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Bertolini R, Vercelino R, Ferreira LF, Telles da Rosa LH. Effects of Tai Chi Chuan on Older Adults' Balance: A Systematic Review With Meta-Analysis. J Aging Phys Act 2024:1-14. [PMID: 39244194 DOI: 10.1123/japa.2023-0423] [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: 12/14/2023] [Revised: 04/26/2024] [Accepted: 06/06/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Tai Chi Chuan (TCC) is considered a mind and body practice of Chinese origin, considered as an intangible cultural heritage of humanity by UNESCO, and recommended by the World Health Organization as a therapeutic approach to prevent falls. OBJECTIVE To assess the effects of TCC on older adult's balance. METHODS A systematic review of randomized clinical trials was conducted by two independent reviewers using the ROB2 tool to assess the risk of bias under the following databases: PubMed, SCOPUS, Web of Science, PEDro, Embase, Cochrane, CINAHL, and LILACS. A meta-analysis of the selected articles for the dynamic and static balance criteria was conducted in a population of older adults (over 65 years) with publications from 2010 to 2024. RESULTS Eighteen randomized clinical trials fulfilled the criteria. TCC improves dynamic balance in the timed up and go and gait speeds tests, and static balance in the single-leg test and functional reach test when compared with the control group in the meta-analysis. Adverse events were found in only one study, and the training parameters were heterogeneous. CONCLUSION TCC improves older adults with both dynamic and static balance. The results of the parameters indicate a direction in which TCC is prescribed for clinical practice with minimal or no risk of adverse effects.
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Affiliation(s)
- Rafael Bertolini
- Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - Rafael Vercelino
- Physiotherapy Department, Anhanguera University, Porto Alegre, RS, Brazil
| | - Luis Fernando Ferreira
- Postgraduation program in Medicine: Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - Luis Henrique Telles da Rosa
- Program of Post-graduation in Rehabilitation Sciences, Physiotherapy Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
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Liu H, Chen X, Li Y, Gao Z, Huang W, Jiang Z. Neuromuscular control strategies of the lower limb during a typical Tai Chi brush knee and twist step in practitioners with and without knee pain: a pilot study. Res Sports Med 2024; 32:679-694. [PMID: 37246805 DOI: 10.1080/15438627.2023.2219799] [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: 01/03/2023] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Abstract
As a complex movement, Tai Chi (TC) could be challenging for knee control, and the compensatory changes in TC biomechanics of knee pain patients are unknown. The Brush Knee and Twist Step (BKTS) is a typical TC movement that involves basic leg motion repeated in the whole TC. This pilot study examined electromyography and retro-reflective marker trajectory data to investigate neuromuscular control strategies of the lower extremity during BKTS in TC practitioners with and without knee pain. Twelve experienced TC practitioners with (n = 6) and without knee pain (n = 6) participated. Our results revealed that knee pain practitioners presented muscle imbalance in the vastus medialis-vastus lateralis and vastus lateralis-biceps femoris, and poor alignment of the knee with the toes in TC lunge. Additionally, they adaptively developed rigid coordination strategies, showing higher levels of lower limb muscle co-contraction and activity compared to controls. Training programs for TC practitioners with knee pain should be designed to modify both abnormal muscle synergy patterns and incorrect lunge during TC, which may improve exercise safety.
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Affiliation(s)
- Hong Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaolin Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yaping Li
- Department of Rehabilitation, Fujian Provincial Hospital, Fuzhou, China
| | - Zhen Gao
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- The First Clinical Medical College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Wujie Huang
- Department of Rehabilitation, Shenzhen Children's Hospital, Shenzhen, China
| | - Zheng Jiang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Tsang SMH, Chan EHW, Chan JYH, Huang GPY, Lam KKT, Lam EWY, Fu ACL, Sun ER. Reactive postural adjustment in response to predictable and unpredictable perturbations in healthy adults: A comparison between swayback, hyperlordotic and erect postures. Gait Posture 2024; 108:35-43. [PMID: 37980833 DOI: 10.1016/j.gaitpost.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 10/11/2023] [Accepted: 11/01/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Promoting an erect posture in standing has been advocated to offer superior protection to the spine when compared to hyperlordotic and swayback postures. RESEARCH QUESTION Do postural adjustments towards external perturbation differ between erect, hyperlordotic and swayback postures? If so, which posture offers better protection to lumbar spine? METHODS Forty-four healthy adults received top-down perturbations under unpredictable (without visual-and-auditory input) and predictable (with visual-and-auditory input) conditions in three simulated postures: erect, hyperlordotic, and swayback. Postural adjustments namely the centre of pressure parameters, joint angle onsets, and neuromuscular responses measured by muscle onsets and co-contraction between muscle pairs upon the perturbation were compared using the two-way repeated measures ANOVA. Post-hoc analysis with Bonferroni correction was conducted to identify the between-posture differences for the respective postural adjustment parameters. RESULTS Path length, ellipse area and average velocity of centre of pressure were significantly greater under unpredictable condition as compared to predictable condition (p < 0.001). Significant between-posture difference was detected in centre of pressure path length (p < 0.035), pelvic tilt onset (p < 0.038) and all muscle co-contraction indexes (p < 0.001). Post-hoc analysis revealed significantly smaller centre of pressure path length in erect posture as compared to hyperlordotic and swayback postures (p < 0.01) under unpredictable conditions. Significantly greater co-contraction indexes of lumbar multifidus and erector spinae, and internal oblique and lumbar multifidus were found in hyperlordotic as compared to erect and swayback postures (p < 0.05). SIGNIFICANCE Compared to erect posture, adoption of hyperlordotic and swayback postures altered the contributions of the active and passive subsystems of the spine that regulates postural control upon external perturbations. Such differences in neuromuscular control may lessen the capacity of the human spine to withstand loading and shear forces. Prospective studies are required to validate if habitually adopted hyperlordotic and swayback postures contribute to an earlier/ higher prevalence of spinal dysfunctions.
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Affiliation(s)
- Sharon M H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
| | - Evest H W Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jason Y H Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Gladys P Y Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Kelly K T Lam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Eunice W Y Lam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Allan C L Fu
- Faculty of Medicine and Health, University of Sydney, Australia
| | - Eliza R Sun
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Ma Y, Gow BJ, Song R, Rist PM, Hausdorff JM, Lipsitz LA, Manor B, Wayne PM. Long-term Tai Chi practice in older adults is associated with "younger" functional abilities. Aging Cell 2024; 23:e14023. [PMID: 37905388 PMCID: PMC10776109 DOI: 10.1111/acel.14023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023] Open
Abstract
Age-related alterations in physiology lead to declines in physical function that are associated with numerous adverse outcomes among older adults. Utilizing a hybrid design, we aimed to understand whether both long-term and short-term Tai Chi (TC) training are associated with age-related decline in physical function in healthy older adults. We first conducted cross-sectional comparisons among TC-naïve older adults (n = 60, 64.2 ± 7.7 years), TC-expert older adults (n = 27, 62.8 ± 7.6 years, 24.5 ± 12 years experience), and TC-naïve younger adults (n = 15, 28.7 ± 3.2 years) to inform long-term effects of TC training on physical function, including single leg stance time with eyes closed, grip strength, Timed Up and Go, maximum walking speed, functional reach, and vertical jump for lower-extremity power. There were significant differences among the three groups on all the six tests. For most functional tests, TC-experts performed better than age-matched TC-naïve controls and were statistically indistinguishable from young healthy adult controls. Long-term TC training was associated with higher levels of physical function in older adults, suggesting a potential preventative healthy aging effect. In the randomized longitudinal trial, TC-naïve subjects were randomized (n = 31 to Tai Chi group, n = 29 to usual care control group) to evaluate the short-term effects of TC over 6 months on all outcomes. TC's short-term impacts on physical function were small and not statistically significant. The impact of short-term training in healthy adults is less clear. Both potential longer-term preventive effects and shorter-term restorative effects warrant further research with rigorous, adequately powered controlled clinical trials.
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Affiliation(s)
- Yan Ma
- Osher Center for Integrative Health, Division of Preventive MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Brian J. Gow
- Osher Center for Integrative Health, Division of Preventive MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
- Laboratory for Computational Physiology (LCP)Massachusetts Institute of TechnologyCambridgeMassachusettsUSA
| | - Rhayun Song
- College of NursingChungnam National UniversityDaejeonKorea
| | - Pamela M. Rist
- Division of Preventive MedicineBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Jeffrey M. Hausdorff
- Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center; Sagol School of Neuroscience and Department of Physical Therapy, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
- Department of Orthopedic Surgery and Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Lewis A. Lipsitz
- Hinda and Arthur Marcus Institute for Aging ResearchHebrew SeniorLifeBostonMassachusettsUSA
- Division of Gerontology, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging ResearchHebrew SeniorLifeBostonMassachusettsUSA
- Division of Gerontology, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
| | - Peter M. Wayne
- Osher Center for Integrative Health, Division of Preventive MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
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Yu H, Wang J, Mao M, Song Q, Zhang C, Fong DTP, Sun W. Muscle co-contraction and pre-activation in knee and ankle joint during a typical Tai Chi brush-knee twist-step. Res Sports Med 2023; 31:628-637. [PMID: 34957881 DOI: 10.1080/15438627.2021.2020788] [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: 10/08/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
Abstract
This study aimed to investigate the co-contraction and pre-activation of agonistic and antagonistic muscles in experienced Tai Chi (TC) practitioners during normal walking (NW) and brush-knee twist-step (BKTS). The electromyographic activities of rectus femoris, biceps femoris, and tibialis anterior and lateral gastrocnemius muscles were collected during BKTS and NW in 28 TC practitioners. The pre-activation of knee and ankle joints before initial landing of left foot, and the co-contraction of knee and ankle joint in double-stance phase I (DSI), single-stance phase (SS), double-stance phase II (DSII), and swing phase (SW) were calculated during BKTS and NW. Ankle co-contraction significantly increased during DSI and SS in BKTS movements than compared with that in NW. For DSI and SW, SS and DSII, and DSII and SW, a significant difference was found in BKTS. The pre-activation of knee joint significantly decreased in BKTS and NW. This study indicated greater ankle joint muscle co-contraction in DSI and SS of stance phase and lower knee joint muscle co-contraction and pre-activation than in NW in BKTS movement. In addition, greater ankle joint muscle co-contraction was observed in the DSI, SS, and DSII of stance phase than those of swing phase in BKTS movement.
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Affiliation(s)
- Hao Yu
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - JiangNa Wang
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Min Mao
- School of Nursing and Rehabilitation Shandong University, Jinan, China
| | - QiPeng Song
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Cui Zhang
- Lab of Biomechanics, Shandong Institute of Sport Science, Jinan, China
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Wei Sun
- College of Sports and Health, Shandong Sport University, Jinan, China
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Faisal MAA, Chowdhury MEH, Khandakar A, Hossain MS, Alhatou M, Mahmud S, Ara I, Sheikh SI, Ahmed MU. An investigation to study the effects of Tai Chi on human gait dynamics using classical machine learning. Comput Biol Med 2022; 142:105184. [PMID: 35016098 DOI: 10.1016/j.compbiomed.2021.105184] [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: 10/31/2021] [Revised: 12/16/2021] [Accepted: 12/26/2021] [Indexed: 11/03/2022]
Abstract
Tai Chi has been proven effective in preventing falls in older adults, improving the joint function of knee osteoarthritis patients, and improving the balance of stroke survivors. However, the effect of Tai Chi on human gait dynamics is still less understood. Studies conducted in this domain only relied on statistical and clinical measurements on the time-series gait data. In recent years machine learning has proven its ability in recognizing complex patterns from time-series data. In this research work, we have evaluated the performance of several machine learning algorithms in classifying the walking gait of Tai Chi masters (people expert on Tai Chi) from the normal subjects. The study is designed in a longitudinal manner where the Tai Chi naive subjects received 6 months of Tai Chi training and the data was recorded during the initial and follow-up sessions. A total of 57 subjects participated in the experiment among which 27 were Tai Chi masters. We have introduced a gender, BMI-based scaling of the features to mitigate their effects from the gait parameters. A hybrid feature ranking technique has also been proposed for selecting the best features for classification. The research reports 88.17% accuracy and 93.10% ROC AUC values from subject-wise 5-fold cross-validation for the Tai Chi masters' vs normal subjects' walking gait classification for the "Single-task" walking scenarios. We have also got fairly good accuracy for the "Dual-task" walking scenarios (82.62% accuracy and 84.11% ROC AUC values). The results indicate that Tai Chi clearly has an effect on the walking gait dynamics. The findings and methodology of this study could provide preliminary guidance for applying machine learning-based approaches to similar gait kinematics analyses.
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Affiliation(s)
- Md Ahasan Atick Faisal
- Department of Electrical and Electronic Engineering, University of Dhaka, Dhaka, 1000, Bangladesh
| | | | - Amith Khandakar
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar
| | - Md Shafayet Hossain
- Department of Electrical, Electronics and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi, Selangor, 43600, Malaysia
| | - Mohammed Alhatou
- Neuromuscular Division, Hamad General Hospital and Department of Neurology, Alkhor Hospital, Doha, 3050, Qatar
| | - Sakib Mahmud
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar
| | - Iffat Ara
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar
| | - Shah Imran Sheikh
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar
| | - Mosabber Uddin Ahmed
- Department of Electrical and Electronic Engineering, University of Dhaka, Dhaka, 1000, Bangladesh.
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Meta-Analysis of Elderly Lower Body Strength: Different Effects of Tai Chi Exercise on the Knee Joint-Related Muscle Groups. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2021:8628182. [PMID: 34976101 PMCID: PMC8716219 DOI: 10.1155/2021/8628182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/09/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine whether lower body strength such as keen extension and flexion strength may be improved by Tai Chi exercise in older adults from the perspective of evidence-based medicine. METHODS Databases of PubMed, Embase, and Cochrane Library were searched up to July 1, 2021. Randomized clinical trials are adopted to compare Tai Chi exercise with sedentary behavior or other low intensity exercise in terms of influence on lower body strength rehabilitation, especially keen extension and flexion strength in people aged over 60. A meta-analysis was performed to discuss outcomes of lower body strength, knee muscle strength, and knee extension/flexion strength. RESULTS A total of 25 randomized trials involving 1995 participants fulfilled the inclusion criteria. (1) Tai Chi exercise significantly improved elderly lower body strength (-0.54, [-0.81, -0.28], p < 0.00001, I 2 = 74%), but there was no differential improvement in the strength of the knee joints (0.10, [-0.02, 0.23], p=0.11, I 2 = 34%). (2) Elderly individual lower body strength declined with age, while this trend was suppressed by Tai Chi exercise (-0.35, [0.14, 0.56], p=0.001, I 2 = 70%). (3) Although Tai Chi exercise did no significantly improve the large muscle group of knee joint extensor like quadriceps femoris (3.15, [-0.69, 6.99], p=0.24, I 2 = 26%), it showed marked enhancement to the strength of deep small muscle group of knee joint flexor (10.25, [6.90, 13.61], p < 0.00001, I 2 = 0%). The heterogeneity might be caused by distinguished measurements of muscle strength. Therefore, Tai Chi exercise specifically enhanced some certain muscle strength of knee joints and improved muscle fitness rehabilitation as well as function activity for elderly. CONCLUSIONS In this RCT meta-analysis, Tai Chi exercise has positive effects on lower body strength of elderly. Although no obvious improvement on the knee extensor is observed, it may be used as a rehabilitation treatment for training stable deep muscle groups to improve the knee flexion strength significantly.
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