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Ma J, Guo G, Yue H, Xie C, Xie F, Chen Z, Gu Y, Zhang S, Fang M, Yao F. Tuina on knee pain and functional decline of lower limbs for patients with mild-to-moderate knee osteoarthritis in Shanghai: protocol for a multicentre, assessor-blinded, randomised controlled trial. BMJ Open 2024; 14:e083440. [PMID: 38866576 PMCID: PMC11177681 DOI: 10.1136/bmjopen-2023-083440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/30/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION Knee osteoarthritis (KOA) is one of the most common osteoarthritis, imposing substantial economic and medical burdens on both individuals and society. In China, Tuina has been selected as a complementary and alternative therapy to relieve knee pain and dysfunction symptoms. However, the current evidence is insufficient to support the efficacy of Tuina therapy in addressing knee pain and improving physical function. The trial aims to compare the effectiveness of Tuina with celecoxib, which is considered as the standard treatment, and to assess its potential as an alternative therapy through changes in outcome measures. METHODS AND ANALYSIS A total of 360 KOA patients aged between 40 and 70 years and classified as Kellgren and Lawrence grades I-II will be recruited from eight subcentral hospitals. The participants will be randomly assigned to either the treatment group (Tuina, Biw) or the control group (celecoxib, Qd), with both groups undergoing a 4-week intervention phase followed by an 8-week follow-up phase. The primary outcome is the change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale at week 4 compared with baseline. Secondary outcomes including WOMAC stiffness and function subscales, WOMAC total score, 36-item Short-Form Health Survey, Timed Up and Go test, Short Physical Performance Battery, gait analysis parameters and pain medication records will be assessed at weeks 4, 8 and 12. Any adverse events that occur during the trial will be promptly recorded. ETHICS AND DISSEMINATION This study has been approved by the Ethics Committee of Shanghai Municipal Hospital of Traditional Chinese Medicine (2023SHL-KY-16-01, 2023SHL-KY-16-02). Written informed consent will be obtained from all participants. Study results will be disseminated through peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER ChiCTR2300069416.
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Affiliation(s)
- Jianwen Ma
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guangxin Guo
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hongyu Yue
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Chaoqun Xie
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fangfang Xie
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ziying Chen
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanjia Gu
- Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shuaipan Zhang
- Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Fang
- Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fei Yao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Guo G, Wang Y, Xu X, Lu K, Zhu X, Gu Y, Yang G, Yao F, Fang M. Effectiveness of Yijinjing exercise in the treatment of early-stage knee osteoarthritis: a randomized controlled trial protocol. BMJ Open 2024; 14:e074508. [PMID: 38453194 PMCID: PMC10921529 DOI: 10.1136/bmjopen-2023-074508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/11/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Knee osteoarthritis (KOA) is still a challenging degenerative joint disease with high morbidity and disease burden. Early-stage KOA, the focus of this study, could present a Window of Opportunity to arrest the disease process and reduce the disease burden. Yijinjing exercise is an important part of physical and psychological therapies in Traditional Chinese Exercise and may be an effective treatment. However, there is no clinical efficacy assessment of Yijinjing exercise for patients with early-stage KOA. Therefore, we designed a randomised controlled trial to evaluate the effectiveness of Yijinjing exercise on patients with early-stage KOA. METHODS AND ANALYSIS This is a parallel-design, two-arm, analyst assessor-blinded, randomised controlled trial. In total, 60 patients with early-stage KOA will be recruited and randomly assigned to the Yijinjing exercise group (n=30) and health education group (n=30) at a ratio of 1:1, receiving 12 weeks of Yijinjing exercise or health education accordingly. The primary outcome will be measured with the Western Ontario and McMaster Universities Osteoarthritis Index, and the secondary outcomes will include the Visual Analogue Scale, Short-Form 36 Item Health Survey Questionnaire, Beck Depression Inventory, Perceived Stress Scale, Berg Balance Scale, and Gait Analysis for a comprehensive assessment. Outcome measures are collected at baseline, at 12 week ending intervention and at the 12 week, 24 week and 48 week ending follow-up. The primay time point will be 12 weeks postintervention. Adverse events will be recorded for safety assessment. ETHICS AND DISSEMINATION This study has been approved by the ethical application of the Shanghai Municipal Hospital of Traditional Chinese Medicine Ethics Committee (2021SHL-KY-78). TRIAL REGISTRATION NUMBER ChiCTR2200065178.
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Affiliation(s)
- Guangxin Guo
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yihang Wang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiruo Xu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kaiqiu Lu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xuanying Zhu
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yijia Gu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guangpu Yang
- School of Basic Medical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fei Yao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Fang
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Tan B, Yan Y, Zhou Q, Ran Q, Chen H, Sun S, Lu W, Chen W, Wang J. Kinesitherapy for Knee Osteoarthritis Patients Physical and Psychological Health Based on "Traditional Chinese Exercise" Management Modalities: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Orthop Surg 2024; 16:3-16. [PMID: 38018392 PMCID: PMC10782256 DOI: 10.1111/os.13920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 11/30/2023] Open
Abstract
Traditional Chinese exercise ("TCE" management modalities), including but not limited to Tai Chi, Baduanjin, and Yijinjing, has a good effect on improving the physical function of patients with knee osteoarthritis, but less attention has been paid to the impact on the psychological health of patients, and currently there is insufficient evidence to support it. We conducted this study to provide a systematic synthesis of best evidence regarding the physical and mental health of patients with knee osteoarthritis treated by traditional Chinese exercise. Literature on the effectiveness of traditional Chinese exercise (Tai Chi, Baduanjin, Yijinjing, Qigong, etc.) versus conventional therapy (muscle-strength training of the lower extremity and aerobic training, wellness education, quadriceps strengthening exercises, etc.) on Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog scale (VAS), Short Form-36 (SF-36), Timed Up and Go Test (TUG), and Berg Balance Scale (BBS) in knee osteoarthritis (KOA) from Pubmed, Web of Science, Ovid Technologies, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database, and SinoMed were collected from their inception to April 2022. Thirty-three studies with 2621 cases were included in this study. The study's results indicated that compared with conventional therapy, traditional Chinese exercise had more advantages on patients' WOMAC score, significantly reducing patients' overall WOMAC score (SMD = -0.99; 95% CI: -1.38, -0.60; p < 0.00001) and relieving pain (SMD = -0.76; 95% CI: -1.11, -0.40; p < 0.0001) in patients with KOA. It also has advantages over conventional therapy in improving mental component score (MCS) (SMD = 0.32; 95% CI: -0.00, 0.65; p = 0.05) and physical component score (PCS) (SMD = 0.34; 95% CI: 0.05, 0.62; p = 0.02). Compared with conventional therapy, traditional Chinese exercise can significantly reduce the effect on timed up and go test (TUG) score (SMD = -0.30; 95% CI: -0.50, -0.11; p = 0.002), beck depression inventory (DBI) score (SMD = -0.62; 95% CI: -1.03, -0.22; p = 0.002), and increase the impact on Berg Balance Scale (BBS) score (SMD = 0.60; 95% CI: 0.37, 0.83; p < 0.00001). The findings of this study indicated that traditional Chinese exercise improved body function and mental health in patients with knee osteoarthritis significantly. More high-quality clinical evidence-based data was needed to confirm the therapeutic effect of traditional Chinese exercise on the physical and mental health in KOA patients.
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Affiliation(s)
- Biao Tan
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Yan Yan
- The Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | - Qiujun Zhou
- Department of First Clinical Medical CollegeZhejiang Chinese Medical UniversityHangzhouChina
| | - Qiang Ran
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Hong Chen
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Shiyi Sun
- Department of OrthopaedicsChina Academy of Chinese Medical Sciences, Wangjing HospitalBeijingChina
| | - Weizhong Lu
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Weiheng Chen
- The Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | - Jiajun Wang
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
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Burley CV, Casey AN, Jones MD, Wright KE, Parmenter BJ. Nonpharmacological approaches for pain and symptoms of depression in people with osteoarthritis: systematic review and meta-analyses. Sci Rep 2023; 13:15449. [PMID: 37723233 PMCID: PMC10507102 DOI: 10.1038/s41598-023-41709-x] [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: 02/07/2023] [Accepted: 08/30/2023] [Indexed: 09/20/2023] Open
Abstract
People with osteoarthritis often experience pain and depression. These meta-analyses examined and compared nonpharmacological randomized controlled trials (RCTs) for pain and symptoms of depression in people living with osteoarthritis. RCTs published up until April 2022 were sourced by searching electronic databases EMBASE, PUBMED & MEDLINE, Web of Science, CINAHL and PEDro. Random-effects meta-analyses were performed to calculate pooled effect sizes (ES) and 95% confidence intervals (CI) for pain and depression. Subgroup analyses examined intervention subtypes. For pain, 29 interventions (n = 4382; 65 ± 6.9 years; 70% female), revealed a significant effect on reducing pain (ES = 0.43, 95% CI [0.25, 0.61], p < 0.001). Effect sizes were significant (p < 0.001) for movement meditation (ES = 0.52; 95% CI [0.35, 0.69]), multimodal approaches (ES = 0.37; 95% CI [0.22, 0.51]), and psychological therapy (ES = 0.21; 95% CI [0.11, 0.31]), and significant (p = 0.046) for resistance exercise (ES = 0.43, 95% CI [- 0.07, 0.94]. Aerobic exercise alone did not improve pain. For depression, 28 interventions (n = 3377; 63 ± 7.0 years; 69% female), revealed a significant effect on reducing depressive symptoms (ES = 0.29, 95% CI [0.08, 0.49], p < 0.001). Effect sizes were significant for movement meditation (ES = 0.30; 95% CI [0.06, 0.55], p = 0.008) and multimodal interventions (ES = 0.12; 95% CI [0.07, 0.18], p < 0.001). Resistance/aerobic exercise or therapy alone did not improve depressive symptoms. Mind-body approaches were more effective than aerobic/resistance exercise or therapy alone for reducing pain and depression in people with osteoarthritis.Systematic review registration: PROSPERO CRD42022338051.
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Affiliation(s)
- Claire V Burley
- UNSW Medicine & Health Lifestyle Clinic, School of Health Sciences, University of New South Wales, Sydney, Australia.
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
| | - Anne-Nicole Casey
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Matthew D Jones
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Kemi E Wright
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, Australia
| | - Belinda J Parmenter
- UNSW Medicine & Health Lifestyle Clinic, School of Health Sciences, University of New South Wales, Sydney, Australia
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, Australia
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Guo W, Xing H, Gong X, He L, Zhang Z, Jia C. Effects of Yi Jin Jing on juvenile cervical spondylopathy in China: A parallel, randomized, assessor-blinded clinical trial. Niger J Clin Pract 2023; 26:1234-1241. [PMID: 37794534 DOI: 10.4103/njcp.njcp_410_22] [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] [Indexed: 10/06/2023]
Abstract
Background Cervical spondylopathy is a common musculo-articular disorder, multiple exercises are recommended. Chinese fitness exercises are prevalent and used to treat various diseases. Aim To explore the efficacy of Chinese fitness exercise Yi Jin Jing exercise in intervening the cervical spondylopathy in adolescents. Patients and Methods The study was conducted in 60 adolescent patients with cervical spondylopathy, with 30 patients in each group. Methods The study was conducted in 60 adolescent patients with cervical spondylopathy, with 30 patients in each group. The observation group was required to take Yi Jin Jing exercise, and the control group took the brisk walking exercise. The first week was the preparatory period for the patients, and then the participants were required to do exercises three times a week for at least 30 minutes in the later 3 weeks. Before and after treatment, Neck Disability Index (NDI) scores, pain visual analog scale (VAS) scores, and cervical curvature in both groups were observed, and the incidence of adverse events in both groups was recorded during the trial. Results The NDI and VAS scores in both groups statistically decreased after intervention and mildly increased at follow-up, while the reduction in scores of the Yi Jin Jing group was more significant. Cervical curvature in both groups improved on day 28 compared to day 0. There were no adverse reactions during the evaluation period. Conclusion The Chinese health-care qigong Yi Jin Jing exercise is more effective than brisk walking in improving the cervical range of motion and relieving pain in adolescents with cervical spondylopathy. Trial registration/Protocol registration: Clinical Trial Registry (ChiCTR2000030723).
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Affiliation(s)
- W Guo
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - H Xing
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - X Gong
- Deparment of Acupuncture and Moxibustion, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - L He
- Deparment of Acupuncture and Moxibustion, Baiyun Hospital of The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Z Zhang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - C Jia
- Deparment of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Zhang S, Huang R, Guo G, Kong L, Li J, Zhu Q, Fang M. Efficacy of traditional Chinese exercise for the treatment of pain and disability on knee osteoarthritis patients: a systematic review and meta-analysis of randomized controlled trials. Front Public Health 2023; 11:1168167. [PMID: 37361162 PMCID: PMC10285305 DOI: 10.3389/fpubh.2023.1168167] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/12/2023] [Indexed: 06/28/2023] Open
Abstract
Objective To evaluate the efficacy of Traditional Chinese Exercises (TCEs) in treating knee osteoarthritis (KOA). Methods Four databases without language or publication status restrictions were searched until April 1, 2022. Based on the principle of Population, Intervention, Comparison, Outcomes and Study design, the researchers searched for randomized controlled trials of TCEs in treating KOA. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain was defined as the primary outcome, whereas stiffness and physical function were the secondary outcomes. Subsequently, two researchers conducted the process independently, and the data were analyzed using the RevManV.5.3 software. Results Overall, 17 randomized trials involving 1174 participants met the inclusion criteria. The synthesized data of TCEs showed a significant improvement in WOMAC pain score [standardized mean difference (SMD) = -0.31; 95% confidence interval (CI): -0.52 to -0.10; p = 0.004], stiffness score (SMD = -0.63; 95% CI: -1.01 to -0.25; p = 0.001) and physical function score (SMD = -0.38; 95% CI: -0.61 to -0.15; p = 0.001) compared with the control group. Sensitivity analyses were performed to determine the combined results' stability, which was unstable after excluding articles with greater heterogeneity. A further subgroup analysis showed that it might be the reason for the heterogeneity of the different traditional exercise intervention methods. Additionally, it showed that the Taijiquan group improved pain (SMD = 0.74; 95% CI: -1.09 to 0.38; p < 0.0001; I2 = 50%), stiffness (SMD = -0.67; 95% CI -1.14 to 0.20; p = 0.005) and physical function score (SMD = -0.35; 95% CI: -0.54 to 0.16; p = 0.0003; I2 = 0%) better than the control group. The Baduanjin group improved stiffness (SMD = -1.30; 95% CI: -2.32 to 0.28; p = 0.01) and physical function (SMD = -0.52; 95% CI: -0.97 to 0.07; p = 0.02) better than the control group. However, the other interventions showed no difference compared with the control group. Conclusion This systematic review provides partial evidence of the benefits of TCEs for knee pain and dysfunction. However, due to the heterogeneity of exercise, more high-quality clinical studies should be conducted to verify the efficacy. Systematic review registration https://inplasy.com/inplasy-2022-4-0154/, identifier: International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) [INPLSY202240154].
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Affiliation(s)
- Shuaipan Zhang
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ruixin Huang
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Guangxin Guo
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lingjun Kong
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Jianhua Li
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qingguang Zhu
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Min Fang
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Zhang T, Tian J, Fan J, Liu X, Wang R. Exercise training-attenuated insulin resistance and liver injury in elderly pre-diabetic patients correlates with NLRP3 inflammasome. Front Immunol 2023; 14:1082050. [PMID: 36817440 PMCID: PMC9929576 DOI: 10.3389/fimmu.2023.1082050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/18/2023] [Indexed: 02/04/2023] Open
Abstract
Background Diabetes is one of the most common metabolic diseases and continues to be a leading cause of death worldwide. The NLRP3 inflammasome has been shown to exert detrimental effects on diabetic models. However, evidence linking NLRP3 inflammasome and pre-diabetes has been scarcely explored. Herein, we aimed to determine whether the NLRP3 inflammasome correlates with insulin resistance and liver pathology in a cohort of pre-diabetic subjects. Methods 50 pre-diabetic subjects were randomly assigned to a Pre-diabetes Control (DC, n=25) and a Pre-diabetes exercise (DEx, n=25) group. 25 Normal subjects (NC) were selected as controls. The DEx group performed a 6-month combined Yijingjing and resistance training intervention, while DC and NC group remained daily routines. Clinical metabolic parameters were determined with an automatic biochemistry analyzer; inflammatory cytokines were quantified by the ELISA assay; the protein expressions of NLRP3 inflammasome components in PBMCs were evaluated by Western Blot. Results The insulin resistance, liver injury and NLRP3 inflammasome activity were higher in pre-diabetic individuals than in normal control group. However, 6-month exercise intervention counteracted this trend, significantly improved insulin sensitivity, reduced liver injury and inhibited the overactivation of NLRP3 inflammasome in pre-diabetic subjects. Moreover, positive correlations between insulin resistance, liver pathology and NLRP3 inflammasome were also found. Conclusions Our study suggests that exercise training is an effective strategy to alleviate insulin resistance and liver injury in elderly pre-diabetic subjects which is probably associated with the inhibition of NLRP3 inflammasome activity.
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Affiliation(s)
- Tan Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
| | - Jingjing Tian
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
| | - Jingcheng Fan
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
| | - Xiangyun Liu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
| | - Ru Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
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Guo J, Peng C, Hu Z, Guo L, Dai R, Li Y. Effect of Wu Qin Xi exercises on pain and function in people with knee osteoarthritis: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:979207. [PMID: 36419784 PMCID: PMC9676488 DOI: 10.3389/fmed.2022.979207] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/01/2022] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND As a chronic disease that affects the whole world, there is no definite treatment for knee osteoarthritis (KOA). Wu Qin Xi (WQX) is still in preliminary exploration as a traditional Chinese exercise in the treatment of osteoarthritis of the knee. The purpose of this study was to conduct a meta-analysis of previous studies and to investigate the efficacy of the WQX exercises on pain and function in patients with KOA. METHODS We searched six databases (Pubmed, Embase, Cochrane Library, Wanfang, CQVIP, and CNKI) for articles on WQX for KOA up to May 10, 2022. Literature search, study selection, data extraction, and quality evaluation were performed by two independent authors. In terms of statistical results, we presented mean differences (MD), 95% CI, and I 2 to show heterogeneity, and, based on that, we chose either a random effects model or a fixed effects model. RESULTS Seven studies were selected for inclusion in this meta-analysis. The WQX intervention group showed statistical differences for both the total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and its various bylaws, the Visual Analogue Score (VAS), and the presence of general functional exercise in the control group. We also demonstrated the clinically meaningful efficacy of WQX treatment by calculating minimum clinical importance difference (MCID) values that met the MCID values on the WOMAC score. A sensitivity analysis was also performed in this study by subgroup analysis for greater heterogeneity, and it was inferred that the difference in follow-up time was a likely source of heterogeneity. CONCLUSION Despite some limitations, the current study showed a definite effect of WQX in improving pain symptoms and joint function in patients with KOA. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier: CRD42022332209.
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Affiliation(s)
| | | | | | | | | | - Yehai Li
- Department of Orthopedics, Chaohu Hospital of Anhui Medical University, Hefei, China
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Wei M, Meng D, Guo H, He S, Tian Z, Wang Z, Yang G, Wang Z. Hybrid Exercise Program for Sarcopenia in Older Adults: The Effectiveness of Explainable Artificial Intelligence-Based Clinical Assistance in Assessing Skeletal Muscle Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19169952. [PMID: 36011588 PMCID: PMC9407935 DOI: 10.3390/ijerph19169952] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/07/2022] [Accepted: 08/10/2022] [Indexed: 06/07/2023]
Abstract
Background: Sarcopenia is a geriatric syndrome characterized by decreased skeletal muscle mass and function with age. It is well-established that resistance exercise and Yi Jin Jing improve the skeletal muscle mass of older adults with sarcopenia. Accordingly, we designed an exercise program incorporating resistance exercise and Yi Jin Jing to increase skeletal muscle mass and reverse sarcopenia in older adults. Additionally, machine learning simulations were used to predict the sarcopenia status after the intervention. Method: This randomized controlled trial assessed the effects of sarcopenia in older adults. For 24 weeks, 90 older adults with sarcopenia were divided into intervention groups, including the Yi Jin Jing and resistance training group (YR, n = 30), the resistance training group (RT, n = 30), and the control group (CG, n = 30). Computed tomography (CT) scans of the abdomen were used to quantify the skeletal muscle cross-sectional area at the third lumbar vertebra (L3 SMA). Participants’ age, body mass, stature, and BMI characteristics were analyzed by one-way ANOVA and the chi-squared test for categorical data. This study explored the improvement effect of three interventions on participants’ L3 SMA, skeletal muscle density at the third lumbar vertebra (L3 SMD), skeletal muscle interstitial fat area at the third lumbar vertebra region of interest (L3 SMFA), skeletal muscle interstitial fat density at the third lumbar vertebra (L3 SMFD), relative skeletal muscle mass index (RSMI), muscle fat infiltration (MFI), and handgrip strength. Experimental data were analyzed using two-way repeated-measures ANOVA. Eleven machine learning models were trained and tested 100 times to assess the model’s performance in predicting whether sarcopenia could be reversed following the intervention. Results: There was a significant interaction in L3 SMA (p < 0.05), RSMI (p < 0.05), MFI (p < 0.05), and handgrip strength (p < 0.05). After the intervention, participants in the YR and RT groups showed significant improvements in L3 SMA, RSMI, and handgrip strength. Post hoc tests showed that the YR group (p < 0.05) yielded significantly better L3 SMA and RSMI than the RT group (p < 0.05) and CG group (p < 0.05) after the intervention. Compared with other models, the stacking model exhibits the best performance in terms of accuracy (85.7%) and F1 (75.3%). Conclusion: One hybrid exercise program with Yi Jin Jing and resistance exercise training can improve skeletal muscle area among older adults with sarcopenia. Accordingly, it is possible to predict whether sarcopenia can be reversed in older adults based on our stacking model.
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Affiliation(s)
- Meiqi Wei
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China
| | - Deyu Meng
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China
| | - Hongzhi Guo
- Graduate School of Human Sciences, Waseda University, Tokorozawa 169-8050, Japan
- AI Group, Intelligent Lancet LLC, Sacramento, CA 95816, USA
| | - Shichun He
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China
| | - Zhibo Tian
- College of Physical Education and Health, Guangxi Normal University, Guilin 541006, China
| | - Ziyi Wang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China
| | - Guang Yang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China
| | - Ziheng Wang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China
- AI Group, Intelligent Lancet LLC, Sacramento, CA 95816, USA
- Advanced Research Center for Human Sciences, Waseda University, Tokorozawa 169-8050, Japan
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Sun P, Zhang S, Jiang L, Ma Z, Yao C, Zhu Q, Fang M. Yijinjing Qigong intervention shows strong evidence on clinical effectiveness and electroencephalography signal features for early poststroke depression: A randomized, controlled trial. Front Aging Neurosci 2022; 14:956316. [PMID: 36034130 PMCID: PMC9400391 DOI: 10.3389/fnagi.2022.956316] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Although Traditional Chinese Yijinjing Qigong Exercise (YJJQE) as mind–body intervention is popularly used among adults to ameliorate depressive symptoms in China, no randomized controlled trials (RCTs) are available to evaluate the effects of YJJQE in patients with poststroke depression (PSD). This study aims to explore the clinical efficacy and the neurological and psychiatric mechanism in brain network functional connectivity underlying electroencephalography (EEG). Materials and methods A total of 60 patients, diagnosed with mild PSD, were randomly (1:1) assigned to YJJQE group (n = 30) and control group of routine segmental rehabilitation training group (n = 30) for a 60-min exercise session once a day for 3 weeks. All outcome measures were collected at baseline and 3-weeks ending intervention. The primary outcome was the 24-item Hamilton Depression Scale (HAMD-24) score, evaluation at more time points for 1 month of follow-up. The secondary outcomes were EEG data in four frequency domains (δ, θ, α, and β), global efficiency (GE), local efficiency (LE), GE/LE curve [areas under the curve (AUC)], Phase Lag Index (PLI), (HAMD-24) Score and EEG correlation analysis. Results All patients showed no significant differences in baseline data. After 3 weeks and 1 month of follow-up, the YJJQE group demonstrated significant decreasing changes compared to the control group on the HAMD-24 scores (p < 0.001). Furthermore, the YJJQE group also showed a significant reduction in θ wave, and an increase in both GE and LE. Compared to the control group, the YJJQE Qigong group showed significantly greater functional connectivity in the δ, θ, and β frequency bands in the brain network of the degree of phase synchronization (p < 0.001). HAMD-24 Score and EEG correlation analysis negative correlation in the Qigong group θ wave (p < 0.001). Conclusion Our findings demonstrated that YJJQE is estimated to effectively alleviate the depressed mood of patients with PSD by promoting the efficiency in information transmission of network functional connectivity and its integration ability in different brain regions. Therefore, the YJJQE would be useful as a non-pharmacological treatment to prevent PSD. Clinical trial registration [http://www.chictr.org.cn/showproj.aspx?proj=55789], identifier [ChiCTR2000035588].
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Affiliation(s)
- Pingping Sun
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shuaipan Zhang
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Linhong Jiang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhenzhen Ma
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chongjie Yao
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qingguang Zhu
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Tuina Research, Research Institute of Traditional Chinese Medicine in Shanghai, Shanghai, China
- *Correspondence: Qingguang Zhu,
| | - Min Fang
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Tuina Research, Research Institute of Traditional Chinese Medicine in Shanghai, Shanghai, China
- Min Fang,
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11
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Scientific Evidence of Traditional Chinese Exercise (Qigong) for Chronic Obstructive Pulmonary Disease: An Overview of Systematic Reviews and Meta-Analyses. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7728973. [PMID: 35958822 PMCID: PMC9363203 DOI: 10.1155/2022/7728973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/26/2022] [Accepted: 07/22/2022] [Indexed: 12/20/2022]
Abstract
Background As a traditional Chinese exercise, Qigong has potential benefits for the management of chronic obstructive pulmonary disease (COPD). This overview is aimed at assessing the existing evidence for the intervention of Qigong in COPD so as to provide scientific guidance for clinical decision-making. Methods The systematic reviews (SRs)/meta-analyses (MAs) of Qigong for the treatment of COPD were obtained from 7 electronic databases with the search date set at April 5, 2022. Two researchers independently assessed the methodological quality, reporting quality, and evidence quality for the included SRs/MAs using the following tools: the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results A total of 13 SRs/MAs were included in this overview. All SRs/MAs assessed by AMSTAR-2 had more than one critical defect, so all SR/MAs were rated very low. Regarding the assessment of reporting quality, the results of PRISMA 2020 showed that none of the SRs/MAs were fully reported. In addition, the results of the GRADE assessment of the quality of evidence indicated that only 3 outcomes were rated as high quality across all SRs/MAs. Conclusion Current evidence suggests that Qigong is effective and safe for the management of patients with COPD. However, the high risk of bias in the original clinical studies and the low quality of the SRs/MAs reduced the reliability of the results.
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