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Cui J, Hao Z, Tian H, Yang Y, Wang J, Lin X. The effects of Tai Chi on standing balance control in older adults may be attributed to the improvement of sensory reweighting and complexity rather than reduced sway velocity or amplitude. Front Aging Neurosci 2024; 16:1330063. [PMID: 38650868 PMCID: PMC11033441 DOI: 10.3389/fnagi.2024.1330063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/18/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction Tai Chi has proved to be an effective therapy for balance performance and cognition. However, non-consistency exists in the results of the effect of Tai Chi training on standing balance control in older adults. This study aimed to use traditional and non-traditional methods to investigate the effect of Tai Chi on standing balance in older adults. Methods Thirty-six Tai Chi practitioners (TC group) and thirty-six older adults with no Tai Chi practice (control group) were recruited in this study. A Nintendo Wii Balance Board was used to record the center of pressure (COP) during standing balance over 20 s in the condition of eyes closed with three repetitions. The wavelet analysis, multiscale entropy, recurrence quantification analysis, and traditional methods were used to evaluate the standing balance control in the anterior-posterior (AP) and mediolateral (ML) directions. Results (1) Greater sway mean velocity in the AP direction and sway Path length were found in the TC group compared with the control group; (2) lower Very-low frequency band (0.10-0.39 Hz) and higher Moderate frequency band (1.56-6.25 Hz) in the AP and ML directions were found in the TC group compared with the control group; (3) greater complexity index (CI) and lower determinism (DET) in the AP and ML directions were observed in the TC group compared with control group; (4) greater path length linked with smaller Very-low frequency band in the AP and ML directions and higher Moderate frequency band in the AP direction in both groups; (5) greater path length linked with lower DET and higher CI in the AP direction only in the TC group. Conclusion Long-term Tai Chi practice improved sensory reweighting (more reliance on the proprioception system and less reliance on the vestibular system) and complexity of standing balance control in older adults. In addition, greater sway velocity may be as an exploratory role in standing balance control of TC older adults, which correlated with greater complexity, but no such significant relationship in the control group. Therefore, the effects of Tai Chi practice on standing balance control in older adults may be attributed to the improvement of sensory reweighting and complexity rather than reduced sway velocity or amplitude.
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Affiliation(s)
- Jianhua Cui
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Zengming Hao
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haibo Tian
- School of Teacher Education, Shaoxing University, Shaoxing, China
| | - Yi Yang
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Jian Wang
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
- Center for Psychological Sciences, Zhejiang University, Hangzhou, China
| | - Xiaomei Lin
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
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Li DE, Chiang JL, Loh ZHM, Zainuldin R. Taekwondo Poomsae practise in slow motion and the balance of healthy older adults: A Pre-Experimental Study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e2027. [PMID: 37313781 DOI: 10.1002/pri.2027] [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: 01/14/2023] [Revised: 05/18/2023] [Accepted: 06/05/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND PURPOSE Poor balance confidence and functional balance can lead to falls in community-dwelling older adults. Exercises utilising slow movements have been shown to improve balance in this population. It is hypothesised that by superimposing the use of slow movements onto Taekwondo Poomsae, there could be similar benefits in improving balance confidence and functional balance in older adults. METHODS This was a pre - experimental study. Fifteen community-dwelling older adults received 11 weeks of Slow Poomsae (SP) training using a proposed 50-min protocol. Pre- and post-intervention scores of the Activities-Specific Balance Confidence Simplified Scale (ABC-S), Berg Balance Scale (BBS), Dynamic Gait Index (DGI), and 'Timed Up and Go' test (TUG) assessments were recorded and compared. RESULTS Fifteen eligible participants with mean and standard deviation (SD) of age 73.8 (6.05) years completed the study. Significant improvements (p < 0.05) were seen in the pre-post differences between ABC-S, BBS, DGI, and TUG, with median score changes of 15 points (Z = -3.408), 3 points (Z = -3.306), 3 points (Z = -2.852), and 3.5 s (Z = -3.296) respectively. CONCLUSION The preliminary findings support the efficacy of SP as a potential balance training programme that is safe for healthy older adults to improve their balance confidence and functional balance. More research is required on this topic that leans towards a large population blinded randomised controlled trial with a longer intervention period and inclusion of a follow-up to further elucidate the effects of long-term practice and novelty of SP.
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Affiliation(s)
- Derong Eric Li
- Physiotherapy, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Ji Long Chiang
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | - Zhi Hao Melvin Loh
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | - Rahizan Zainuldin
- Physiotherapy, Ng Teng Fong General Hospital, Singapore, Singapore
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
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Troisi Lopez E, Liparoti M, Passarello N, Lucidi F, Mandolesi L. Multimodal Physical Exercise Affects Visuo-Spatial Working Memory: Preliminary Evidence from a Descriptive Study on Tai-Chi Practitioners and Runners. Brain Sci 2023; 13:1400. [PMID: 37891768 PMCID: PMC10605525 DOI: 10.3390/brainsci13101400] [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: 07/29/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023] Open
Abstract
Recent evidence has shown a relationship between physical exercise (PE) and cognitive functioning. However, it is unknown if unimodal and multimodal modalities of PE affect cognitive abilities in different ways. To fill this gap, we analyzed the effects of unimodal PE (running) and multimodal PE (Tai Chi) on specific cognitive abilities. A sample of 33 participants (mean age = 52.6 ± 7.2) divided into eleven runners, eleven Tai Chi practitioners, and eleven age-matched sedentary individuals were subjected to a neuropsychological tests battery to assess shifting and problem solving abilities (Rule Shift Cards, BADS-RS, and Key Search tasks), verbal fluency (semantic and phonemic verbal fluency tasks), verbal memory (Rey's 15 words test), visuo-spatial working memory (Corsi test), and global cognitive functioning (clock-drawing test). The results showed significantly higher BADS-RS scores in runners and Tai Chi practitioners in comparison to the sedentary participants, thus evidencing improved shifting abilities for active individuals. Interestingly, post hoc analysis showed significantly higher span scores of Corsi test only in Tai Chi practitioners as compared to sedentary participants, suggesting how multimodal PE facilitates the visuo-spatial working memory processes. Although preliminary, our descriptive study indicates that the type of PE could modulate specific cognitive domains, even if the practice of motor activity favors a global cognitive improvement.
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Affiliation(s)
- Emahnuel Troisi Lopez
- Institute of Applied Sciences and Intelligent Systems, National Research Council, 80078 Pozzuoli, Italy;
| | - Marianna Liparoti
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, University of Roma “Sapienza”, 00185 Rome, Italy; (M.L.); (F.L.)
| | - Noemi Passarello
- Department of Humanities, University of Naples Federico II, 80138 Naples, Italy;
| | - Fabio Lucidi
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, University of Roma “Sapienza”, 00185 Rome, Italy; (M.L.); (F.L.)
| | - Laura Mandolesi
- Department of Humanities, University of Naples Federico II, 80138 Naples, Italy;
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Lee C, Ahn J, Lee BC. A Systematic Review of the Long-Term Effects of Using Smartphone- and Tablet-Based Rehabilitation Technology for Balance and Gait Training and Exercise Programs. Bioengineering (Basel) 2023; 10:1142. [PMID: 37892872 PMCID: PMC10604191 DOI: 10.3390/bioengineering10101142] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/13/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
Recent advances in wearable motion sensors, mobile devices, the Internet of Things, and telecommunications have created new potential for telerehabilitation. Recognizing that there is no systematic review of smartphone- or tablet-based balance and gait telerehabilitation technology for long-term use (i.e., four weeks or more), this systematic review summarizes the effects of smartphone- or tablet-based rehabilitation technology on balance and gait exercise and training in balance and gait disorders. The review examined studies written in English published from 2013 to 2023 in Web of Science, Pubmed, Scopus, and Google Scholar. Of the 806 studies identified, 14 were selected, and the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was applied to evaluate methodological quality. The systematic review concluded that all 14 studies found balance and gait performance improvement after four weeks or more of balance and gait telerehabilitation. Ten of the 14 studies found that carry-over effects (improved functional movements, muscle strength, motor capacity, cognition, and reduced fear of falling and anxiety levels) were maintained for weeks to months. The results of the systematic review have positive technical and clinical implications for the next-generation design of rehabilitation technology in balance and gait training and exercise programs.
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Affiliation(s)
- Chihyeong Lee
- Department of Physical Education, Seoul National University, Seoul 08826, Republic of Korea;
| | - Jooeun Ahn
- Department of Physical Education, Seoul National University, Seoul 08826, Republic of Korea;
- Institute of Sport Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Beom-Chan Lee
- Institute of Sport Science, Seoul National University, Seoul 08826, Republic of Korea
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, USA
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Gravesande J, Almeida de Oliveira L, Malik N, Vrkljan B, Zheng R, Gardner PM, Carlesso LC. Feasibility, Usability, and Acceptability of Online Mind-Body Exercise Programs for Older Adults: A Scoping Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:538-549. [PMID: 36944159 DOI: 10.1089/jicm.2022.0822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Objectives: Engaging in mind-body exercises (MBEs: e.g., Tai Chi and yoga) can have physical and mental health benefits particularly for older adults. Many MBEs require precise timing and coordination of complex body postures posing challenges for online instruction. Such challenges include difficulty viewing instructors as they demonstrate different movements and lack of feedback to participants. With the shift of exercise programs to online platforms during the COVID-19 pandemic, we conducted a scoping review to examine the feasibility, usability, and acceptability of online MBE classes for older adults. Materials and Methods: We followed the scoping review methodology and adhered to the PRISMA reporting checklist. We searched five databases: Medline, Embase, CINHAL, Web of Science, and ACM digital library. Screening of articles and data extraction was conducted independently by two reviewers. Settings/Location: Online/virtual. Subjects: Older adults ≥55 years of age. Outcome Measures: Feasibility measures. Results: Of 6711 studies retrieved, 18 studies were included (715 participants, mean age 66.9 years). Studies reported moderate to high retention and adherence rates (mean >75%). Older adults reported online MBE classes were easy to use and reported high satisfaction with the online format. We also identified barriers (e.g., lack of space and privacy and unstable internet connection) and facilitators (e.g., convenience and technical support) to the online format. Opinions related to social connectedness were mixed. Conclusion: Online MBE programs for older adults appear to be a feasible and acceptable alternative to in-person programs. It is important to consider the type of exercise (e.g., MBE), diverse teaching styles, and learner needs when designing online exercise classes.
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Affiliation(s)
| | | | - Natasha Malik
- Department of Communication Studies and Media Arts and McMaster University, Hamilton, Canada
| | - Brenda Vrkljan
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Rong Zheng
- Department of Computing and Software, McMaster University, Hamilton, Canada
| | - Paula M Gardner
- Department of Communication Studies and Media Arts and McMaster University, Hamilton, Canada
| | - Lisa C Carlesso
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
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Law NY, Li JX, Zhu Q, Nantel J. Effects of a biomechanical-based Tai Chi program on gait and posture in people with Parkinson's disease: study protocol for a randomized controlled trial. Trials 2023; 24:241. [PMID: 37386473 DOI: 10.1186/s13063-023-07146-x] [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: 05/22/2021] [Accepted: 02/08/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is associated with changes in gait and posture, which increases the rate of falls and injuries in this population. Tai Chi (TC) training enhances the movement capacity of patients with PD. However, the understanding of the effect of TC training on gait and postural stability in PD is lacking. This study aims to examine the effect of biomechanical-based TC training on dynamic postural stability and its relationship with walking performance. METHODS/DESIGN A single-blind, randomized control trial of 40 individuals with early-stage PD was conducted (Hoehn and Yahr stages 1 to 3). Patients with PD will be randomly assigned to either the TC or control group. The TC group will participate in a biomechanical-based TC training program that is formed based on the movement analysis of TC and will be practiced thrice a week for 12 weeks. The control group will be required to engage in at least 60 min of regular physical activity (PA) on their own for three times per week for 12 weeks. The primary and secondary outcomes will be assessed at baseline and at 6 and 12 weeks after commencing the study protocol. The primary outcome measures will include dynamic postural stability indicated by the center of mass and center of pressure separation distance and clearance distance of the heel and toe measured during fixed-obstacle crossing. The secondary measures are gait speed, cadence, step length during level surface walking (simple task), and fixed-obstacle crossing (challenging task). The Unified Parkinson's Disease Rating Scale, single leg-stance test with eyes open and closed, and three cognitive scores (Stroop Test, Trail Making Test Part B, and the Wisconsin Card Sorting Test) were also employed. DISCUSSION This protocol could lead to the development of a biomechanics TC training program for the improvement of gait and postural stability among individuals with PD. The program could enhance the understanding of the effect of TC training on gait and postural stability and could help improve or preserve the postural stability, self-confidence, and active participation in social activities of the participants, thus enhancing their overall quality of life. TRIAL REGISTRATION ClinicalTrials.gov NCT04644367. Registered on 25 November 2020.
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Affiliation(s)
- Nok-Yeung Law
- Schools of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| | - Jing Xian Li
- Schools of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| | - Qingguang Zhu
- Research Institute of Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Julie Nantel
- Schools of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Hariri R, Nakhostin-Ansari A, Mohammadi F, Memari AH, Oskouie IM, Haghparast A. An Overview of the Available Intervention Strategies for Postural Balance Control in Individuals with Autism Spectrum Disorder. AUTISM RESEARCH AND TREATMENT 2022; 2022:3639352. [PMID: 36452121 PMCID: PMC9705119 DOI: 10.1155/2022/3639352] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 10/30/2022] [Accepted: 11/15/2022] [Indexed: 04/03/2024]
Abstract
BACKGROUND Postural instability is a prevalent issue among individuals with autism spectrum disorder (ASD) that affects the development of their perceptual-motor skills and social functioning. Visual and somatosensory processing deficits, hypotonia, basal ganglia dysfunction, and anxiety are some of the concurrent disorders in individuals with ASD. Nevertheless, a definite management protocol for postural instability in ASD has not been introduced yet. Hence, we aim to shed light on the available intervention strategies for postural instability in individuals with ASD. METHODS Even though several studies have been conducted on the effects of various interventions for balance control in individuals with ASD, no study has compared their efficacy, limitations, and clinical implications. RESULTS This review discusses diverse proposed interventions contributing to ASD postural instability, including martial arts, water-based interventions, animal-assisted therapies, trampoline, balance training, vestibular therapy, transcranial direct current stimulation, sports, play, and active recreation for kids (SPARK), and square-stepping exercise (SSE). CONCLUSION Enhancing motor skills, cerebellum function, and sensory input integration were some of the main mechanisms of these interventions to improve balance control in ASD. Some interventions, such as water-based exercises and video games, were enjoyable for children with ASD and could raise their treatment adherence. In most studies, small sample sizes and the lack of a control group represented their major limitations. Therefore, future well-designed randomized controlled trials are required to assess the effects of available interventions on postural control in ASD.
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Affiliation(s)
- Rabeeh Hariri
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mohammadi
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Memari
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Iman Menbari Oskouie
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Afarin Haghparast
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Chen J, Xue X, Xu J, Zeng J, Xu F. Emerging Trends and Hotspots in Tai Chi Fall Prevention: Analysis and Visualization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148326. [PMID: 35886172 PMCID: PMC9320470 DOI: 10.3390/ijerph19148326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023]
Abstract
Recently, substantial studies have increased around the topic of the tai chi fall-prevention field. Few studies, however, have revealed the current progress and hotspots under a bibliometric analysis. Therefore, the present study aimed to conduct Citespace, a significant application for bibliometric analysis, to carry out the situation and trend in this field. This study has identified the core countries are the United States, China, Australia, and England, which are also the origins of the core institutions. Besides this, we also have found two large research groups led by Li and Sherrington. Moreover, the result has revealed that J Aging Phys Act and J Am Geriatr Soc are the primary journals. Geriatrics and gerontology, sport sciences, rehabilitation, and gerontology are the leading categories. Furthermore, one of the more important findings to come out in this study are that “elderly”, “Parkinson’s disease”, “vestibular rehabilitation”, “frail patient”, and “community fall prevention” are the research hotspots. “Women”, “proprioception”, “cognitive impairment”, “dementia”, “osteoarthritis”, and “stroke” are the potential research trend in the future. These findings suggest that the tai chi fall-prevention field has a broad research prospect. Although several questions remain uncertain currently, it is worthy for scholars to do further study.
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Affiliation(s)
- Jiesi Chen
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
| | - Xin Xue
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
| | - Jing Xu
- School of Physical Education, Nanjing Xiaozhuang University, Nanjing 211171, China;
| | - Jinshu Zeng
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
| | - Fei Xu
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
- Correspondence:
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Law NY, Li JX. Biomechanics analysis of seven Tai Chi movements. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:245-252. [PMID: 36600972 PMCID: PMC9806716 DOI: 10.1016/j.smhs.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 01/07/2023] Open
Abstract
This study examined the maximum joint angles and moments, and electromyography (EMG) activity of the lower limbs in an experienced Tai Chi (TC) practitioner in performing four dynamic (Repulse Monkey, Wave-hand in Clouds, Brush Knee Twist Step, and Lateral Forward Step) and three static TC movements (Starting Form, Hero Touch Sky, and Push Hand Back) and compared them with the measures from walking. Integrated EMG (iEMG) and peak EMG of the rectus femoris, adductor longus, tibialis anterior, semitendinosus, erector spinae, gluteus medius, tensor fasciae latae, medial and lateral gastrocnemius muscles were analyzed. One-way analysis of variance showed that compared with walking, TC presented 1) significantly larger hip flexion (71.4° vs. 42.2°) and abduction angles (11.9° vs. 5.3°), smaller knee flexion (45.2° vs. 71.1°) and abduction angles (13.0° vs. 27.7°), larger ankle dorsiflexion (41.4° vs. 11.3°) and abduction angles (8.8° vs. 7.2°); 2) hip flexion moment and knee flexion and abduction moment were significantly larger. Ankle dorsiflexion moment were significantly smaller, whereas ankle abduction moment was significantly larger in two TC movements; and 3) the EMG activity of the muscles in TC varied from 10% to 610% of walking. The knee extensors, hip adductors and abductors had significantly higher peak EMG (430% ± 40%, 240% ± 30%, and 320% ± 90%) and iEMG values (610% ± 30%, 311% ± 30%, and 1.4% ± 20%), respectively. The findings suggested that these TC movements could be a good option for the improvement of muscle strength and range of motion of the lower limbs.
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Affiliation(s)
| | - Jing Xian Li
- Corresponding author. School of Human Kinetics, University of Ottawa, Ottawa, K1N 6N5, Canada.
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Zahedian-Nasab N, Jaberi A, Shirazi F, Kavousipor S. Effect of virtual reality exercises on balance and fall in elderly people with fall risk: a randomized controlled trial. BMC Geriatr 2021; 21:509. [PMID: 34563120 PMCID: PMC8465759 DOI: 10.1186/s12877-021-02462-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 09/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Deficient balance and fear of falling in elderly people can lead to disturbed daily activities, falling, and finally reduced quality of life. Therefore, evaluation of low-risk methods that might partially improve balance in this group of people is of utmost importance. The present study aimed to investigate the impact of Virtual Reality (VR) exercises based on Xbox Kinect on balance and fear of falling among elderly people. METHODS This clinical trial was performed on 60 elderly individuals living in nursing homes divided into two groups of control and Xbox. The participants in the intervention group received VR exercises based on Xbox Kinect in form of two 30-45-min sessions held on a weekly basis for 6 weeks. The individuals in the control group, on the other hand, received routine exercises of the nursing homes. The research tools used in this study included a demographic questionnaire, the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test, and the Falling Efficacy Scale (FES). RESULTS The findings of the current study demonstrated that the scores of BBS and TUG test as the indices of balance among elderly people improved significantly in the Xbox group after the intervention (p < 0.001 for both BBS and TUG test). Moreover, the score of fear of falling diminished significantly in the intervention group compared to the control group (p < 0.001). CONCLUSION According to the results of the present investigation, 6 weeks of VR balance exercises could enhance balance and fear of falling among elderly people living in nursing homes. TRIAL REGISTRATION Code: IRCT20190727044347N1 , Date: 17-8-2019.
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Affiliation(s)
- Noorolla Zahedian-Nasab
- Student Resarch Committe, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Jaberi
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Shirazi
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Somayyeh Kavousipor
- Occupational Therapy Department, School of Rehabilitation Sciences, Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Litrownik D, Gilliam EA, Wayne PM, Richardson CR, Kadri R, Rist PM, Moy ML, Yeh GY. Development of a Novel Intervention (Mindful Steps) to Promote Long-Term Walking Behavior in Chronic Cardiopulmonary Disease: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e27826. [PMID: 33913819 PMCID: PMC8120426 DOI: 10.2196/27826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/14/2021] [Accepted: 02/22/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Despite current rehabilitation programs, long-term engagement in physical activity remains a significant challenge for patients with chronic obstructive pulmonary disease (COPD) and heart failure (HF). Novel strategies to promote physical activity in these populations are greatly needed. Emerging literature on the benefits of both mind-body interventions and web-based interventions provide the rationale for the development of the Mindful Steps intervention for increasing walking behavior. OBJECTIVE This study aims to develop a novel multimodal mind-body exercise intervention through adaptation of an existing web-based physical activity intervention and incorporation of mind-body exercise, and to pilot test the delivery of the new intervention, Mindful Steps, in a randomized controlled feasibility trial in older adults with COPD and/or HF. METHODS In phase 1, guided by a theoretical conceptual model and review of the literature on facilitators and barriers of physical activity in COPD and HF, we convened an expert panel of researchers, mind-body practitioners, and clinicians to inform development of the novel, multimodal intervention. In phase 2, we are conducting a pilot randomized controlled feasibility trial of the Mindful Steps intervention that includes in-person mind-body exercise classes, an educational website, online mind-body videos, and a pedometer with step-count feedback and goals to increase walking behavior in patients with COPD and/or HF. Outcomes include feasibility measures as well as patient-centered measures. RESULTS The study is currently ongoing. Phase 1 intervention development was completed in March 2019, and phase 2 data collection began in April 2019. CONCLUSIONS Through the integration of components from a web-based physical activity intervention and mind-body exercise, we created a novel, multimodal program to impact long-term physical activity engagement for individuals with COPD and HF. This developmental work and pilot study will provide valuable information needed to design a future clinical trial assessing efficacy of this multimodal approach. TRIAL REGISTRATION ClinicalTrials.gov NCT03003780; https://clinicaltrials.gov/ct2/show/NCT03003780. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/27826.
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Affiliation(s)
- Daniel Litrownik
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Elizabeth A Gilliam
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States
| | | | - Reema Kadri
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Pamela M Rist
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States
| | - Marilyn L Moy
- Pulmonary and Critical Care Section, Department of Medicine, Veterans Administration Boston Healthcare System, Boston, MA, United States
| | - Gloria Y Yeh
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States
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12
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Yang SY, Lee HC, Huang CM, Chen JJ. Efficacy of Tai Chi-Style Multi-Component Exercise on Frontal-Related Cognition and Physical Health in Elderly With Amnestic Mild Cognitive Impairment. FRONTIERS IN AGING 2021; 2:636390. [PMID: 35822039 PMCID: PMC9261301 DOI: 10.3389/fragi.2021.636390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/17/2021] [Indexed: 02/06/2023]
Abstract
Early prevention from accelerated neurocognitive declines with advanced aging and the delay of the onset of dementia have became paramount for the achievement of active aging. The present study examined whether the proposed non-pharmaceutical, multi-component exercise training which combined Tai-Chi exercise, Aerobic fitness, and thera-band therapy protects against age-related neurocognitive and physical deterioration in the older participants with amnestic mild cognitive impairment (aMCI). Participants with aMCI in the quasi-experimental design were assigned to the multi-component exercise group or care control group. Evaluations of neuropsychological function and functional fitness were performed before and after 12-weeks intervention, and after 24-weeks follow-up. Our results showed that the multi-component intervention significantly improved various domains of neurocognitive function, particularly in memory- and frontal-related cognition, and better performance on functional fitness, including muscle strength, cardiopulmonary endurance, and agility. Furthermore, such beneficial effects were preserved after 24 weeks. The findings provide supportive evidence that non-pharmaceutically multi-component intervention with Tai-Chi style practice as a core exercise may protect against age-related neurocognitive and physical deficits and lay the path on developing age-friendly intervention programs to delay, or even reverse, the progression of MCI to dementia.
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Affiliation(s)
- Shao-Yun Yang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sports and Health Science Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsuei-Chen Lee
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sports and Health Science Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-devices (IDSB), National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- *Correspondence: Chih-Mao Huang, ; Jin-Jong Chen,
| | - Jin-Jong Chen
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sports and Health Science Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Innovation Center of Artificial Intelligence for Precision Exercise and Health Promotion, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- *Correspondence: Chih-Mao Huang, ; Jin-Jong Chen,
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13
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Effects of Tai Chi on Patients with Mild Cognitive Impairment: A Systematic Review and Meta-analysis of Randomized Controlled Trials. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5530149. [PMID: 33977103 PMCID: PMC8087475 DOI: 10.1155/2021/5530149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/28/2021] [Accepted: 04/02/2021] [Indexed: 12/02/2022]
Abstract
Design Randomized controlled trials (RCTs) from multiple databases from inception to December 2020 published in English were searched. Two researchers independently performed eligible study screening and data extraction. The methodological quality was assessed with the Jadad score. Meta-analysis of RCTs on TC in the treatment of MCI was performed with RevMan Version 5.4.1. Results Seven RCTs with 1265 participants were included. For most RCTs, the overall reporting of methodological quality was high. Results of the meta-analysis indicate that TC improved MCI patients' cognitive function significantly, including overall cognitive function (MD = −2.24, 95% CI -3.51 to -0.97, P = 0.0005), memory and learning (SMD = 0.83, 95% CI 0.22 to 1.45, P = 0.008), visuospatial ability (MD = 3.15, 95% CI 0.74 to 5.56, P = 0.01), executive functions (MD = 0.32, 95% CI 0.03 to 0.61, P = 0.03), and physical activity (MD = 18.78, 95% CI 10.80 to 26.76, P < 0.00001). However, no significant benefit was found for TC on psychological activity (MD = 0.17, 95% CI -0.62 to 0.96, P = 0.36) and biomarker improvement. Conclusion The meta-analysis confirmed the clinical therapeutic effect of TC for MCI. More rigorous and long-term follow-up RCTs should be conducted in the future.
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Wang LC, Ye MZ, Xiong J, Wang XQ, Wu JW, Zheng GH. Optimal exercise parameters of tai chi for balance performance in older adults: A meta-analysis. J Am Geriatr Soc 2021; 69:2000-2010. [PMID: 33769556 DOI: 10.1111/jgs.17094] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Tai chi is considered a safe and low-cost treatment for improving balance ability among an older population. However, there is no existing evidence on the optimal exercise parameters of tai chi for improving balance in older adults. OBJECTIVES To investigate the optimal parameters of a tai chi intervention to improve balance performance of older adults. DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs). SETTING PubMed, Embase, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure, Wanfang, Chinese Science and Technology Periodical and China Biology Medicine were searched from inception until November 30, 2020. PARTICIPANTS Adults aged 60 years and over. MEASUREMENTS Two reviewers independently extracted the data and assessed the quality of the included studies according to the Physiotherapy Evidence Database (PEDro) scale. Subgroup analyses and meta-regressions were conducted to elucidate the impact of tai chi training programs on balance measures. RESULTS Twenty-six eligible RCTs were included in the meta-analysis. Pooled results showed that tai chi has moderate effects for improving proactive balance (weighted mean standardized mean differences [SMDwm ] = 0.61, 95% CI 0.33-0.89) and static steady-state balance (SMDwm = 0.62, 95% CI 0.30-0.95) and small effects for improving dynamic steady-state balance (SMDwm = 0.38, 95% CI 0.03-0.73) and balance test batteries (SMDwm = 0.47, 95% CI 0.13-0.81) in adults over 60 years of age. The practice frequency could predict the effects of tai chi on static steady-state balance, and the 24-form simplified Yang style tai chi (45-60 min/session, more than four sessions per week and at least 8 weeks) was the most optimal. CONCLUSIONS Tai chi is effective at improving the balance ability of adults over 60 years of age. A medium duration and high frequency of 24-form tai chi may be the optimal program for improving balance, but this evidence should be recommended with caution due to limitations of the methodology and small sample sizes.
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Affiliation(s)
- Le-Cong Wang
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ming-Zhu Ye
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian Xiong
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao-Qian Wang
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia-Wei Wu
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guo-Hua Zheng
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China.,College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
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15
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Circulating Mediators of Apoptosis and Inflammation in Aging; Physical Exercise Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063165. [PMID: 33808526 PMCID: PMC8003155 DOI: 10.3390/ijerph18063165] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/13/2021] [Accepted: 03/17/2021] [Indexed: 12/27/2022]
Abstract
Sarcopenia is an age-related loss of skeletal muscle mass caused by many cellular mechanisms and also by lifestyle factors such as low daily physical activity. In addition, it has been shown that sarcopenia may be associated with inflammation and cognitive impairment in old age. Regular exercise is key in reducing inflammation and preventing sarcopenia and diseases related to cognitive impairment. The study was designed to assess the impact of exercise training on circulating apoptotic and inflammatory markers of sarcopenia in older adults. Eighty older adults aged 70.5 ± 5.8 years were randomized to the physically active group who participated in a 10-month Tai-Chi training session (TC, n = 40) and the control group who participated in health education sessions (HE, n = 40). Tai-Chi training caused a significant decrease in fat mass (FM) by 3.02 ± 3.99%, but an increase in appendicular skeletal muscle mass index (ASMI) by 1.76 ± 3.17% and gait speed by 9.07 ± 11.45%. Tai-Chi training elevated the plasma levels of C-reactive protein (CRP), tumor necrosis factor (TNFα), and tumor necrosis receptor factor II (TNFRII), and decreased caspases 8 and 9. Despite the increase in TNFα, apoptosis was not initiated, i.e., the cell-free DNA level did not change in the TC group. The study demonstrated that Tai-Chi training significantly reduced the symptoms of sarcopenia through the changes in body composition and physical performance, and improvements in cytokine-related mechanisms of apoptosis.
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Feasibility of Implementing a Tai Chi Program in an Assisted Living Facility: Reducing Fall Risks and Improving Quality of Life. J Clin Med 2021; 10:jcm10061277. [PMID: 33808636 PMCID: PMC8003394 DOI: 10.3390/jcm10061277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/16/2022] Open
Abstract
One in four American older adults fall every year, resulting in injuries, death, and significant financial burden. Although fall etiology is multifactorial, the medical problems and aging factors that lead to unsteady gait and imbalance represent one of the major fall risks among older adults. A growing number of research studies support the health benefits of regular Tai Chi (TC) practice including improved physical, cognitive, and psychological function. The purpose of this quality improvement project was to assess the feasibility of establishing a 12-week (45 min per session) Tai Chi (TC) program (Sun Style Tai Chi) in a 75 bed assisted living facility as well as to evaluate the potential of the TC program to improve the fear of falling and functional mobility (as proxy for fall risk) and quality of life (QoL). A nurse who was a certified TC instructor taught the program. Twenty-three participants, 96% female and 96% white, mean (SD) age 83 (±7) years, attended one or more TC classes. Class attendance, self-reported questionnaires (e.g., fear of falling, QoL), and objective measure Timed Up and Go (TUG) were used to collect data. Nine participants (39%) completed 9 out of 12 sessions. Eleven participants (48%) completed both pre- and post-intervention measurements and twelve (52%) provided feedback on a post-intervention satisfaction survey. Participants showed 20% improvement in fear of falling (mean relative change) and 21% decrease (mean relative change) in TUG test (p = 0.001) with no clinically important changes in QoL. This quality improvement project suggested that TC is a feasible exercise that might have the potential to reduce risk of falls in older adults, and the program was well accepted with no serious or other adverse events reported. Further research studies are needed to examine the potential effects of TC programs with an appropriately powered RCT and longer intervention period.
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17
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Preventing dementia? Interventional approaches in mild cognitive impairment. Neurosci Biobehav Rev 2021; 122:143-164. [PMID: 33440197 DOI: 10.1016/j.neubiorev.2020.12.022] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/13/2020] [Accepted: 12/19/2020] [Indexed: 12/19/2022]
Abstract
Mild cognitive impairment (MCI) is defined as an intermediate state between normal cognitive aging and dementia. It describes a status of the subjective impression of cognitive decline and objectively detectible memory impairment beyond normal age-related changes. Activities of daily living are not affected. As the population ages, there is a growing need for early, proactive programs that can delay the consequences of dementia and improve the well-being of people with MCI and their caregivers. Various forms and approaches of intervention for older people with MCI have been suggested to delay cognitive decline. Pharmacological as well as non-pharmacological approaches (cognitive, physiological, nutritional supplementation, electric stimulation, psychosocial therapeutic) and multicomponent interventions have been proposed. Interventional approaches in MCI from 2009 to April 2019 concerning the cognitive performance are presented in this review.
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18
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Lo OY, Conboy LA, Rukhadze A, Georgetti C, Gagnon MM, Manor B, Lachman ME, Lipsitz LA, Wayne PM. In the Eyes of Those Who Were Randomized: Perceptions of Disadvantaged Older Adults in a Tai Chi Trial. THE GERONTOLOGIST 2020; 60:672-682. [PMID: 30544227 DOI: 10.1093/geront/gny165] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Older adults living in subsidized housing have typically been excluded from exercise intervention studies. We conducted a qualitative study to explore the perceived physical, psychological, social, and economic factors that influenced participation in and adherence to a year-long Tai Chi intervention within an ongoing cluster-randomized controlled trial (RCT) for older adults living within subsidized housing facilities. RESEARCH DESIGN AND METHODS Focus groups were held with participants of the RCT who were allocated to the trial's Tai Chi intervention. Individual phone interviews were conducted with those allocated to Tai Chi who had low adherence or who had withdrawn their participation from the study. Emergent themes were extracted using grounded-theory methods. RESULTS In this qualitative study, we enrolled 41 participants who were allocated to the RCT's Tai Chi intervention: 38 completed and 3 withdrew from the study. Average Tai Chi class attendance was 64.3%. Pragmatic factors that led to higher adherence and retention included: locating classes within each facility; providing programs at no cost; and deployment of a skilled research support team. In addition, the use of an accessible, simplified Tai Chi program improved confidence, social support, self-efficacy, and self-reported improvements in physical and psychological well-being. DISCUSSION AND IMPLICATIONS Perceived physical, psychological, social benefits, and self-efficacy likely enhance adherence and retention to research-based Tai Chi interventions for older adults. Delivering an on-site, no cost, and supportive program appears critical to overcoming financial and environmental barriers to participation for those living within subsidized housing.
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Affiliation(s)
- On-Yee Lo
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Lisa A Conboy
- New England School of Acupuncture, Newton, Massachusetts
| | | | - Caroline Georgetti
- New England School of Acupuncture at Massachusetts College of Pharmacy and Health Sciences, Worcester, Massachusetts
| | - Margaret M Gagnon
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Margie E Lachman
- Department of Psychology, Brandeis University, Waltham, Massachusetts
| | - Lewis A Lipsitz
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Peter M Wayne
- Harvard Medical School, Boston, Massachusetts.,Osher Center for Integrative Medicine at Brigham and Women's Hospital, Boston, Massachusetts
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19
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Chewning B, Hallisy KM, Mahoney JE, Wilson D, Sangasubana N, Gangnon R. Disseminating Tai Chi in the Community: Promoting Home Practice and Improving Balance. THE GERONTOLOGIST 2020; 60:765-775. [PMID: 30811543 DOI: 10.1093/geront/gnz006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Falls among older adults is a pressing public health challenge. Considerable research documents that longer tai chi courses can reduce falls and improve balance. However, longer courses can be challenging to implement. Our goal was to evaluate whether a short 6-week modified tai chi course could be effective at reducing falls risk if older adults designed a personal home practice plan to receive a greater tai chi "dose" during the 6 weeks. DESIGN A 3-city wait-listed randomized trial was conducted. Habituation Intention and Social Cognitive Theories framed the "coaching" strategy by which participants designed practice plans. RE-AIM and Treatment Fidelity Frameworks were used to evaluate implementation and dissemination issues. Three advisory groups advised the study on intervention planning, implementation, and evaluation. To measure effectiveness, we used Centers for Disease Control and Prevention recommended measures for falls risk including leg strength, balance, and mobility and gait. In addition, we measured balance confidence and executive function. RESULTS Program Implementation resulted in large class sizes, strong participant retention, high program fidelity and effectiveness. Participants reported practicing an average of 6 days a week and more than 25 min/day. Leg strength, tandem balance, mobility and gait, balance confidence, and executive function were significantly better for the experimental group than control group. CONCLUSION The tai chi short course resulted in substantial tai chi practice by older adults outside of class as well as better physical and executive function. The course reach, retention, fidelity, and implementation across 3 cities suggest strong potential for implementation and dissemination of the 6-week course.
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Affiliation(s)
- Betty Chewning
- Social and Administrative Sciences Division, School of Pharmacy
| | - Kristine M Hallisy
- Doctor of Physical Therapy Program, Department of Family Medicine and Community Health
| | - Jane E Mahoney
- Division of Geriatrics, Department of Medicine, School of Medicine and Public Health
| | - Dale Wilson
- Social and Administrative Sciences Division, School of Pharmacy
| | | | - Ronald Gangnon
- Population Health, Department of Population Health Sciences.,Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison
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20
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Abstract
Tai chi is an ancient Chinese internal martial art that has increased in popularity across the United States over the past 2 decades. Tai chi combines gentle physical movement, mental imagery, and natural, relaxed breathing. There is increasing scientific evidence showing the impact of tai chi exercise on multifaceted areas of health and well-being, including positive effects on cognition, depression, anxiety, sleep, cardiovascular health, and fall prevention. A review of the health benefits of tai chi exercise is presented, as well as recommendations for nurses seeking to answer patient questions about tai chi.
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21
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Palermi S, Sacco AM, Belviso I, Marino N, Gambardella F, Loiacono C, Sirico F. Effectiveness of Tai Chi on Balance Improvement in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis. J Aging Phys Act 2020; 28:787-797. [PMID: 32131053 DOI: 10.1123/japa.2019-0242] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 12/24/2019] [Accepted: 12/28/2019] [Indexed: 11/18/2022]
Abstract
Balance impairments are a relevant problem in patients with diabetes, and interventions to manage this issue represent a public health need. This study reviewed the literature about the effectiveness of Tai Chi on balance improvement in patients with type 2 diabetes. Springerlink, MEDLINE, PubMed, CINAHL, Web of Science, Scopus, and Cochrane CENTRAL databases were screened. Randomized and nonrandomized controlled trials assessing balance in patients with type 2 diabetes enrolled in a Tai Chi program were considered eligible. Four studies were included in qualitative synthesis and in quantitative analysis (three randomized controlled trials and one pretest-posttest quasi-experimental study). Evidence supporting Tai Chi to improve balance in patients with type 2 diabetes was found (effect size: 0.52; 95% confidence interval [0.20, 0.84]); however, the analysis relied on a small number of studies, which raises concerns about the risk of bias. In conclusion, the results support the benefits of Tai Chi intervention to improve balance in patients with type 2 diabetes.
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22
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Tai Chi for the Prevention of Falls Among Older Adults: A Critical Analysis of the Evidence. J Aging Phys Act 2020; 29:343-352. [PMID: 32839351 DOI: 10.1123/japa.2020-0155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/28/2020] [Accepted: 06/28/2020] [Indexed: 11/18/2022]
Abstract
Despite interest as to the benefits of Tai Chi, there remains a controversy over its effectiveness as an exercise intervention for preventing falls among older adults. This review synthesizes the evidence base with a focus on meta-analyses and randomized controlled trials with community-dwelling older adults. It provides a critical lens on the evidence and quality of the trials. High-quality evidence suggests that Tai Chi is an effective intervention for preventing falls in community settings; however, there is unclear evidence for long-term care facilities and an absence of evidence for hospital settings. When compared directly with other exercise interventions, Tai Chi may offer a superior strategy for reducing falls through its benefits on cognitive functioning. Using data from the current Cochrane review, a new synthesis is presented suggesting that 71-81% of community-dwelling older adults are adherent to class-based Tai Chi interventions. The practical opportunities and challenges for practitioners are discussed.
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23
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Buto MSDS, de Oliveira MPB, Carvalho C, Vassimon-Barroso V, Takahashi ACDM. Effect of complementary therapies on functional capacity and quality of life among prefrail and frail older adults: A systematic review of randomized controlled trials. Arch Gerontol Geriatr 2020; 91:104236. [PMID: 32860990 DOI: 10.1016/j.archger.2020.104236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/03/2020] [Accepted: 08/17/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Investigate the effects of complementary therapies on functional capacity and quality of life among prefrail and frail older adults. MATERIALS AND METHOD An electronic search was performed in the PubMed, EMBASE, Web of Science, Cochrane Library, LILACS and PEDro databases for relevant articles published up to September 2019. Only randomized controlled trials with interventions involving complementary therapies for prefrail and frail older adults were included. This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Cochrane recommendations. The methodological quality of the selected studies was appraised using the PEDro scale and the evidence was synthesized using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) scale. RESULTS Fifteen studies met the inclusion criteria and were selected for the present review. Six different complementary therapies were identified and the main findings were related to Tai Chi. A very low to moderate level of evidence was found regarding the effectiveness of Tai Chi in terms a functional capacity (balance, mobility, gait speed, functional reach and lower limb muscle strength) and a low level of evidence was found regarding its effect on quality of life. To the other complementary therapies it was not possible to synthetize evidence level. CONCLUSION Tai chi may be used as an important resource to improve functional capacity and quality of life among prefrail and frail older adults.
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Affiliation(s)
| | - Marcos Paulo Braz de Oliveira
- Elder Health Research Laboratory, Department of Physiotherapy, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Cristiano Carvalho
- Rheumatology and Hand Rehabilitation Research Laboratory, Department of Physiotherapy, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Verena Vassimon-Barroso
- Elder Health Research Laboratory, Department of Physiotherapy, Federal University of São Carlos, São Carlos, SP, Brazil.
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24
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Stahl JE, Belisle SS, Zhao W. Medical Qigong for Mobility and Balance Self-Confidence in Older Adults. Front Med (Lausanne) 2020; 7:422. [PMID: 32923446 PMCID: PMC7456993 DOI: 10.3389/fmed.2020.00422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/30/2020] [Indexed: 12/03/2022] Open
Abstract
Background/Objectives: Physical inactivity, sedentary lifestyle, and impaired neuromuscular function increases fall risk and fractures in our aging population. Mind-body modalities, improve strength, balance and coordination, mitigating these risks. This study examined whether a manualized Medical Qigong protocol measurably improves balance, gait, and health self-confidence among older adults. Design: Randomized prospective cohort pre-post study with wait time control. Setting: Two martial arts centers in Massachusetts and Arizona. Participants: Ninety-five adults age ≥ 50 (mean age 68.6 y.o., range 51-96) were randomly assigned to an immediate start group (N = 53) or 4-week delayed start group (N = 43). Intervention: A 10 form qigong protocol taught over 12 weekly classes. Measurments: Primary outcome measures were the Community Balance and Mobility Scale (CBMS) and Activities-Specific Balance Confidence (ABC) Scale. Data was collected at baseline, 1-month and 4-months. Results: Both groups at both sites demonstrated improved balance and gait (CBMS + 11.9 points, p < 0.001). This effect was strongest in patients in their 60 s (CBMS +12.9 p < 0.01) and 70 s (CBMS + 14.3, p < 0.001), was equal across genders and socioeconomic status. Balance self-confidence did not significantly change (ABC + 0.9, p = 0.48), though several elements within ABC trended toward improvement [e.g., walk up/down ramp (p = 0.07), bend over/pick up (p = 0.09)]. Falls in the past year was inversely correlated with balance self-confidence (p = 0.01). Conclusion: A 12-week manualized Medical Qigong protocol significantly improved balance and gait and modestly improved balance self-confidence among older adults. Medical Qigong may be a useful clinical intervention for older adults at heightened risk for falls and related injuries. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04430751.
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Affiliation(s)
- James E. Stahl
- Dartmouth-Hitchcock Medical Center, Section General Internal Medicine, Lebanon, NH, United States
- The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, United States
- The Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Shoshana S. Belisle
- Dartmouth-Hitchcock Medical Center, Section General Internal Medicine, Lebanon, NH, United States
| | - Wenyan Zhao
- The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, United States
- The Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- The Dartmouth Synergy Clinical and Translational Science Institute, Biostatistics Consultation Core, Lebanon, NH, United States
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25
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Lee TL, Sherman KJ, Hawkes RJ, Phelan EA, Turner JA. The Benefits of T'ai Chi for Older Adults with Chronic Back Pain: A Qualitative Study. J Altern Complement Med 2020; 26:456-462. [PMID: 32379976 DOI: 10.1089/acm.2019.0455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To determine the perceived benefits of t'ai chi in older adults with chronic low-back pain (cLBP). Design: A qualitative analysis from a randomized controlled feasibility trial. Subjects: Eighteen participants (65+ years old) with cLBP of at least moderate intensity. Intervention: A 36-week intervention beginning with twice weekly classes for 12 weeks, weekly classes for 6 weeks, biweekly classes for 6 weeks, and monthly classes for 12 weeks. Participants were asked to practice at home on nonclass days and videos were provided to assist in that process. Outcome Measures: Participants in the focus groups were asked to provide feedback on their experiences with the study as well as the benefits of their t'ai chi practice. We used demographic and class attendance data to describe the sample. Results: Regarding the benefits of t'ai chi practice, five major themes were identified: functional benefits, pain reduction/pain relief, psychospiritual benefits, the importance of social support in learning t'ai chi, and the integration of t'ai chi into daily activities. The most common functional benefits were improvements in balance, flexibility, leg strength, and posture. Some reported pain reduction or pain relief, but others did not. Increased relaxation, mindfulness, and a sense of connectedness were subthemes that emerged from psychospiritual benefits. Social support benefits included motivation to attend class and group support while learning a new skill. Finally, improved body awareness allowed participants to integrate t'ai chi skills into their daily activities. Conclusions: This qualitative analysis demonstrates the multifaceted benefits of t'ai chi for older adults living with cLBP.
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Affiliation(s)
- Tamsin L Lee
- Department of Child, Family and Population Health Nursing, University of Washington, Seattle, WA, USA
| | - Karen J Sherman
- Kaiser Permanente WA Health Research Institute, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Rene J Hawkes
- Kaiser Permanente WA Health Research Institute, Seattle, WA, USA
| | - Elizabeth A Phelan
- Department of Medicine and Health Services, University of Washington, Seattle, WA, USA
| | - Judith A Turner
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.,Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
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Cohen RG, Baer JL, Ravichandra R, Kral D, McGowan C, Cacciatore TW. Lighten Up! Postural Instructions Affect Static and Dynamic Balance in Healthy Older Adults. Innov Aging 2020; 4:igz056. [PMID: 32226825 PMCID: PMC7092748 DOI: 10.1093/geroni/igz056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Indexed: 02/01/2023] Open
Abstract
Background and Objectives Increased fall risk in older adults is associated with declining balance. Previous work showed that brief postural instructions can affect balance control in older adults with Parkinson's disease. Here, we assessed the effects of brief instructions on static and dynamic balance in healthy older adults. Research Design and Methods Nineteen participants practiced three sets of instructions, then attempted to implement each instructional set during: (1) quiet standing on foam for 30 s with eyes open; (2) a 3-s foot lift. "Light" instructions relied on principles of reducing excess tension while encouraging length. "Effortful" instructions relied on popular concepts of effortful posture correction. "Relax" instructions encouraged minimization of effort. We measured kinematics and muscle activity. Results During quiet stance, Effortful instructions increased mediolateral jerk and path length. In the foot lift task, Light instructions led to the longest foot-in-air duration and the smallest anteroposterior variability of the center of mass, Relax instructions led to the farthest forward head position, and Effortful instructions led to the highest activity in torso muscles. Discussion and Implications Thinking of upright posture as effortless may reduce excessive co-contractions and improve static and dynamic balance, while thinking of upright posture as inherently effortful may make balance worse. This may partly account for the benefits of embodied mindfulness practices such as tai chi and Alexander technique for balance in older adults. Pending larger-scale replication, this discovery may enable physiotherapists and teachers of dance, exercise, and martial arts to improve balance and reduce fall risk in their older students and clients simply by modifying how they talk about posture.
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Affiliation(s)
- Rajal G Cohen
- Department of Psychology and Communication, University of Idaho, Moscow, Idaho.,Department of Biological Sciences, University of Idaho, Moscow, Idaho
| | - Jason L Baer
- Department of Psychology and Communication, University of Idaho, Moscow, Idaho.,Department of Biological Sciences, University of Idaho, Moscow, Idaho
| | - Ramyaa Ravichandra
- Department of Psychology and Communication, University of Idaho, Moscow, Idaho
| | - Daniel Kral
- Department of Psychology and Communication, University of Idaho, Moscow, Idaho
| | - Craig McGowan
- Department of Biological Sciences, University of Idaho, Moscow, Idaho.,WWAMI Medical Education Program, University of Idaho, Moscow, Idaho
| | - Timothy W Cacciatore
- Sobell Department of Motor Neuroscience, Institute of Neurology, University College London, London, UK
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Sherman KJ, Wellman RD, Hawkes RJ, Phelan EA, Lee T, Turner JA. T'ai Chi for Chronic Low Back Pain in Older Adults: A Feasibility Trial. J Altern Complement Med 2020; 26:176-189. [PMID: 32013530 DOI: 10.1089/acm.2019.0438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Objectives: T'ai chi (TC) has been found effective for improving chronic low back pain (cLBP). However, such studies did not include adults over 65 years of age. This study was designed to evaluate the feasibility and acceptability of TC in this population compared with Health Education (HE) and with Usual Care (UC). Design: Feasibility randomized controlled trial. Settings/Location: Participants were recruited from Kaiser Permanente Washington and classes took place in a Kaiser facility. Patients: Adults 65 years of age and older with cLBP. Interventions: Twenty-eight participants were randomized to 12 weeks of TC followed by a 24-week tapered TC program, 12 were assigned to a 12-week HE intervention and 17 were assigned to UC only. Outcome Measures: Feasibility and acceptability were determined by recruitment, retention and 12-, 26-, and 52-week follow-up rates, instructor adherence to protocol, class attendance, TC home practice, class satisfaction, and adverse events. Results: Fifty-seven participants were enrolled in two cohorts of 28 and 29 during two 4-month recruitment periods. Questionnaire follow-up completion rates ranged between 88% and 93%. Two major class protocol deviations were noted in TC and none in HE. Sixty-two percent of TC participants versus 50% of HE participants attended at least 70% of the classes during the 12-week initial intervention period. Weekly rates of TC home practice were high among class attendees (median of 4.2 days) at 12 weeks, with fewer people practicing at 26 and 52 weeks. By 52 weeks, 70% of TC participants reported practicing the week before, with a median of 3 days per week and 15 min/session. TC participants rated the helpfulness of their classes significantly higher than did HE participants, but the groups were similarly likely to recommend the classes. Conclusion: The TC intervention is feasible in this population, while the HE group requires modifications in delivery.
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Affiliation(s)
- Karen J Sherman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA.,Department of Epidemiology, University of Washington, Seattle, WA
| | - Robert D Wellman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Rene J Hawkes
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Elizabeth A Phelan
- Department of Medicine and Health Services, University of Washington, Seattle, WA
| | - Tamsin Lee
- Department of Child, Family and Population Health Nursing, University of Washington, Seattle, WA
| | - Judith A Turner
- Department of Psychiatry and Behavioral Sciences and Rehabilitation Medicine, University of Washington, Seattle, WA
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Wingert JR, Corle CE, Saccone DF, Lee J, Rote AE. Effects of a Community-Based Tai Chi Program on Balance, Functional Outcomes, and Sensorimotor Function in Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2019.1709600] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jason R. Wingert
- Department of Health and Wellness, One University Heights, University of North Carolina Asheville, Asheville, North Carolina, USA
| | - Caitlin E. Corle
- Department of Health and Wellness, One University Heights, University of North Carolina Asheville, Asheville, North Carolina, USA
| | - Diane F. Saccone
- Healthy Aging Initiatives, YMCA of Western North Carolina, Asheville, North Carolina, USA
| | - Jimin Lee
- Department of Mathematics, One University Heights, University of North Carolina Asheville, Asheville, North Carolina, USA
| | - Aubrianne E. Rote
- Department of Health and Wellness, One University Heights, University of North Carolina Asheville, Asheville, North Carolina, USA
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Mancini M, Chung K, Zajack A, Martini DN, Ramsey K, Lapidus J, Horak FB, Nutt JG. Effects of augmenting cholinergic neurotransmission on balance in Parkinson's disease. Parkinsonism Relat Disord 2019; 69:40-47. [DOI: 10.1016/j.parkreldis.2019.10.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 11/16/2022]
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Adcock M, Thalmann M, Schättin A, Gennaro F, de Bruin ED. A Pilot Study of an In-Home Multicomponent Exergame Training for Older Adults: Feasibility, Usability and Pre-Post Evaluation. Front Aging Neurosci 2019; 11:304. [PMID: 31824295 PMCID: PMC6882741 DOI: 10.3389/fnagi.2019.00304] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/24/2019] [Indexed: 11/13/2022] Open
Abstract
Aging is associated with sensory, motor and cognitive impairments that may lead to reduced daily life functioning including gait disturbances, falls, injuries and mobility restrictions. A strong need exists for implementing effective evidence-based interventions for healthy aging. Therefore, the aim of this study was to (i) evaluate the feasibility and usability of an in-home multicomponent exergame training and (ii) explore its effects on physical functions, cognition and cortical activity. Twenty-one healthy and independently living older adults were included (11 female, 74.4 ± 7.0 years, range: 65-92 years) and performed 24 trainings sessions (each 40 min) over eight weeks. The first part was conducted in a living lab (home-like laboratory environment), the second part at participants' home. The multicomponent exergame included Tai Chi-inspired exercises, dance movements and step-based cognitive games to train strength, balance and cognition. Attendance and attrition rates were calculated and safety during training was evaluated to determine feasibility. Participants rated the usability of the exergame (System Usability Scale) and reported on their game experience (Game Experience Questionnaire). Physical and cognitive functions and cortical activity (resting state electroencephalopathy) were assessed pre and post intervention. Results showed a high training attendance rate for the living lab and the home-based setting (91.7 and 91.0%, respectively) with a rather high attrition rate (28.6%, six drop-outs). Half of the drop-out reasons were related to personal or health issues. System usability was rated acceptable with a mean score of 70.6/100. Affective game experience was rated favorable. Significant improvements were found for minimal toe clearance, short-term attentional span, and information processing speed (p < 0.05). No significant pre-post differences were found for cortical activity. To summarize, the exergame is generally feasible and usable for healthy older adults applied in an in-home setting and provides an overall positive emotional game experience. Nevertheless, flawless technical functionality should be a mandatory consideration. Additionally, the training might have potential positive influence on specific functions in older adults. However, the efficacy has to be evaluated in a future randomized controlled trial assessing the behavioral and neuroplastic changes in a larger population after a longer training period.
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Affiliation(s)
- Manuela Adcock
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Melanie Thalmann
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Alexandra Schättin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Federico Gennaro
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Eling D. de Bruin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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31
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Yang J, Chon TY, Li G, Mallory MJ, Bublitz SE, Do A, Xiao L, Xiong D, Bauer BA. Tai Chi for patients with mild cognitive impairment: A protocol for a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2019; 98:e17118. [PMID: 31577701 PMCID: PMC6783215 DOI: 10.1097/md.0000000000017118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 08/19/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is an intermediate stage between the cognitive changes of normal aging and early dementia. Tai Chi (TC) may be particularly beneficial to patients with MCI due to its whole-body coordination characteristics. This systematic review protocol aims to outline the methods that will be used to assess the comparative effectiveness and safety of TC for MCI through a systematic review and meta-analysis. METHODS A systematic review will identify and evaluate randomized controlled trials (RCTs) that examined the effects and safety of TC compared to a placebo, conventional treatment, and no treatment on cognitive function in individuals with MCI. Studies from databases of MEDLINE, PubMed, Embase, Global Health, Cochrane Library, and Scopus from January 1990 to March 2019 reported in English will be searched. Two independent reviewers will screen the studies for inclusion with the eligibility criteria and extract data. Risk of bias of individual studies will be assessed in line with Cochrane risk of bias tool. The overall quality of cumulative evidence will be assessed using selected Grading of Recommendations, Assessment, Development, and Evaluations criteria. Statistics will be used for heterogeneity assessment, sensitivity analysis, data synthesis, generating funnel plots, and subgroup analysis. Meta-analysis will be performed, if sufficiently homogeneous studies are found. A narrative synthesis will be conducted, grouping studies by exposure and outcome definitions, and describing any differences by subgroups. RESULTS This study will provide practical and targeted evidence in investigating the impact of TC exercise for individuals with MCI. CONCLUSION The findings of our study will provide updated evidence to determine whether TC is an effective intervention to patients with MCI. TRIAL REGISTRATION NUMBER International Prospective Register for Systematic Reviews (PROSPERO) number CRD42019125104.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
- Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Guangdong Medical University, Shenzhen
| | - Tony Y. Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Guangxi Li
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Division of Pulmonary and Critical Care Medicine, Mayo Epidemiology and Translational Research in Intensive Care, Rochester, MN
| | - Molly J. Mallory
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Sara E. Bublitz
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Alexander Do
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Lizu Xiao
- Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Guangdong Medical University, Shenzhen
| | - Donglin Xiong
- Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Guangdong Medical University, Shenzhen
| | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
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Bubela D, Sacharko L, Chan J, Brady M. Balance and Functional Outcomes for Older Community-Dwelling Adults Who Practice Tai Chi and Those Who Do Not: A Comparative Study. J Geriatr Phys Ther 2019; 42:209-215. [DOI: 10.1519/jpt.0000000000000153] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Affiliation(s)
- Raymond Pary
- a Veterans Administration Medical Center , Louisville , KY , USA
| | - Simrat Kaur Sarai
- b University of Louisville School of Medicine , Louisville , KY , USA
| | - Riley Sumner
- c University of Louisville , Louisville , KY , USA
| | - Steven Lippmann
- b University of Louisville School of Medicine , Louisville , KY , USA
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Lipsitz LA, Macklin EA, Travison TG, Manor B, Gagnon P, Tsai T, Aizpurúa II, Lo OY, Wayne PM. A Cluster Randomized Trial of Tai Chi vs Health Education in Subsidized Housing: The MI-WiSH Study. J Am Geriatr Soc 2019; 67:1812-1819. [PMID: 31116883 DOI: 10.1111/jgs.15986] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/25/2019] [Accepted: 04/25/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Tai Chi (TC) may benefit older adults with a variety of diseases and disabilities. We tested the hypothesis that TC improves physical function in older adults living in low-income housing facilities. DESIGN Cluster randomized controlled trial. SETTING Subsidized housing facilities in Boston, Massachusetts, and neighboring communities. PARTICIPANTS Volunteers were recruited from 15 facilities. The 180 randomized participants were 60 years of age or older, able to understand English and participate in TC, expected to remain in the facility for 1 year, and able to walk independently. INTERVENTION TC classes were conducted in the housing facilities twice/week for 1 year and compared with monthly health promotion educational classes and social calls. MEASUREMENTS The primary outcome was physical function measured by the Short Physical Performance Battery (SPPB). Secondary outcomes included other aspects of physical and cognitive function, and falls. RESULTS An interim analysis revealed less improvement over 12 months in SPPB scores among TC participants (+.20 units; 95% confidence interval [CI] = -.20 to +.60; P = .69) vs control participants (+.51 units; 95% CI = +.15 to +.87; P = .007), a difference of -.31 units (95% CI = -.66 to .04; P = .082). This met the criterion for futility, and the Data Safety Monitoring Board recommended trial termination. No differences were found in 6- or 12-month changes favoring TC in any secondary outcomes or adverse events. CONCLUSION In older adults with multiple chronic conditions living in subsidized housing facilities, 6 and 12 months of twice/week TC classes were not associated with improvements in functional health. J Am Geriatr Soc 67:1812-1819, 2019.
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Affiliation(s)
- Lewis A Lipsitz
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts.,Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Eric A Macklin
- Harvard Medical School, Boston, Massachusetts.,Massachusetts General Hospital, Boston, Massachusetts
| | - Thomas G Travison
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts.,Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts.,Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Peggy Gagnon
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts
| | - Timothy Tsai
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts
| | - Ilean Isaza Aizpurúa
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts
| | - On-Yee Lo
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts.,Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Peter M Wayne
- Harvard Medical School, Boston, Massachusetts.,Osher Center for Integrative Medicine at Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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35
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Ma AWW, Wang HK, Chen DR, Chen YM, Chak YTC, Chan JWY, Yam TTT, Cheng YTY, Ganesan B, Fong SSM. Chinese Martial Art Training Failed to Improve Balance or Inhibit Falls in Older Adults. Percept Mot Skills 2019; 126:389-409. [PMID: 30803309 DOI: 10.1177/0031512518824945] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This randomized controlled trial explored the effects of a Ving Tsun (VT) Chinese martial art training program on reactive standing balance performance, postural muscle reflex contraction latency, leg muscle performance, balance confidence and falls in community-dwelling older adults. We randomly assigned 33 healthy older adults to either a VT group (mean age = 67.5 years) or a control group (mean age = 72.1 years). The VT group received two 1-hour VT training sessions per week for three months (24 sessions). Primary outcome measures collected before and after the intervention period were electromyographic muscle activation onset latencies of the hamstring and gastrocnemius and the center of pressure path, length and movement velocity in standing (reactive balance performance). Secondary outcome measures included isometric peak force and time to isometric peak force of the knee extensors and flexors, the Activities-Specific Balance Confidence Scale score, and fall history. Results revealed that the mean gastrocnemius muscle activation onset latency was significantly longer (22.53 ms) in the VT group after the intervention. The peak force of the knee flexors significantly increased (by 1.58 kg) in the control group over time but not in the VT group. The time to reach peak force in the knee flexors was significantly longer (by 0.51 s) in the control group (but not the VT group) at posttest compared with the pretest value. No other significant group, time, or group-by-time interaction effects were noted. We discussed possible reasons for the failure of three months of martial art training to benefit fall risks among these older adults.
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Affiliation(s)
- Ada W W Ma
- 1 Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, People's Republic of China
| | - Hsing-Kuo Wang
- 2 School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,3 Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan
| | - Duan-Rung Chen
- 4 Institute of Health Behaviors and Community Sciences, National Taiwan University, Taipei, Taiwan
| | - Ya-Mei Chen
- 5 Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan
| | - Yvonne T C Chak
- 6 Hong Kong Christian Service, Tsim Sha Tsui, Hong Kong, People's Republic of China
| | - Joan W Y Chan
- 7 Hong Kong Christian Service, Un Chau Neighborhood Elderly Centre, Shum Shui Po, Hong Kong, People's Republic of China
| | - Timothy T T Yam
- 8 School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Yoyo T Y Cheng
- 8 School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Balasankar Ganesan
- 8 School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China.,9 Faculty of Engineering and Information Technology, University of Technology Sydney, Ultimo, Australia
| | - Shirley S M Fong
- 1 Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, People's Republic of China.,8 School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China.,10 Ving Tsun Athletic Association, Hong Kong, People's Republic of China
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Gatica-Rojas V, Cartes-Velásquez R, Albornoz-Verdugo ME, Soto-Poblete A, Monteiro-Junior RS, Elgueta-Cancino E. Effects of a Nintendo Wii exercise program versus Tai Chi Chuan on standing balance in older adults: a preliminary study. J Phys Ther Sci 2019; 31:1-4. [PMID: 30774195 PMCID: PMC6348192 DOI: 10.1589/jpts.31.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 09/12/2018] [Indexed: 12/02/2022] Open
Abstract
[Purpose] This study compared the effect of the Nintendo Wii balance board (NWBB) and Tai
Chi Chuan (TCC) on the standing balance (SB) of older adults. [Participants and Methods]
Twelve older adults (NWBB=7 and TCC=5) completed the intervention and two testing sessions
(pre-post). SB was assessed using posturographic measures with the center of pressure
(CoP) in five modes: quiet eyes open (QSB-EO) and eyes closed (QSB-EC), on sponge (SBS-EO
and SBS-EC), and with optokinetic field (SB-OF). [Results] Both interventions
significantly decrease the area of CoP sway (CoPSway) in QSB-EO and SB-OF. The
NWBB-group decreased CoPSway in SBS-EC and CoP velocity (Vmean) in
QSB-EO, QSB-EC, and SBS-EC. The TCC-group decreased the Vmean in SBS-EO and
conversely the Vmean in QSB-EC increased. [Conclusion] Sponge and optokinetic
field were the most unstable assessments. These findings reveal the potential benefits for
SB of both interventions, however the NWBB improved more variables in the postural control
of older adults.
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Affiliation(s)
- Valeska Gatica-Rojas
- Human Motor Control Laboratory, Department of Human Movement Sciences, Faculty of Health Sciences, Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), Universidad de Talca: Av. Lircay S/N, Talca, Chile
| | - Ricardo Cartes-Velásquez
- School of Dentistry, Universidad Andrés Bello, Chile.,Center of Research in Biomedical Science, Universidad Autónoma de Chile, Chile
| | | | | | | | - Edith Elgueta-Cancino
- Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Australia
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Qi M, Moyle W, Jones C, Weeks B. Tai Chi Combined With Resistance Training for Adults Aged 50 Years and Older: A Systematic Review. J Geriatr Phys Ther 2018; 43:32-41. [PMID: 30531200 DOI: 10.1519/jpt.0000000000000218] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Despite Tai Chi and resistance training being recommended as suitable exercise for older adults, there are no systematic reviews synthesizing the effectiveness of a combination of Tai Chi and resistance training on health promotion of older adults. This study aimed to review the existing literature regarding the effect of Tai Chi and resistance training on physical health, mental health, pain, health-related quality of life, and age-related impairment in adults aged 50 years and older. METHODS A systematic review was conducted to report the health outcomes of Tai Chi combined with resistance training research in adults aged 50 years and older. Articles were identified by searching PubMed, Scopus, Web of Science, CINAHL, MEDLINE, Physiotherapy Evidence Database (PEDro), and the Cochrane library using search terms representing "Tai Chi" and "resistance" and "older adults." Quantitative experimental studies with participants aged 50 years and older, where one of the interventions was Tai Chi and resistance training, were included. RESULTS AND DISCUSSION The literature search yielded 648 articles from which 7 met the inclusion criteria. Collectively, the studies involved 703 participants aged 50 years and older, including healthy older adults, older adults with history of falls, postmenopausal women, and people diagnosed with end-stage hip osteoarthritis. Studies included different Tai Chi forms in combination with various types of resistance training. Training sessions were 2 to 7.5 h/wk and lasted between 12 weeks and 12 months. After long-term Tai Chi and resistance training, the participants showed significant improvement in upper and lower extremity muscle strength, aerobic endurance, balance, and mobility. However, 1 study failed to show improvement in Functional Movement Screening compared with traditional Tai Chi and nonexercise groups. No study examined the effects of Tai Chi and resistance training on health-related quality of life, fear of falling, or mental health in adults aged 50 years and older. CONCLUSIONS The review supports that Tai Chi in combination with resistance training improves physical function and muscle strength in adults aged 50 years and older.
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Affiliation(s)
- Meiling Qi
- School of Nursing and Midwifery, Griffith University, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Wendy Moyle
- School of Nursing and Midwifery, Griffith University, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Cindy Jones
- School of Nursing and Midwifery, Griffith University, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Benjamin Weeks
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia.,School of Allied Health Sciences, Griffith University, Queensland, Australia
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Riegle van West K, Stinear C, Buck R. The Effects of Poi on Physical and Cognitive Function in Healthy Older Adults. J Aging Phys Act 2018; 27:1-9. [PMID: 29543125 DOI: 10.1123/japa.2017-0273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study investigated the effects of poi (a weight on the end of a cord which is swung in circular patterns around the body) compared with Tai Chi on physical and cognitive function in healthy older adults. A total of 79 participants (60-86 years) were randomly allocated to the poi or Tai Chi group. Physical and cognitive function was measured 1 month before, immediately before, immediately after, and 1 month after the intervention (two lessons a week, for 4 weeks). Immediately postintervention, both groups improved postural stability, upper limb strength, and simple attention. Tai Chi also improved systolic blood pressure. One-month postintervention, compared with immediately postintervention, both groups improved upper limb strength, upper limb range of motion, and memory. Poi also improved systolic blood pressure. Therefore, poi seems to be as effective as Tai Chi for improving physical and cognitive function in healthy older adults.
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Musich S, Wang SS, Ruiz J, Hawkins K, Wicker E. The impact of mobility limitations on health outcomes among older adults. Geriatr Nurs 2018; 39:162-169. [DOI: 10.1016/j.gerinurse.2017.08.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/01/2017] [Accepted: 08/07/2017] [Indexed: 01/09/2023]
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Tai Chi Beyond Balance and Fall Prevention: Health Benefits and Its Potential Role in Combatting Social Isolation in the Aging Population. CURRENT GERIATRICS REPORTS 2018. [DOI: 10.1007/s13670-018-0233-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Jiménez-Martín PJ, Liu H, Meléndez Ortega A. The importance of differentiating the three modalities of Tai Chi Chuan practice in clinical trials – A critical review. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2017.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Correlates of Exercise Self-efficacy in a Randomized Trial of Mind-Body Exercise in Patients With Chronic Heart Failure. J Cardiopulm Rehabil Prev 2017; 36:186-94. [PMID: 26959498 DOI: 10.1097/hcr.0000000000000170] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE Exercise self-efficacy is one of the strongest predictors of physical activity behavior. Prior literature suggests that tai chi, a mind-body exercise, may increase self-efficacy; however, this is not extensively studied. Little is known about the factors associated with development of exercise self-efficacy in a population with heart failure. METHODS We utilized data from a randomized controlled trial of 12 weeks of group tai chi classes versus education in patients with chronic heart failure (n = 100). Multivariable linear regression was used to explore possible correlates of change in exercise self-efficacy in the entire sample and in the subgroup who received tai chi (n = 50). Covariates included baseline quality of life, social support, functional parameters, physical activity, serum biomarkers, sociodemographics, and clinical heart failure parameters. RESULTS Baseline 6-minute walk (β=-0.0003, SE = 0.0001, P = .02) and fatigue score (β= 0.03, SE = 0.01, P = .004) were significantly associated with change in self-efficacy, with those in the lowest tertile for 6-minute walk and higher tertiles for fatigue score experiencing the greatest change. Intervention group assignment was highly significant, with self-efficacy significantly improved in the tai chi group compared to the education control over 12 weeks (β= 0.39, SE = 0.11, P < .001). In the tai chi group alone, lower baseline oxygen uptake (β=-0.05, SE = 0.01, P = .001), decreased mood (β=-0.01, SE = 0.003, P = .004), and higher catecholamine level (epinephrine β= 0.003, SE = 0.001, P = .005) were significantly associated with improvements in self-efficacy. CONCLUSIONS In this exploratory analysis, our initial findings support the concept that interventions like tai chi may be beneficial in improving exercise self-efficacy, especially in patients with heart failure who are deconditioned, with lower functional status and mood.
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Lauche R, Peng W, Ferguson C, Cramer H, Frawley J, Adams J, Sibbritt D. Efficacy of Tai Chi and qigong for the prevention of stroke and stroke risk factors: A systematic review with meta-analysis. Medicine (Baltimore) 2017; 96:e8517. [PMID: 29137055 PMCID: PMC5690748 DOI: 10.1097/md.0000000000008517] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 10/08/2017] [Accepted: 10/11/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND This review aims to summarize the evidence of Tai Chi and qigong interventions for the primary prevention of stroke, including the effects on populations with major stroke risk factors. METHODS A systematic literature search was conducted on January 16, 2017 using the PubMed, Scopus, Cochrane Library, and CINAHL databases. Randomized controlled trials examining the efficacy of Tai Chi or qigong for stroke prevention and stroke risk factors were included. Risk of bias was assessed using the Cochrane Risk of Bias tool. RESULTS Twenty-one trials with n = 1604 patients with hypertension, hyperlipidaemia, diabetes, overweight or obesity, or metabolic syndrome were included. No trials were found that examined the effects of Tai Chi/qigong on stroke incidence. Meta-analyses revealed significant, but not robust, benefits of Tai Chi/qigong over no interventions for hypertension (systolic blood pressure: -15.55 mm Hg (95% CI: -21.16; -9.95); diastolic blood pressure: -10.66 mm Hg (95% CI: -14.90, -6.43); the homeostatic model assessment (HOMA) index (-2.86%; 95% CI: -5.35, -0.38) and fasting blood glucose (-9.6 mg/dL; 95% CI: -17.28, -1.91), and for the body mass index compared with exercise controls (-1.65 kg/m; 95% CI: -3.11, -0.20). Risk of bias was unclear or high for the majority of trials and domains, and heterogeneity between trials was high. Only 6 trials adequately reported safety. No recommendation for the use of Tai Chi/qigong for the prevention of stroke can be given. CONCLUSION Although Tai Chi and qigong show some potential more robust studies are required to provide conclusive evidence on the efficacy and safety of Tai Chi and qigong for reducing major stroke risk factors.
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Affiliation(s)
- Romy Lauche
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)
| | - Wenbo Peng
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)
| | - Caleb Ferguson
- Faculty of Health, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Sydney, NSW, Australia
| | - Holger Cramer
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jane Frawley
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)
| | - Jon Adams
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)
| | - David Sibbritt
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)
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Can Tai Chi training impact fractal stride time dynamics, an index of gait health, in older adults? Cross-sectional and randomized trial studies. PLoS One 2017; 12:e0186212. [PMID: 29020106 PMCID: PMC5636131 DOI: 10.1371/journal.pone.0186212] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 09/19/2017] [Indexed: 02/07/2023] Open
Abstract
Purpose To determine if Tai Chi (TC) has an impact on long-range correlations and fractal-like scaling in gait stride time dynamics, previously shown to be associated with aging, neurodegenerative disease, and fall risk. Methods Using Detrended Fluctuation Analysis (DFA), this study evaluated the impact of TC mind-body exercise training on stride time dynamics assessed during 10 minute bouts of overground walking. A hybrid study design investigated long-term effects of TC via a cross-sectional comparison of 27 TC experts (24.5 ± 11.8 yrs experience) and 60 age- and gender matched TC-naïve older adults (50–70 yrs). Shorter-term effects of TC were assessed by randomly allocating TC-naïve participants to either 6 months of TC training or to a waitlist control. The alpha (α) long-range scaling coefficient derived from DFA and gait speed were evaluated as outcomes. Results Cross-sectional comparisons using confounder adjusted linear models suggest that TC experts exhibited significantly greater long-range scaling of gait stride time dynamics compared with TC-naïve adults. Longitudinal random-slopes with shared baseline models accounting for multiple confounders suggest that the effects of shorter-term TC training on gait dynamics were not statistically significant, but trended in the same direction as longer-term effects although effect sizes were very small. In contrast, gait speed was unaffected in both cross-sectional and longitudinal comparisons. Conclusion These preliminary findings suggest that fractal-like measures of gait health may be sufficiently precise to capture the positive effects of exercise in the form of Tai Chi, thus warranting further investigation. These results motivate larger and longer-duration trials, in both healthy and health-challenged populations, to further evaluate the potential of Tai Chi to restore age-related declines in gait dynamics. Trial registration The randomized trial component of this study was registered at ClinicalTrials.gov (NCT01340365).
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Does Postural Awareness Contribute to Exercise-Induced Improvements in Neck Pain Intensity? A Secondary Analysis of a Randomized Controlled Trial Evaluating Tai Chi and Neck Exercises. Spine (Phila Pa 1976) 2017; 42:1195-1200. [PMID: 28146026 DOI: 10.1097/brs.0000000000002078] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Secondary analysis of a randomized controlled trial. OBJECTIVE This secondary analysis aims to examine associations of improvement of chronic neck pain with patients' and intervention-related characteristics. SUMMARY OF BACKGROUND DATA Previous research has found that Tai Chi and neck exercises significantly improved chronic nonspecific neck pain; however, the factors for treatment success remain unclear. METHODS Subjects with chronic nonspecific neck pain were randomly assigned to 12 weeks of group Tai Chi or conventional neck exercises, and they attended 12 weekly sessions of 60 to 90 minutes. The interventions included exercises to improve body awareness, that is, interoceptive and postural awareness. A linear forward stepwise regression analysis was conducted to examine associations with improvements in neck pain intensity. Potential predictor variables included baseline pain, age, sex, the type of intervention, attendance rate and home practice duration, and changes in psychological well-being, perceived stress, and postural and interoceptive awareness during the study. RESULTS Overall 75 patients were randomized into Tai Chi or conventional exercises, with the majority being women (78.7%). Participants reported an average pain intensity of 50.7 ± 20.4 mm visual analog scale at baseline, and the average reduction of pain intensity in both groups was 21.4 ± 21.3 mm visual analog scale. Regression analysis revealed that reductions in pain intensity from baseline to 12 weeks were predicted by higher pain intensity at baseline (r = 0.226, P < 0.001), a decrease in anxiety (r = 0.102, P = 0.001), and an increase in postural awareness (r = 0.078, P = 0.0033), explaining a total of 40.6% of variance. CONCLUSION Neck pain improvement was significantly associated with changes in postural awareness in subject with chronic nonspecific neck pain independent of treatment characteristics. Training of postural awareness might be an important mechanism of action of different exercise-based interventions for chronic neck pain. LEVEL OF EVIDENCE N /A.
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Lomas-Vega R, Obrero-Gaitán E, Molina-Ortega FJ, Del-Pino-Casado R. Tai Chi for Risk of Falls. A Meta-analysis. J Am Geriatr Soc 2017; 65:2037-2043. [PMID: 28736853 DOI: 10.1111/jgs.15008] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To analyze the effectiveness of tai chi for falls prevention. DESIGN Systematic review and meta-analysis. SETTING Pubmed, Scopus, CINHAL, and Physiotherapy Evidence Database (PEDro) were searched to May 26, 2016. PARTICIPANTS Older adult population and at-risk adults. INTERVENTION Randomized controlled trials analyzing the effect of tai chi versus other treatments on risk of falls. MEASUREMENTS The incidence rate ratio (IRR) for falls incidence and hazard ratio (HR) for time to first fall. RESULTS The search strategy identified 891 potentially eligible studies, of which 10 met the inclusion criteria. There was high-quality evidence of a medium protective effect for fall incidence over the short term (IRR = 0.57; 95% CI = 0.46, 0.70) and a small protective effect over the long term (IRR = 0.87; 95% CI = 0.77, 0.98). Regarding injurious falls, we found very low-quality evidence of a medium protective effect over the short term (IRR = 0.50; 95% CI = 0.33, 0.74) and a small effect over the long term (IRR = 0.72; 95% CI = 0.54, 0.95). There was no effect on time to first fall, with moderate quality of evidence (HR = 0.98; 95% CI = 0.69, 1.37). CONCLUSION In at-risk adults and older adults, tai chi practice may reduce the rate of falls and injury-related falls over the short term (<12 months) by approximately 43% and 50%, respectively. Tai chi practice may not influence time to first fall in these populations. Due to the low quality of evidence, more studies investigating the effects of tai chi on injurious falls and time to first fall are required.
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Sungkarat S, Boripuntakul S, Chattipakorn N, Watcharasaksilp K, Lord SR. Effects of Tai Chi on Cognition and Fall Risk in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial. J Am Geriatr Soc 2016; 65:721-727. [DOI: 10.1111/jgs.14594] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Somporn Sungkarat
- Department of Physical Therapy; Faculty of Associated Medical Sciences, Chiang Mai University; Chiang Mai Thailand
| | - Sirinun Boripuntakul
- Department of Physical Therapy; Faculty of Associated Medical Sciences, Chiang Mai University; Chiang Mai Thailand
| | - Nipon Chattipakorn
- Department of Cardiac Electrophysiology Research and Training Center; Chiang Mai University; Chiang Mai Thailand
| | - Kanokwan Watcharasaksilp
- Division of Neurology; Department of Internal Medicine; Faculty of Medicine; Chiang Mai University; Chiang Mai Thailand
| | - Stephen R Lord
- Neuroscience Research Australia; University of New South Wales; Randwick New South Wales Australia
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The Effects of Tai Chi and Neck Exercises in the Treatment of Chronic Nonspecific Neck Pain: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2016; 17:1013-27. [DOI: 10.1016/j.jpain.2016.06.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 03/24/2016] [Accepted: 06/10/2016] [Indexed: 12/19/2022]
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Lauche R, Wayne PM, Dobos G, Cramer H. Prevalence, Patterns, and Predictors of T'ai Chi and Qigong Use in the United States: Results of a Nationally Representative Survey. J Altern Complement Med 2016; 22:336-42. [PMID: 26981616 DOI: 10.1089/acm.2015.0356] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE This study examined the prevalence, patterns, and predictors of t'ai chi and qigong use in the U.S. general population. DESIGN Cross-sectional survey. METHODS Data from the 2012 National Health Interview Survey (n = 34,525). Weighted frequencies were used to analyze lifetime and 12-month prevalence and patterns of use. Independent predictors of practice were analyzed by using logistic regression models. Analyzes were conducted in 2015. RESULTS The lifetime and 12-month prevalence of t'ai chi/qigong practice were 3.1% and 1.2%, respectively. The 12-month prevalence was associated with age older than 30 years; being African American, Asian, or other ethnic origin; living in the West; being college educated and single; and being a light to heavy alcohol consumer. Almost 39% of users attended formal classes. T'ai chi/qigong was practiced for wellness/disease prevention and to improve energy, immune function, athletic performance, or memory/concentration. Stress, arthritis, and joint problems were the most frequent specific health problems for practice. CONCLUSIONS Despite an only marginal increase of t'ai chi/qigong practice in the United States over the past 10 years, the proportion of minorities among practitioners has increased significantly. Gaps between clinical application and research are discussed.
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Affiliation(s)
- Romy Lauche
- 1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen , Essen, Germany .,2 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney , Sydney, Australia
| | - Peter M Wayne
- 3 Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, MA
| | - Gustav Dobos
- 1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen , Essen, Germany
| | - Holger Cramer
- 1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen , Essen, Germany .,2 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney , Sydney, Australia
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