Tai Chi Expertise Classification in Older Adults Using Wrist Wearables and Machine Learning

Tai Chi is a Chinese martial art that provides an adaptive and accessible exercise for older adults with varying functional capacity. While Tai Chi is widely recommended for its physical benefits, wider adoption in at-home practice presents challenges for practitioners, as limited feedback may hamper learning. This study examined the feasibility of using a wearable sensor, combined with machine learning (ML) approaches, to automatically and objectively classify Tai Chi expertise. We hypothesized that the combination of wrist acceleration profiles with ML approaches would be able to accurately classify practitioners' Tai Chi expertise levels. Twelve older active Tai Chi practitioners were recruited for this study. The self-reported lifetime practice hours were used to identify subjects in low, medium, or highly experienced groups. Using 15 acceleration-derived features from a wearable sensor during a self-guided Tai Chi movement and 8 ML architectures, we found multiclass classification performance to range from 0.73 to 0.97 in accuracy and F1-score. Based on feature importance analysis, the top three features were found to each result in a 16-19% performance drop in accuracy. These findings suggest that wrist-wearable-based ML models may accurately classify practice-related changes in movement patterns, which may be helpful in quantifying progress in at-home exercises.

Enhanced Integrity of White Matter Microstructure in Mind-Body Practitioners: A Whole-Brain Diffusion Tensor Imaging Study

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.

Effects of Mind-Body Exercise on Brain Structure and Function: A Systematic Review on MRI Studies

Mind–body exercise has been proposed to confer both physical and mental health benefits. However, there is no clear consensus on the neural mechanisms underlying the improvements in health. Herein, we conducted a systematic review to reveal which brain region or network is regulated by mind–body exercise. PubMed, Web of Science, PsycINFO, SPORTDiscus, and China National Knowledge Infrastructure databases were systematically searched to identify cross-sectional and intervention studies using magnetic resonance imaging (MRI) to explore the effect of mind–body exercise on brain structure and function, from their inception to June 2020. The risk of bias for cross-sectional studies was assessed using the Joanna Briggs Institute (JBI) checklist, whereas that of interventional studies was analyzed using the Physiotherapy Evidence Database (PEDro) scale. A total of 15 studies met the inclusion criteria. Our analysis revealed that mind–body exercise modulated brain structure, brain neural activity, and functional connectivity, mainly in the prefrontal cortex, hippocampus/medial temporal lobe, lateral temporal lobe, insula, and the cingulate cortex, as well as the cognitive control and default mode networks, which might underlie the beneficial effects of such exercises on health. However, due to the heterogeneity of included studies, more randomized controlled trials with rigorous designs, similar measured outcomes, and whole-brain analyses are warranted.

Effects of Tai Chi Yunshou exercise on community-based stroke patients: a cluster randomized controlled trial

Backgroud

Tai Chi Chuan was used for stroke survivors with balance impairments. However, even a short-form of Tai Chi Chuan includes forms that make the exercise challenging for the stroke survivors. Tai Chi Yunshou (wave hands in the cloud) is the “mother” form and the fundamental form of all Tai Chi Chuan styles, which is considered more suitable and feasible for stroke survivors with balance impairments. So this study was designed to evaluate the effects of Tai Chi Yunshou exercise on community-based stroke patients with balance dysfunctions.

Methods

A total of 250 participants from 10 community health centers (5 per arm) were selected and randomly allocated into Tai Chi Yunshou exercise group (TC group) or a balance rehabilitation training group (control group) in an equal ratio. Participants in the TC group were received Tai Chi Yunshou exercise training five times per week for 12 weeks and those in control group were received balance rehabilitation training five times per week for 12 weeks. Outcome assessments including Berg Balance Scale (BBS), Time up to go test (TUGT), Modified Barthel Index (MBI) were measured at baseline, 4 weeks, 8 weeks, 12 weeks and followed-up 6 weeks (18 weeks), 12 weeks (24 weeks). Intention-to-treat analysis was performed. Analysis of variance of repeated measures was used to assess between-group differences.

Results

A total of 244 participants, 120 in the TC group and 124 in the rehabilitation group, were included in final analysis. There was no siginificant difference in Tai Chi Yunshou and balance rehabilitation training on the improvement of balance ability and mobility (P = 0.531 and P = 0.839, respectively) after adjustment for baseline. However, there was significant difference between two groups on improvement of motor funtion (P = 0.022), fear of falling (P < 0.001) and depression (P = 0.035) for the post stroke patients. No adverse events were reported during the study.

Conclusion

Tai Chi Yunshou and balance rehabilitation training led to improved balance ability and functional mobility, and both are suitable community-based programs that may benefit for stroke recovery and community reintegration. Our data demonstrated that a 12-week Tai Chi Yunshou intervention was more effective in motor function, fear of falling and depression than balance rehabilitation training. Future studies examining the effectiveness of Tai Chi Yunahou as a balance ability improvement strategy for community-dwelling survivors of stroke are recommended.

Trial registration

Chinese Clinical Trail Registry: ChiCRT-TRC-13003641. Registration date: 22 August, 2013.

Regular tai chi exercise decreases the percentage of type 2 cytokine-producing cells in postsurgical non-small cell lung cancer survivors

BACKGROUND

Tai Chi combines aspects of meditation and aerobic exercise. Its effect on the balance between cellular and humoral immunity, which potentiates human immunity against tumors, remains to be determined.

OBJECTIVE

The objective was to investigate the effect of a 16-week Tai Chi exercise intervention on the recovery of postsurgical non-small cell lung cancer survivors.

INTERVENTIONS/METHODS

A controlled study was performed in 32 lung cancer survivors who practiced Tai Chi during a 16-week period. The percentages of interferon γ-producing CD3 T lymphocyte cells (T1) and interleukin 4-producing CD3 T lymphocyte cells (T2) and CD3 T lymphocyte subsets (T helper cell type 1 [TH1], TH2; cytotoxic T cell type 1 [Tc1], Tc2) were determined as well as levels of hormones β-endorphin, general catecholamines, and cortisol.

RESULTS

Whereas the T1/T2 and Tc1/Tc2 ratios in the control group decreased in the natural course of postsurgical non-small cell lung cancer recovery (both P < .01), no changes were observed in the Tai Chi group. The differences in changes in the T1/T2 and Tc1/Tc2 ratios (both P < .01) and in T2 and Tc2 levels (P < .01) between the 2 groups were significant. The cortisol level increased in the control group (P < .05) but not in Tai Chi group.

CONCLUSIONS

A 16-week Tai Chi exercise significantly diminished the magnitude of the decreased T1/T2 ratio in the natural course of recovery in a population of postsurgical non-small cell lung cancer survivors.

IMPLICATIONS FOR PRACTICE

Tai Chi may have a role in ameliorating the imbalance between humoral and cellular immunity, potentiating human immunity against tumors.

Can Taichi reshape the brain? A brain morphometry study

Although research has provided abundant evidence for Taichi-induced improvements in psychological and physiological well-being, little is known about possible links to brain structure of Taichi practice. Using high-resolution MRI of 22 Tai Chi Chuan (TCC) practitioners and 18 controls matched for age, sex and education, we set out to examine the underlying anatomical correlates of long-term Taichi practice at two different levels of regional specificity. For this purpose, parcel-wise and vertex-wise analyses were employed to quantify the difference between TCC practitioners and the controls based on cortical surface reconstruction. We also adopted the Attention Network Test (ANT) to explore the effect of TCC on executive control. TCC practitioners, compared with controls, showed significantly thicker cortex in precentral gyrus, insula sulcus and middle frontal sulcus in the right hemisphere and superior temporal gyrus and medial occipito-temporal sulcus and lingual sulcus in the left hemisphere. Moreover, we found that thicker cortex in left medial occipito-temporal sulcus and lingual sulcus was associated with greater intensity of TCC practice. These findings indicate that long-term TCC practice could induce regional structural change and also suggest TCC might share similar patterns of neural correlates with meditation and aerobic exercise.

Getting started with taiji: investigating students expectations and teachers appraisals of taiji beginners courses

In recent years, Taiji has been frequently investigated and considered as a stress management intervention. Although health care providers' appraisals and consumers' expectations are regarded as essential for treatment outcome, little attention has been drawn to this issue in Taiji research. In our study we have conducted two surveys to explore beginners' (n = 74) expectations and teachers' (n = 136) appraisals of their Taiji courses in general as well as more particularly related to stress management. Qualitative data analysis revealed that beginners mainly expected to learn a new method that is applicable in their daily life to foster peace of mind and to enhance their stress management. Congruently moderate-to-high improvements in stress management have also been found in quantitative analysis, whereby a lower educational level predicted higher expectations (P = 0.016). Taiji-teachers stated body- and mind-related benefits most frequently and appraised moderate-to-high improvements in stress management. Higher appraisals were predicted by a shorter teaching experience (P = 0.024). Our results inform about beginners' expectations and teachers' appraisals related to a Taiji-beginners course and highlight the role of educational background and teaching experience in shaping stress-management-related beginners' expectations and teachers' appraisals.

Sign Chi Do and physical function: a pilot study

Participating in strength, balance, and flexibility training reduces the risk for decreased physical function for older adults. This pilot study tested the effect of an exercise intervention on physical function. A pretest/posttest single-group design was used to test the effect of a 12-week Sign Chi Do (SCD) exercise intervention on upper body strength (arm curls) and lower body strength (chair stands); balance (Timed Up & Go and one-leg stance), and flexibility (back scratch). Five community-dwelling older adults not participating in strength, flexibility, or balance training completed the study. Strength scores improved by at least 2 arm curls or chair stands for those at risk for loss of physical function. Timed Up & Go scores improved by an average of 3.83 (range 1.98-4.98) seconds for those at risk for falls. All flexibility scores remained in the upper 75th percentile. Continued practice of SCD has the potential to improve physical function for older adults.