Effects of Baduanjin exercise on the physical function of middle-aged and elderly people: a systematic review and meta-analysis of randomized controlled trials

Meta-analysis of the intervention effects of tai chi on fasting blood glucose, blood pressure and triglyceride in middle-aged and elderly people

BACKGROUND

Hypertension, hyperlipidemia, and hyperglycemia have emerged as global health concerns of paramount significance. With the burgeoning popularity of mind-body therapy, cardiovascular patients have increasingly exhibited a vested interest in the practice of Tai Chi. The objective of this study seeks to quantitatively assess the impact of Tai Chi interventions on blood pressure, lipid levels, and glucose concentrations among the elderly population, thereby explaining the optimal intervention protocol.

METHODS

An extensive search was conducted across multiple databases, including Web of Science, PubMed, CNKI, WANFANG DATA, RISS, KISS, and DBPIA, comprising English, Korean, and Chinese literature. The search strategy employed a retrieval method of subject term 1 + subject term 2, which included both full names and abbreviations of the terms. Specifically, "taijiquan" or "Tai Chi" were set as the Term 1, while Term 2 was set as "blood pressure," "BP," "Fasting blood glucose," "FBG," "Triglyceride," and "TG." Thereafter, the retrieved articles were filtered in accordance with the PICOS method. Risk of bias assessment was performed using RoB 2.0, while data analysis was conducted using Comprehensive Meta-Analysis 3.7.

RESULTS

A total of 57 studies, including 3,856 research subjects, were eligible for inclusion. The findings of the primary effect quantitative synthesis demonstrated that Tai Chi exerted an improvement on systolic blood pressure (SBP) (ES = -0.764, p < .001), diastolic blood pressure (DBP) (ES = -0.426, p = .001), triglyceride (TG) (ES = -0.452, p < .001), and fasting blood glucose concentrations (FBG) (ES = -0.552, p = .002) among middle-aged and elderly individuals. Subgroup analysis further revealed that the intervention effects were significantly influenced by the characteristics of the research subjects and the specific intervention protocol employed.

CONCLUSION

Tai Chi, as a gentle form of aerobic exercise, exerts a profound impact on reducing blood pressure, fasting blood glucose levels, and triglyceride concentrations among middle-aged and elderly individuals. Notably, the intervention effect is particularly pronounced among male patients afflicted with hypertension, hyperglycemia, and hyperlipidemia. Based on the collective advantages underscored by this research, we strongly recommend engaging in Tai Chi exercises for a minimum duration of 16 weeks, with each session lasting 30-50 min and conducted 6-7 times per week, without any restrictions on the style employed.

The effect of Ba Duan Jin exercise intervention on cardiovascular disease: a meta-analysis of randomized controlled trials

Background

There is a growing interest in the use of complementary therapies for the prevention of disease and the maintenance of health. Furthermore, complementary therapies that incorporate exercise are becoming increasingly prevalent among the older adult, and thus may represent a crucial strategy for the primary and secondary prevention of cardiovascular disease (CVD). Exercise therapy, as a means to prevent and treat cardiovascular diseases, has been gradually applied in clinical practice. It has the advantages of reducing mortality, improving clinical symptoms, restoring physical function and improving quality of life. In recent years, traditional Chinese sports such as Ba Duan Jin and Qigong have developed rapidly. Therefore, a comprehensive systematic review is required to examine interventions involving Ba Duan Jin exercise in healthy adults or those at increased risk of CVD in order to determine the effectiveness of Ba Duan Jin exercise for the primary prevention of CVD.

Objective

To investigate the effect of Ba Duan Jin exercise intervention for the primary prevention of cardiovascular diseases.

Methods

Eight databases were systematically searched from inception to July, 2024 for randomized controlled trials (RCTs) to evaluated the impact of Ba Duan Jin exercise intervention on cardiovascular diseases. The search terms were "Cardiovascular diseases" "Ba Duan Jin" and "Randomized controlled." The Cochrane risk assessment tool was used to evaluate the study quality, and the meta-analysis was performed using Rev. Man 5.4 software.

Results

Seventeen completed trials were conducted with 1,755 participants who were randomly assigned and met the inclusion criteria. All 17 studies were conducted in China. The meta-analysis indicates that Ba Duan Jin exercise therapy can provide long-term benefits (20-30 years) by reducing all-cause mortality (RR = 0.55, 95% CI: 0.44-0.68, p < 0.01) and stroke mortality (RR = 0.49, 95% CI: 0.36-0.66, p < 0.01) in hypertensive patients. Subgroup analyses reveal that Ba Duan Jin exercise therapy decreases SBP (MD = -4.05, 95% CI = -6.84 to -1.26, p < 0.01) and DBP (MD = -3.21, 95% CI = -5.22 to -1.20, p < 0.01) levels in patients with essential hypertension, significantly reduces serum TC (MD = -0.78, 95% CI = -1.06 to -0.50, p < 0.01), TG (MD = -0.78, 95% CI = -0.93 to -0.62, p < 0.01), and LDL-C (MD = -0.76, 95% CI = -0.92 to -0.60, p < 0.01) levels in patients with hyperlipidemia, increases HDL-C (MD = 0.32, 95% CI = 0.14-0.51, p < 0.01) levels, and produces beneficial effects on cardiovascular function. Additionally, it can alleviate anxiety (MD = -3.37, 95% CI = -3.84 to -2.89, p < 0.01) and improve sleep quality (MD = -2.68, 95% CI = -3.63to -1.73, p < 0.01).

Conclusion

Ba Duan Jin exercise therapy can improve the physical and mental condition and quality of life of patients with cardiovascular diseases, and it is worthy of further promotion and application in clinical practice.

Systematic review registration

PROSPERO, identifier: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024496934.

A systematic review and meta-analysis on sodium tanshinone IIA sulfonate injection for the adjunctive therapy of pulmonary heart disease

AIMS

Sodium tanshinone IIA sulfonate (STS) injection has been widely used as adjunctive therapy for pulmonary heart disease (PHD) in China. Nevertheless, the efficacy of STS injection has not been systematically evaluated so far. Hence, the efficacy of STS injection as adjunctive therapy for PHD was explored in this study.

METHODS

Randomized controlled trials (RCTs) were screened from China Science and Technology Journal Database, China National Knowledge Infrastructure, Wanfang Database, PubMed, Sino-Med, Google Scholar, Medline, Chinese Biomedical Literature Database, Cochrane Library, Embase and Chinese Science Citation Database until 20 January 2024. Literature searching, data collection and quality assessment were independently performed by two investigators. The extracted data was analyzed with RevMan 5.4 and STATA 14.0. Basing on the methodological quality, dosage of STS injection, control group measures and intervention time, sensitivity analysis and subgroup analysis were performed.

RESULTS

19 RCTs with 1739 patients were included in this study. Results showed that as adjunctive therapy, STS injection combined with Western medicine showed better therapeutic efficacy than Western medicine alone for PHD by increasing the clinical effective rate (RR = 1.22; 95% CI, 1.17 to 1.27; p < 0.001), partial pressure of oxygen (MD = 10.16; 95% CI, 5.07 to 15.24; p < 0.001), left ventricular ejection fraction (MD = 8.66; 95% CI, 6.14 to 11.18; p < 0.001) and stroke volume (MD = 13.10; 95% CI, 11.83 to 14.38; p < 0.001), meanwhile decreasing the low shear blood viscosity (MD = -1.16; 95% CI, -1.57 to -0.74; p < 0.001), high shear blood viscosity (MD = -0.64; 95% CI, -0.86 to -0.42; p < 0.001), plasma viscosity (MD = -0.23; 95% CI, -0.30 to -0.17; p < 0.001), hematokrit (MD = -8.52; 95% CI, -11.06 to -5.98; p < 0.001), fibrinogen (MD = -0.62; 95% CI, -0.87 to -0.37; p < 0.001) and partial pressure of carbon dioxide (MD = -8.56; 95% CI, -12.09 to -5.02; p < 0.001).

CONCLUSION

STS injection as adjunctive therapy seemed to be more effective than Western medicine alone for PHD. However, due to low quality of the included RCTs, more well-designed RCTs were necessary to verify the efficacy of STS injection.

Effect of Baduanjin exercise on executive function in older adults with cognitive frailty: A randomized controlled trial

OBJECTIVE

To investigate the effectiveness of Baduanjin exercise on executive function in community-dwelling older adults with cognitive frailty.

DESIGN

Randomized controlled trial.

SETTING

Community residential centers.

SUBJECTS

120 eligible older adults.

INTERVENTIONS

Baduanjin training group received supervised Baduanjin training, 60 min sessions three times per week for 24 weeks. The control group did not receive any exercise intervention.

MAIN MEASURES

Primary outcome was executive function, assessed using Clock Drawing Test. Secondary outcomes included the subcomponents of executive function (working memory, inhibitory control and cognitive flexibility), attention and cognitive frailty (global cognitive function, physical frailty) assessed using Verbal Fluency Test, Trail Making Test-A/B, Stroop Test, Montreal Cognitive Assessment and Edmonton Frailty Scale, respectively, at baseline and 24 weeks after intervention.

RESULTS

After the 24-week intervention, the scores of Clock Drawing Test and Verbal Fluency Test, the Trail Making Test-B time and the Card correct numbers of Stroop Test in Baduanjin training group showed significant improvement compared with control group (all P < 0.05) with small to moderate effect sizes and the significant interaction effect of group by time in the Clock Drawing Test and Trail Making Test-B test (P = 0.003 and P = 0.043); cognitive frailty variables, including Montreal Cognitive Assessment and Edmonton Frail Scale scores, also showed significant improvement (P = 0.002 and P = 0.004) with a moderate effect sizes and a significant interaction effect (P < 0.001, P = 0.013). No adverse events were reported.

CONCLUSION

Regular Baduanjin training may be an effective and safe intervention to improve cognitive frailty and executive function in community-dwelling older adults with cognitive frailty.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR2100050857. Data of registration: 8/5/2020, https://www.chictr.org.cn/showproj.html?proj = 133037.

Effects of Mind-Body Qigong Exercise on Overall Health, Fatigue/Sleep, and Cognition in Older Chinese Immigrants in the US: An Intervention Study with Control

Background

Culturally relevant exercises may help improve health and address disparities faced by older immigrants due to language and cultural barriers. Few studies have focused on such exercise interventions among older Chinese immigrants at US daycare centers.

Methods

We conducted a 10-week nonrandomized controlled trial in older Chinese immigrants in Philadelphia, US. The intervention group practiced Chinese Qigong (Baduanjin) 5 days a week guided by trained research assistants and video instructions. The control group maintained their usual daily activities. We collected self-report assessments on overall health, sleep, and fatigue and implemented two computerized cognitive tests measuring psychomotor vigilance task (PVT) and memory twice, preintervention and postintervention. Repeated measures general linear model (GLM) and paired samples t-tests were used for data analyses.

Results

Eighty-eight older adults (Qigong, n = 53; control, n = 35) with an average age of 78.13 (SD = 5.05) were included. Groups showed no significant differences at baseline evaluation. After the 10-week exercise, the intervention group showed significant improvements in overall health (p=0.032), fatigue (p < 0.001), and cognitive functions including memory (p=0.01), response speed (p=0.002), and response time (p=0.012) on the PVT, as well as marginally significant benefits in sleep (p=0.058). Between-group comparisons identified significant group-by-time interactions in health (p=0.024), sleep (p=0.004), fatigue (p=0.004), and memory (p=0.004).

Conclusion

We revealed significant positive effects of Qigong in older Chinese immigrants across multiple health domains. Findings highlight the potential of a culturally relevant exercise in addressing health disparities.