Dyspnea, a prevalent and debilitating symptom in patients with advanced lung cancer, negatively affects symptom burden and prognosis. Physical activity has emerged as a promising non-pharmacological ...intervention for managing dyspnea.
This study compared the effectiveness of two widely-recognized physical activity modalities, namely Tai Chi (TC) and aerobic exercise (AE) for treating dyspnea in patients with advanced lung cancer.
Patients with advanced lung cancer (n=226) were randomized into TC, AE, or control groups. There was no baseline dyspnea requirement for patients. The AE group received two 60-minute supervised sessions and home-based exercises per month, the TC group received 60-minute sessions twice weekly, and the control group received exercise guidelines for 16 weeks. The primary outcome (sleep quality) of the study has been previously reported. In this secondary analysis, we focused on dyspnea outcomes, including overall and lung cancer-specific dyspnea. Assessments were conducted at baseline (T0), 16 weeks (T1), and one year (T2).
Compared to the control group, TC significantly improved overall dyspnea at T1 (between-group difference, −8.69; P=0.03) and T2 (between-group difference, −11.45; P=0.01), but not AE. Both AE (between-group difference, −11.04; P=0.01) and TC (between-group difference, −14.19; P<0.001) significantly alleviated lung cancer-specific dyspnea at T2 compared with the control group.
Both TC and AE alleviate dyspnea severity in patients with advanced lung cancer, and continuous exercise can yield substantial improvements. Due to its multi-component nature, Tai Chi has a greater effect on dyspnea.
Tai Chi is an ancient exercise originated from China. The slow movements of Tai Chi are not thought to evoke an increase in heart rate above 60% HRM, and yet Tai Chi has been found to improve ...vascular health. We are interested in the response to a single session of Tai Chi, as a mild physical stressor. The acute response to exercise is very important as a stimulus for adaptation, but to our knowledge, no previous studies have assessed the acute response to Tai Chi. The aim of this study was to investigate the response to a single session of Tai Chi. Blood markers of oxidative stress (lipid peroxidation, antioxidant capacity) and inflammation (IL-6) were assessed along with flow-mediated dilation (FMD) in young (18-25years old) and elderly participants (65–75 years old). Participants visited the laboratory twice to undertake Tai Chi or a control visit. Blood withdrawal and FMD assessment were performed every hour, for 4 consecutive hours. Inflammation at baseline was increased in older participants, compared to young and MDA and IL-6 increased immediately after Tai Chi in both groups. Antioxidant capacity increased immediately and post one hour after Tai Chi in both groups. A single bout of Tai Chi was seen to promote cytokine release and increased antioxidant capacity, and may have a beneficial effect in improving human vasculature via these mechanisms in both old and young.
To investigate whether a simplified and personalized Tai-Chi program could be beneficial for practitioners. A prospective quasi-experimental observer-blinded controlled trial was done in Beitou ...District of Taipei City.
Community-dwelling adults aged 65 and older without debilitating disease (N = 50) participated the study. Those who were willing to participate in exercise program were assigned to individualized Tai-Chi (iTC) group (n = 20), receiving iTC training for 8 weeks, and traditional Tai-Chi (tTC) group (n = 15), receiving tTC training for 8 weeks. Those who were not willing to participate in exercise training were included in the control group (n = 15). Functional balance tests, the Berg Balance Scale (BBS), timed up-and-go (TUG) test, functional-reach test, and measurement of lower-extremity muscle strength were conducted before and 8 weeks after the intervention.
Significant improvements were noted in all functional balance tests and strength assessments of 16 major lower-limb muscle groups in participants of the iTC group compared to the control group, whereas only BBS and muscle strength of hips and ankles were improved in the tTC group. Practitioners of iTC outperformed tTC in BBS and strength of two major muscles.
Personalized Tai-Chi training designed based on an objective measurement and conducted according to graded intensity and complexity benefitted practitioners after a short period.
Trial registration number: ClinicalTrials.gov ID: NCT03659396 , Unique Protocol ID: 1000087 Date of registration: 03/28/2017 The trial was registered retrospectively.
•Tai Chi mind–body exercise was compared to brisk walking aerobic exercise on modulating the interactions between heart rate variability (HRV) and blood flow oscillations (BFO) of the upper and lower ...limbs.•Tai Chi is effectively on modulating the degree of coherence between HRV and BFO of the upper limb.•Brisk walking is effectively on modulating the degree of coherence between HRV and BFO of the lower limb.•Wavelet phase coherence between HRV and BFO is able to differentiate the effect of mind–body exercise from aerobic exercise.
Tai Chi exercise has been demonstrated to be beneficial for health and quality of life. However, the mind–body effect of Tai Chi on modulating interactions of the cardiovascular components has not been investigated. This study aimed to differentiate the effect of Tai Chi (mind–body exercise) and brisk walking (aerobic exercise) on modulating skin blood flow oscillations (BFO) of the upper and lower limbs and heart rate variability (HRV). Bafa Wubu of Tai Chi for 15 min and brisk walking for 15 min were performed by 30 adults in two different days. Wavelet phase coherence was employed to assess the coordination between HRV and BFO before and after exercise. Two indices were proposed to quantify the coherence, i.e., the area (Aϕ) and maximal difference (dmax) between the coherence function and the threshold obtained by surrogate test. The results demonstrated that Tai Chi resulted in a significant decrease in phase coherence between HRV and BFO of the upper limb in the frequency interval 0.05–0.15 Hz (Aϕ baseline 0.1600 ± 0.0288, post-exercise 0.0486 ± 0.0220, p < 0.001; dmax baseline 0.3222 ± 0.0220, post-exercise 0.2578 ± 0.0219, p < 0.005), but not between HRV and BFO of the lower limb. Brisk walking resulted in a significant increase in phase coherence between HRV and BFO of the lower limb in the frequency interval 0.05–0.15 Hz (Aϕ baseline 0.0455 ± 0.0251, post-exercise 0.1190 ± 0.0241, p < 0.05; dmax baseline 0.2191 ± 0.0225, post-exercise 0.3103 ± 0.0208, p < 0.05) but not between HRV and BFO of the upper limb. Our finding indicates that mind–body exercise and aerobic exercise modulate cardiovascular regulations through different mechanisms of action.
In COPD, functional status is improved by pulmonary rehabilitation (PR) but requires specific facilities. Tai Chi, which combines psychological treatment and physical exercise and requires no special ...equipment, is widely practiced in China and is becoming increasingly popular in the rest of the world. We hypothesized that Tai Chi is equivalent (ie, difference less than ±4 St. George’s Respiratory Questionnaire SGRQ points) to PR.
A total of 120 patients (mean FEV1, 1.11 ± 0.42 L; 43.6% predicted) bronchodilator-naive patients were studied. Two weeks after starting indacaterol 150 μg once daily, they randomly received either standard PR thrice weekly or group Tai Chi five times weekly, for 12 weeks. The primary end point was change in SGRQ prior to and following the exercise intervention; measurements were also made 12 weeks after the end of the intervention.
The between-group difference for SGRQ at the end of the exercise interventions was –0.48 (95% CI PR vs Tai Chi, –3.6 to 2.6; P = .76), excluding a difference exceeding the minimal clinically important difference. Twelve weeks later, the between-group difference for SGRQ was 4.5 (95% CI, 1.9 to 7.0; P < .001), favoring Tai Chi. Similar trends were observed for 6-min walk distance; no change in FEV1 was observed.
Tai Chi is equivalent to PR for improving SGRQ in COPD. Twelve weeks after exercise cessation, a clinically significant difference in SGRQ emerged favoring Tai Chi. Tai Chi is an appropriate substitute for PR.
ClinicalTrials.gov; No.: NCT02665130; URL: www.clinicaltrials.gov.
Insomnia contributes to inflammation in breast cancer survivors. This study evaluates whether insomnia treatment reverses inflammation in breast cancer survivors with insomnia.
Participants (n = 90) ...were randomized to 3 months of Tai Chi (n = 45) or cognitive behavioral therapy for insomnia (CBT-I)(n = 45), and followed for one year post-intervention to 15 month endpoint. Our previous report found that Tai Chi as compared to CBT-I resulted in similar rates of insomnia response and remission over 15 months. Here, we analyze changes in plasma C-reactive protein and pro- and anti-inflammatory cytokines, Toll-like receptor (TLR)-4 stimulated monocyte production of interleukin (IL)-6 and tumor necrosis factor-α (TNF), and cellular pro-inflammatory and anti-viral gene expression (Conserved Transcriptional Response to Adversity RNA profile; CTRA) over 15 months.
Insomnia treatment resulted in decreases in the TLR-4 stimulated monocyte production of IL-6, TNF, and their co-expression, as well as decreases in the CTRA profile, decreases inflammatory gene transcripts, and increases in anti-viral gene transcripts over 15 months (all P's < 0.01). In addition, as compared to CBT-I, Tai Chi resulted in greater decreases in plasma IL-6 (P < 0.05), and greater decreases in TLR-4 activated monocyte production of IL-6 and co-expression of IL-6 and TNF at 15 month endpoint. CBT-I resulted in greater increases in anti-viral gene transcripts.
Administration of either CBT-I or Tai Chi effectively treats insomnia, and shows additional benefits of reducing cellular and genomic markers of inflammation, and increasing anti-viral genomic markers in breast cancer survivors with insomnia. Tai Chi, as compared to CBT-I, yields greater and more durable decreases in systemic- and cellular inflammation. Targeting insomnia might mitigate the risk of inflammation-related co-morbidities in breast cancer survivors.
Exercise for osteoarthritis of the knee Fransen, Marlene; McConnell, Sara; Harmer, Alison R ...
Cochrane database of systematic reviews,
01/2015, Letnik:
2015, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Background
Knee osteoarthritis (OA) is a major public health issue because it causes chronic pain, reduces physical function and diminishes quality of life. Ageing of the population and increased ...global prevalence of obesity are anticipated to dramatically increase the prevalence of knee OA and its associated impairments. No cure for knee OA is known, but exercise therapy is among the dominant non‐pharmacological interventions recommended by international guidelines.
Objectives
To determine whether land‐based therapeutic exercise is beneficial for people with knee OA in terms of reduced joint pain or improved physical function and quality of life.
Search methods
Five electronic databases were searched, up until May 2013.
Selection criteria
All randomised controlled trials (RCTs) randomly assigning individuals and comparing groups treated with some form of land‐based therapeutic exercise (as opposed to exercise conducted in the water) with a non‐exercise group or a non‐treatment control group.
Data collection and analysis
Three teams of two review authors independently extracted data, assessed risk of bias for each study and assessed the quality of the body of evidence for each outcome using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach. We conducted analyses on continuous outcomes (pain, physical function and quality of life) immediately after treatment and on dichotomous outcomes (proportion of study withdrawals) at the end of the study; we also conducted analyses on the sustained effects of exercise on pain and function (two to six months, and longer than six months).
Main results
In total, we extracted data from 54 studies. Overall, 19 (20%) studies reported adequate random sequence generation and allocation concealment and adequately accounted for incomplete outcome data; we considered these studies to have an overall low risk of bias. Studies were largely free from selection bias, but research results may be vulnerable to performance and detection bias, as only four of the RCTs reported blinding of participants to treatment allocation, and, although most RCTs reported blinded outcome assessment, pain, physical function and quality of life were participant self‐reported.
High‐quality evidence from 44 trials (3537 participants) indicates that exercise reduced pain (standardised mean difference (SMD) ‐0.49, 95% confidence interval (CI) ‐0.39 to ‐0.59) immediately after treatment. Pain was estimated at 44 points on a 0 to 100‐point scale (0 indicated no pain) in the control group; exercise reduced pain by an equivalent of 12 points (95% CI 10 to 15 points). Moderate‐quality evidence from 44 trials (3913 participants) showed that exercise improved physical function (SMD ‐0.52, 95% CI ‐0.39 to ‐0.64) immediately after treatment. Physical function was estimated at 38 points on a 0 to 100‐point scale (0 indicated no loss of physical function) in the control group; exercise improved physical function by an equivalent of 10 points (95% CI 8 to 13 points). High‐quality evidence from 13 studies (1073 participants) revealed that exercise improved quality of life (SMD 0.28, 95% CI 0.15 to 0.40) immediately after treatment. Quality of life was estimated at 43 points on a 0 to 100‐point scale (100 indicated best quality of life) in the control group; exercise improved quality of life by an equivalent of 4 points (95% CI 2 to 5 points).
High‐quality evidence from 45 studies (4607 participants) showed a comparable likelihood of withdrawal from exercise allocation (event rate 14%) compared with the control group (event rate 15%), and this difference was not significant: odds ratio (OR) 0.93 (95% CI 0.75 to 1.15). Eight studies reported adverse events, all of which were related to increased knee or low back pain attributed to the exercise intervention provided. No study reported a serious adverse event.
In addition, 12 included studies provided two to six‐month post‐treatment sustainability data on 1468 participants for knee pain and on 1279 (10 studies) participants for physical function. These studies indicated sustainability of treatment effect for pain (SMD ‐0.24, 95% CI ‐0.35 to ‐0.14), with an equivalent reduction of 6 (3 to 9) points on 0 to 100‐point scale, and of physical function (SMD ‐0.15 95% CI ‐0.26 to ‐0.04), with an equivalent improvement of 3 (1 to 5) points on 0 to 100‐point scale.
Marked variability was noted across included studies among participants recruited, symptom duration, exercise interventions assessed and important aspects of study methodology. Individually delivered programmes tended to result in greater reductions in pain and improvements in physical function, compared to class‐based exercise programmes or home‐based programmes; however between‐study heterogeneity was marked within the individually provided treatment delivery subgroup.
Authors' conclusions
High‐quality evidence indicates that land‐based therapeutic exercise provides short‐term benefit that is sustained for at least two to six months after cessation of formal treatment in terms of reduced knee pain, and moderate‐quality evidence shows improvement in physical function among people with knee OA. The magnitude of the treatment effect would be considered moderate (immediate) to small (two to six months) but comparable with estimates reported for non‐steroidal anti‐inflammatory drugs. Confidence intervals around demonstrated pooled results for pain reduction and improvement in physical function do not exclude a minimal clinically important treatment effect. Since the participants in most trials were aware of their treatment, this may have contributed to their improvement. Despite the lack of blinding we did not downgrade the quality of evidence for risk of performance or detection bias. This reflects our belief that further research in this area is unlikely to change the findings of our review.
La inclusión es respeto, compromiso social, sacrificio, identidad y amor; acreditado en una investigación realizada por la Facultad de Cultura Física de la Universidad de Cienfuegos, basados en el ...significado de la educación inclusiva mediante el deporte, con residentes de la comunidad de Pastorita (orientado por estudiantes y profesores de la carrera) desde un enfoque inclusivo, reconoce y valora las diferencias individuales y las concibe como una fuente de enriquecimiento de la calidad profesional. Estas diferencias se hacen aún más presentes, teniendo en cuenta necesidades educativas comunes. Su dirección desde la actividad deportiva, garantiza la igualdad de oportunidades, no es tarea fácil, implica transformar procesos del aprendizaje. El Tai chi o Tai chi chuan, antigua tradición china, hoy en día se practica como una forma elegante de ejercicio. Implica movimientos realizados de forma lenta, concentrada y acompañada de respiración profunda, asegurando que el cuerpo esté en constante movimiento. Si se busca una manera de reducir el estrés, considere el Tai chi. Originalmente desarrollado para la defensa personal, evolucionando hasta convertirse en una forma elegante de ejercicio utilizado para mejorar otras afecciones de salud. A menudo descrito como meditación en movimiento, promueve la serenidad a través de movimientos suaves y fluidos.
To objectively evaluate the most common forms of mind-body exercise (MBE) (tai chi, yoga, qigong) on cognitive function among people with mild cognitive impairment (MCI).
We searched 6 electronic ...databases (Scopus, PubMed, PsycINFO, WanFang, Web of Science, CNKI) from inception until September 2018.
Nine randomized controlled trials and 3 nonrandomized controlled trials were included for meta-analysis.
Two researchers independently performed the literature searches, study selection, data extraction, and methodological quality assessment using the revised Physiotherapy Evidence Database (PEDro) scale.
The pooled effect size (standardized mean difference SMD) was calculated while random-effect model was selected. Overall results of the meta-analysis (N=1298 people with MCI) indicated that MBE significantly improved attention (SMD=0.39, 95% confidence interval CI 0.07-0.71, P=.02, I
=31.6%, n=245), short-term memory (SMD=0.74, 95% CI 0.57-0.90, P<.001, I
=0%, n=861), executive function (SMD=-0.42, 95% CI -0.63 to -0.21, P<.001, I
=38.54%, n=701), visual-spatial/executive function (SMD=0.35, 95% CI 0.07-0.64, P<.05, I
=0%, n=285), and global cognitive function (SMD=0.36, 95% CI 0.2-0.52, P<.001, I
=15.12%, n=902). However, the significant positive effect on cognitive processing speed was not observed following MBE interventions (SMD=0.31, 95% CI -0.01 to 0.63, P=.054, I
=28.66%, n=233).
Study findings of this meta-analysis suggest that MBE have the potential to improve various cognitive functions in people with MCI.
Abstract
The default mode network (DMN) plays an important role in age-related cognitive decline. This study aims to explore the modulation effect of two mind–body interventions (Tai Chi Chuan and ...Baduanjin) on DMN in elderly individuals. Participants between 50 and 70 years old were recruited and randomized into a Tai Chi Chuan, Baduanjin or control group. The Wechsler Memory Scale-Chinese Revision and resting-state fMRI scans were administered at baseline and following 12 weeks of exercise. Seed-based resting-state functional connectivity (rsFC) was calculated. We found that (i) compared to the Baduanjin group, Tai Chi Chuan was significantly associated with increased rsFC between the medial prefrontal cortex (mPFC) and right putamen/caudate and (ii) compared to the control group, Tai Chi Chuan increased posterior cingulate cortex rsFC with the right putamen/caudate, while Baduanjin decreased rsFC between the mPFC and orbital prefrontal gyrus/putamen. Baseline mPFC rsFC with orbital prefrontal gyrus was negatively correlated with visual reproduction subscore. These results suggest that both Tai Chi Chuan and Baduanjin can modulate the DMN, but through different pathways. Elucidating the mechanisms underlying different mind–body interventions may shed light on the development of new methods to prevent age-related diseases as well as other disorders associated with disrupted DMN.
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