at baseline and at 6 weeks. The participants in the Wu-style Tai Chi group performed, at 6 weeks, significantly better than baseline on all of the primary outcomes (p value ≤ 0.05). The results also show significant difference within the simplified Tai Chi group from baseline to 6 weeks in TCHO (mmol/L), SBP (mmHg), and LDL-C (mmol/L) (p value < 0.05). From baseline to 6 weeks, the Wu-style Tai Chi group had significant differences at more test indexes in serum and blood pressure than the simplified Tai Chi group. At 6 weeks, the Wu-style Tai Chi group had a significantly greater mean improvement in the SBP (mmHg) than did the simplified Tai Chi group (mean between-group difference, −5.80 (mmHg) [95% CI, −14.01 to 2.41]; p = 0.007). The results showed that, compared with simplified Tai Chi, Wu-style Tai Chi had a better effect on hypertension in the middle-aged and elderly. At 6 weeks in LDL-C (mmol/L), the Wu-style Tai Chi group had significantly greater improvement between the two groups (means between-group difference, −0.45 (mmol/L) [95% CI, −0.89 to −0.17]; p = 0.03). The results showed that Wu-style Tai Chi protected the cardiovascular system of the middle-aged and elderly in improving LDL-C (mmol/L), and was more significant than simplified Tai Chi. After 6 weeks of exercise, Wu-style Tai Chi could effectively improve hyperlipidemia and hypertension. The total effective rate of cardiovascular disease was 90.00%. There was significant difference in the treatment effect of hypertension and hyperlipidemia between the two groups during 6 weeks (p = 0.039), showing that, in a small population of middle-aged and elderly subjects, Wu style Tai Chi could be useful in managing important CV risk factors, such as hypertension and hyperlipidemia.
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22
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The Effect of Tai Chi Chuan on Emotional Health: Potential Mechanisms and Prefrontal Cortex Hypothesis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5549006. [PMID: 34007290 PMCID: PMC8110391 DOI: 10.1155/2021/5549006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/25/2021] [Accepted: 04/22/2021] [Indexed: 12/31/2022]
Abstract
Deep involvement in the negative mood over long periods of time likely results in emotional disturbances/disorders and poor mental health. Tai Chi Chuan (TCC) is regarded as a typical mind-body practice combining aerobic exercise and meditation to prevent and treat negative mood. Although there are an increasing number of TCC studies examining anxiety, depression, and mental stress, the mechanisms underlying these negative emotions are not fully understood. This review study examined TCC studies related to emotional health from both clinical patients and healthy individuals. Next, several potential mechanisms from physiological, psychological, and neurological perspectives were evaluated based on direct and indirect research evidence. We reviewed recent functional magnetic resonance imaging studies, which demonstrated changes in brain anatomy and function, mainly in the prefrontal cortex, following TCC practice. Finally, the effects of TCC on emotion/mental health is depicted with a prefrontal cortex hypothesis that proposed “an immune system of the mind” indicating the role of the prefrontal cortex as a flexible hub in regulating an individual's mental health. The prefrontal cortex is likely a key biomarker among the multiple complex neural correlates to help an individual manage negative emotions/mental health. Future research is needed to examine TCC effects on mental health by examining the relationship between the executive control system (mainly prefrontal cortex) and limbic network (including amygdala, insula, and hippocampal gyrus).
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23
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Hellem T, Benavides-Vaello S, Taylor-Piliae R. National Internet-Based Survey of the Use, Barriers, Reasons and Beliefs of Mind-Body Practices During the Early Months of the COVID-19 Pandemic. J Evid Based Integr Med 2021; 26:2515690X211006332. [PMID: 33829877 PMCID: PMC8040606 DOI: 10.1177/2515690x211006332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to learn about the use, barriers, reasons and beliefs regarding mind-body practices among adults living in the United States during the beginning months of the 2019 novel coronavirus disease (COVID-19) pandemic. An on-line survey was developed following the Checklist for Reporting Results of Internet e-Surveys (CHERRIES) guidelines and using the online survey software program, Qualtrics®XM, platform. Pilot testing of the survey was conducted for usability and functionality. The final 24-item survey was distributed via email and social media. A total of 338 adults responded to the survey, with 68.8% indicating that they participated in mind-body activities since the start of the pandemic. Physical activity was the most frequently (61.5%, n = 227) used mind-body practice. Further, 2 of the common barriers to engaging in mind-body practices were lack of motivation and wandering mind. Frequently listed reasons for using mind-body practices were to promote health, reduce stress and relaxation. Respondents believed that mind-body practices resulted in less stress. These findings may be applicable for reducing psychological stress related to the pandemic, as the pandemic continues to impact many areas of the United States.
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Affiliation(s)
- Tracy Hellem
- College of Nursing, 33052Montana State University, Missoula, MT, USA
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24
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Ibañez GE, Fennie K, Larkey L, Hu N, Algarin AB, Valdivia C, Lavretsky H. A tai chi/qigong intervention for older adults living with HIV: a study protocol of an exploratory clinical trial. Trials 2020; 21:804. [PMID: 32962749 PMCID: PMC7506206 DOI: 10.1186/s13063-020-04728-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/08/2020] [Indexed: 01/18/2023] Open
Abstract
Background Almost half of people living with HIV (PLWH) in the USA are over 50 years of age; this is expected to increase to 70% by 2020. Yet, few interventions exist for older PLWH that address psychological and physical symptoms combined, both prevalent in this population. There is a need to find innovative and accessible interventions that can help older PLWH to manage their symptoms. Mind-body interventions, like tai chi/qigong (TCQ), improve both physical and psychological health. TCQ is a series of slow, low-impact meditative movements that integrates breathwork, meditation, and stances. Methods The present study is an exploratory clinical trial that will evaluate the acceptability and feasibility of a 12-week, small group TCQ intervention (n = 24), a sham qigong control condition (n = 24), and a standard of care control condition (n = 24) for older people living with HIV/AIDS. It will also explore any preliminary associations between the TCQ intervention and symptom alleviation. Participants will be recruited from community-based health and social services organizations in Miami, FL, and randomized to one of the 3 conditions. Discussion We will assess feasibility and acceptability through questionnaires and adherence to TCQ. We will assess preliminary associations with symptoms such as depression, anxiety, social support, chronic HIV-related fatigue, and clinical outcomes. These will be described through proportions, means, and changes over time through graphing techniques. Outcomes will be assessed at baseline, at post-intervention, and at 3 months follow-up. These preliminary analyses also will provide information necessary to estimate effect size and power needed for a larger clinical trial. Trial registration ClinicalTrials.gov NCT03840525. Registered on 16 July 2018.
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Affiliation(s)
- Gladys E Ibañez
- Department of Epidemiology, Florida International University, 11200 SW 8th St AHC5, Miami, FL, 33199, USA.
| | - Kristopher Fennie
- Division of Natural Sciences, New College of Florida, 5800 Bay Shore Road, Sarasota, FL, 34243, USA
| | - Linda Larkey
- College of Nursing and Health Innovation, Arizona State University, 550 N 3rd St, Phoenix, AZ, 85004, USA
| | - Nan Hu
- Department of Biostatistics, Florida International University, 11200 SW 8th St AHC5, Miami, FL, 33199, USA.,Division of Public Health, Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, 84132, USA
| | - Angel B Algarin
- Department of Epidemiology, Florida International University, 11200 SW 8th St AHC5, Miami, FL, 33199, USA.,Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, 92093, USA
| | - Chelsea Valdivia
- Department of Biostatistics, Florida International University, 11200 SW 8th St AHC5, Miami, FL, 33199, USA
| | - Helen Lavretsky
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, The University of California, Los Angeles (UCLA), 760 Westwood Plaza, Los Angeles, CA, 90095, USA
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