Network meta-analysis of the efficacy of four traditional Chinese physical exercise therapies on the prevention of falls in the elderly

Introduction

In recent years, traditional Chinese exercises have been passed down and reformed to play a significant role in the study of interventions for the treatment of falls in older people. However, few studies have evaluated the efficacy of various Chinese traditional exercises in the intervention of falls behavior in the elderly. In this study, four Chinese traditional exercises commonly used in clinical practice were selected as subjects to systematically evaluate the effectiveness of Tai Chi, Ba Duan Jin, Yi Jin Jing and Wu Qin Xi in intervening in the treatment of fall behavior in the elderly.

Methods

We conducted a systematic review in accordance with the PRISMA guidelines. Four published randomized controlled trials (RCTs) of traditional Chinese exercise interventions for the treatment of falls behavior in older adults were searched through authoritative databases such as CNKI, Web of Science, PubMed, EMbase and the Cochrane Library, all from the time of construction to November 2022.

Results

A total of 45 studies with 4 traditional interventions were included. Ba Duan Jin was more effective in improving TUGT [SMD = -1.93 (-2.49, -1.38), P < 0.05] and MFES [SMD = -33.45 (-63.93, -2.97), P < 0.05], while Yi Jin Jing was more effective in enhancing ECLSB [SMD = -0.19 (-5.12, -4.74), P < 0.05] and BBS [SMD = -5.79 (-10.80, -0.78), P < 0.05], both of which showed better effects.

Discussion

The present evidence suggests that all four traditional Chinese body-building exercise therapies have a preventive effect on fall behavior in older adults. In clinical treatment and daily physical exercise, two exercises, BaDuan Jin and Yi Jin Jing, may be preferred to reduce the risk of falls in the elderly, but the exercise regimen of Qigong should be selected scientifically and rationally according to their actual conditions.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/#myprospero.

Hybrid Exercise Program Enhances Physical Fitness and Reverses Frailty in Older Adults: Insights and Predictions from Machine Learning

PURPOSE

The declining physical condition of the older adults is a pressing issue. Wu Qin Xi exercise, despite being low-intensity, is highly effective among older adults. Inspired by its characteristics, we designed a new exercise program for frail older adults, combining strength, endurance, and Wu Qin Xi. Furthermore, we employed machine learning to predict whether frailty can be reversed in older adults after the intervention.

METHODS

A total of 181 community-dwelling frail older adults aged 65 years or older participated in this single-center, randomized controlled study, with 54.7% (n=99) being female. The study assessed the effectiveness of several exercise modalities in reversing frailty. The Fried's frailty criterion was used to assess the degree of frailty of the subjects. Participants were assigned a three-digit code 001-163 and randomly assigned (1:1:1) by computer to three different groups based on the study participant number: the Wu Qin Xi group (WQX), the strength exercise mixed with endurance exercise training group (SE), and the WQXSE hybrid exercise group incorporated the above two. Body composition and frailty-related physical fitness factors were measured before and after a 24-week intervention. The measurements included Body height, Body mass, Timed Up and Go Test (TUGT), grip strength assessment (GS), 6min walk test (6 min WT), and 10 m maximum walk speed (10 m MWS). Data were analyzed using repeated measures ANOVA to determine group and time interaction effects and machine learning models were used to predict program effectiveness.

RESULTS

A total of 163 participants completed the study, with 53.9% (n=88) of them being female. The two items, 10 m maximum walking speed (10 m MWS) and grip strength, were significantly affected by the interaction of group and time. Compared to the other two groups, the WQXSE group showed the most improvement in the item 10 m MWS. In addition, following 24 weeks of training, 68 (41.7%) of the initially frail older adults had reversed their frailty status. Among them, 19 (36.5%) were in the WQX group, 24 (44.4%) were in the WQXSE group, and 25 (43.9%) were in the SE group. The stacking model exhibited superior performance when compared to other algorithms.

CONCLUSION

A hybrid exercise regimen comprising the Wu Qin Xi routine and exercises focused on both strength and endurance holds the potential to yield greater improvements in the physical fitness of older adults, as well as reducing frailty. Leveraging a stacking model, it is possible to forecast the likelihood of older adults successfully reversing their frailty status following participation in a prevention exercise program.

Effect of Wu Qin Xi exercises on pain and function in people with knee osteoarthritis: A systematic review and meta-analysis

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.