Objectives
To summarize and critically evaluate research on the effects of Tai Chi on cognitive function in older adults.
Design
Systematic review with meta‐analysis.
Setting
Community and ...residential care.
Participants
Individuals aged 60 and older (with the exception of one study) with and without cognitive impairment.
Measurements
Cognitive ability using a variety of neuropsychological testing.
Results
Twenty eligible studies with a total of 2,553 participants were identified that met inclusion criteria for the systematic review; 11 of the 20 eligible studies were randomized controlled trials (RCTs), one was a prospective nonrandomized controlled study, four were prospective noncontrolled observational studies, and four were cross‐sectional studies. Overall quality of RCTs was modest, with three of 11 trials categorized as high risk of bias. Meta‐analyses of outcomes related to executive function in RCTs of cognitively healthy adults indicated a large effect size when Tai Chi participants were compared with nonintervention controls (Hedges' g = 0.90; P = .04) and a moderate effect size when compared with exercise controls (Hedges' g = 0.51; P = .003). Meta‐analyses of outcomes related to global cognitive function in RCTs of cognitively impaired adults, ranging from mild cognitive impairment to dementia, showed smaller but statistically significant effects when Tai Chi was compared with nonintervention controls (Hedges' g = 0.35; P = .004) and other active interventions (Hedges' g = 0.30; P = .002). Findings from nonrandomized studies add further evidence that Tai Chi may positively affect these and other domains of cognitive function.
Conclusion
Tai Chi shows potential to enhance cognitive function in older adults, particularly in the realm of executive functioning and in individuals without significant impairment. Larger and methodologically sound trials with longer follow‐up periods are needed before more‐definitive conclusions can be drawn.
Virtual reality can be used to visually substitute a person's body by a life-sized virtual one. Such embodiment results in a perceptual illusion of body ownership over the virtual body (VB). Previous ...research has shown that the form of the VB can influence implicit attitudes. In particular, embodying White people in a Black virtual body is associated with an immediate decrease in their implicit racial bias against Black people. We tested whether the reduction in implicit bias lasts for at least 1 week and whether it is enhanced by multiple exposures. Two experiments were carried out with a total of 90 female participants where the virtual body was either Black or White. Participants were required to follow a virtual Tai Chi teacher who was either Asian or European Caucasian. Each participant had 1, 2, or 3 exposures separated by days. Implicit racial bias was measured 1 week before their first exposure and 1 week after their last. The results show that implicit bias decreased more for those with the Black virtual body than the White. There was also some evidence of a general decrease in bias independently of body type for which possible explanations are put forward.
Exercise for osteoarthritis of the hip Fransen, Marlene; McConnell, Sara; Hernandez‐Molina, Gabriela ...
Cochrane database of systematic reviews,
04/2014, Letnik:
2014, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Background
Current international treatment guidelines recommending therapeutic exercise for people with symptomatic hip osteoarthritis (OA) report are based on limited evidence.
Objectives
To ...determine whether land‐based therapeutic exercise is beneficial for people with hip OA in terms of reduced joint pain and improved physical function and quality of life.
Search methods
We searched five databases from inception up to February 2013.
Selection criteria
All randomised controlled trials (RCTs) recruiting people with hip OA and comparing some form of land‐based therapeutic exercise (as opposed to exercises conducted in water) with a non‐exercise group.
Data collection and analysis
Four review authors independently selected studies for inclusion. We resolved disagreements through consensus. Two review authors independently extracted data, assessed risk of bias and the quality of the body of evidence for each outcome using the GRADE approach. We conducted analyses on continuous outcomes (pain, physical function and quality of life) and dichotomous outcomes (proportion of study withdrawals).
Main results
We considered that seven of the 10 included RCTs had a low risk of bias. However, the results may be vulnerable to performance and detection bias as none of the RCTs were able to blind participants to treatment allocation and, while most RCTs reported blinded outcome assessment, pain, physical function and quality of life were participant self reported. One of the 10 RCTs was only reported as a conference and did not provide sufficient data for the evaluation of bias risk.
High‐quality evidence from nine trials (549 participants) indicated that exercise reduced pain (standardised mean difference (SMD) ‐0.38, 95% confidence interval (CI) ‐0.55 to ‐0.20) and improved physical function (SMD ‐0.38, 95% CI ‐0.54 to ‐0.05) immediately after treatment. Pain and physical function were estimated to be 29 points on a 0‐ to 100‐point scale (0 was no pain or loss of physical function) in the control group; exercise reduced pain by an equivalent of 8 points (95% CI 4 to 11 points; number needed to treat for an additional beneficial outcome (NNTB) 6) and improved physical function by an equivalent of 7 points (95% CI 1 to 12 points; NNTB 6). Only three small studies (183 participants) evaluated quality of life, with overall low quality evidence, with no benefit of exercise demonstrated (SMD ‐0.07, 95% CI ‐0.23 to 0.36). Quality of life was estimated to be 50 points on a norm‐based mean (standard deviation (SD)) score of 50 (10) in the general population in the control group; exercise improved quality of life by 0 points. Moderate‐quality evidence from seven trials (715 participants) indicated an increased likelihood of withdrawal from the exercise allocation (event rate 6%) compared with the control group (event rate 3%), but this difference was not significant (risk difference 1%; 95% CI ‐1% to 4%). Of the five studies reporting adverse events, each study reported only one or two events and all were related to increased pain attributed to the exercise programme.
The reduction in pain was sustained at least three to six months after ceasing monitored treatment (five RCTs, 391 participants): pain (SMD ‐0.38, 95% CI ‐0.58 to ‐0.18). Pain was estimated to be 29 points on a 0‐ to 100‐point scale (0 was no pain) in the control group, the improvement in pain translated to a sustained reduction in pain intensity of 8 points (95% CI 4 to 12 points) compared with the control group (0 to 100 scale). The improvement in physical function was also sustained (five RCTs, 367 participants): physical function (SMD ‐0.37, 95% CI ‐0.57 to ‐0.16). Physical function was estimated to be 24 points on a 0‐ to 100‐point scale (0 was no loss of physical function) in the control group, the improvement translated to a mean of 7 points (95% CI 4 to 13) compared with the control group.
Only five of the 10 RCTs exclusively recruited people with symptomatic hip OA (419 participants). There was no significant difference in pain or physical function outcomes compared with five studies recruiting participants with hip or knee OA (130 participants).
Authors' conclusions
Pooling the results of these 10 RCTs demonstrated that land‐based therapeutic exercise programmes can reduce pain and improve physical function among people with symptomatic hip OA.
Urban green open space is a valuable resource for physical activities of urban inhabitants and has the potential to reduce chronic illness and improve health. Research on the relationships between ...green open space and physical activity is incomplete and limited in China. Thus, the study examines how the urban green open space contributes to physical activity.
A questionnaire was designed based on the social ecology theory to investigate the physical activity of 513 residents in urban green open space. We use the time and frequency of residents exercising in urban green space to measure physical activity, and use the factor analysis to synthesize a large number of original factors (i.e., infrastructure, safety, accessibility, landscape quality, and space environment) into relatively few composite indicators. Based on the collected data of the cross-sectional population, the Order Probit regression model was constructed to analyze how urban green open space affects the residents' physical activity from the perspective of social ecology.
① in community factors: accessibility is significantly positive correlation with residents' physical activity, and there is no significant correlation between safety and physical activity; ②in natural factors: space environment and landscape quality are not significantly correlated with residents' physical activity; ③ in built environmental factors: infrastructures, the area of green space, the size of open space, and entertainment facilities are significantly correlated to residents' activity. Basketball courts, volleyball courts, swimming pools, and sports equipment will promote physical activity; ④ apart from the attributes of green open space, other factors are significantly correlated to physical activity in the green open space, e.g. having a companion.
Urban green open space plays an important role in promoting physical activity especially among the women and the old, and improving the attributes (such as accessibility, infrastructures, the area of green space, the size of open space and entertainment facilities) of the urban green open space and trying to set up group sports proper to play with companion (like "square dancing" and "Tai Chi") can promote Chinese residents' physical activity so as to improve public health. The results are significant to facilitate environment health.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Knee osteoarthritis (KOA) is the leading cause of pain and stiffness, affecting older adults’ physical function and quality of life. As a form of mind-body exercise, Tai Chi has been ...recommended as an exercise prescription for KOA patients. This study examined the effects and continuation of modified Tai Chi exercises on physical function and quality of life in elderly women with KOA.
Methods
We conducted a single-blind, randomized controlled trial (RCT) on 40 older women with KOA. The participants were randomized to a 12 weeks Tai Chi or control group. The Tai Chi group attended a kind of modified Tai Chi training sessions three times per week; the control group attended wellness education sessions once a week. The primary outcome was the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Secondary outcomes were the Berg Balance Scale (BBS), Timed Up and Go (TUG), Short-Form 36 (SF-36), Pittsburgh Sleep Quality of Index (PSQI), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS).
Results
After the 12-weeks the Tai Chi group showed significan improvement in the WOMAC pain (mean difference, −5.09 points,
p
= 0.001), WOMAC stiffness (mean difference, −3.60 points,
p
= 0.002), WOMAC physical function (mean difference, −11.21 points,
p
= 0.001) compared to the control group. In addition, the Tai Chi group had also significant improvement in the BBS (mean difference, 1.70 points,
p
= 0.008), TUG (mean difference, −0.52s,
p
= 0.001), SF-36PCS (mean difference, 7.60 points,
p
= 0.001), MCS (mean difference, 7.30 points,
p
= 0.001), PSQI (mean difference, −3.71 points,
p
= 0.001), SDS (mean difference, −5.37 points,
p
= 0.025) and SAS (mean difference, −5.06 points,
p
= 0.002).
Conclusion
The modified Tai Chi exercises are an effective treatment for improved physical function and quality of life in elderly women with KOA.
Clinical Trial Registration
The trial was registered in Chinese Clinical Trial Registry (ChiCTR2000040721),
http://www.chictr.org.cn/edit.aspx?pid=65419&htm=4
.
Stroke is a major cause of poor health and has numerous complications. Tai Chi (TC) may have positive effects on the rehabilitation of stroke survivors, but recent clinical findings have not been ...included in previously published reviews.
We conducted this systematic review and meta-analysis to determine the effectiveness of all types of TC vs. conventional rehabilitation therapy for all aspects of stroke survivors' rehabilitation that have been studied.
We searched seven electronic literature databases (three in English, four in Chinese) and one clinical registry platform using established strategies to identify randomized controlled trials performed up to October 2017. Screening, quality assessment, and data collection were performed by two researchers separately, using the same standard. The results were analyzed using RevMan 5.3.0. The quality of evidence was evaluated with GRADEpro.
A total of 21 studies with 1,293 stroke survivors met inclusion criteria; 14 were included in the quantitative synthesis to evaluate four aspects and five outcomes. Nine studies indicated that TC was able to improve independent activities of daily living (ADL), especially TC vs. conventional rehabilitation therapy mean difference (MD) 95% confidence interval (CI) = 9.92 6.82, 13.02,
< 0.00001. Five studies reported significant effects of TC plus conventional rehabilitation therapy in increasing scores on the Fugl-Meyer Assessment for the upper limb MD (95%CI) = 8.27 4.69, 11.84,
< 0.0001, lower limb MD (95%CI) = 2.75 0.95, 4.56,
= 0.003, and overall MD (95%CI) = 4.49 1.92, 7.06,
= 0.0006. The Berg Balance Scale revealed significant improvements according to pooled estimates for TC vs. conventional rehabilitation therapy MD (95%CI) = 5.23 3.42, 7.05,
< 0.00001. TC plus conventional rehabilitation therapy also improved walking ability as measured by the Holden scale MD (95%CI) = 0.61 0.38, 0.85,
< 0.00001 and up-and-go time MD (95%CI) = 2.59 1.76, 3.43,
< 0.00001.
TC has an overall beneficial effect on ADL, balance, limb motor function, and walking ability among stroke survivors, based on very low-quality evidence, and may also improve sleep quality, mood, mental health, and other motor function. Well-designed, higher-quality trials with longer-term follow-up periods are needed to develop better-quality evidence.
Objectives: Tai Chi (TC) shows some beneficial effects in reducing pain in knee osteoarthritis (OA). However, the selection of criteria TC forms in previous studies were unclear and inconsistent, ...possibly accounting for the varying outcomes and rendering the training effects suboptimal. We have selected four optimal TC (OTC) forms based on the knee joint load and its association with pain. This pilot study sought to examine the effect of the OTC forms on reducing knee pain in individuals with knee OA. Methods: Fifteen knee OA participants were recruited. Their knee joint pain level was rated by using the Visual Analogue Scale before and after two weeks of OTC training and compared between these two assessments. Results: The two-week OTC training course was well accepted by our participants. The knee OA pain showed a significant reduction (median pain score: 5 cm before training and 1 cm post-training, Wilcoxon p < 0.001) after the two-week training program. Conclusions: Our pilot results revealed that the 2-week four-form-based OTC program could significantly reduce the knee pain level in people with knee OA. Additionally, our OTC program appears to be about 50% more effective in reducing knee pain than the existing TC-based program, which uses 10 TC forms over 12 weeks (1.59 vs. 1.06 in Hedge's g). The findings in this study may inform the development of OTC-based knee pain reduction programs and the design of relevant clinical trials to establish OTC's effectiveness, safety, and dose-response relationship in easing knee OA pain.
Tai Chi (TC) shows some beneficial effects in reducing pain in knee osteoarthritis (OA). However, the selection of criteria TC forms in previous studies were unclear and inconsistent, possibly ...accounting for the varying outcomes and rendering the training effects suboptimal. We have selected four optimal TC (OTC) forms based on the knee joint load and its association with pain. This pilot study sought to examine the effect of the OTC forms on reducing knee pain in individuals with knee OA.
Fifteen knee OA participants were recruited. Their knee joint pain level was rated by using the Visual Analogue Scale before and after two weeks of OTC training and compared between these two assessments.
The two-week OTC training course was well accepted by our participants. The knee OA pain showed a significant reduction (median pain score: 5 cm before training and 1 cm post-training, Wilcoxon p < 0.001) after the two-week training program.
Our pilot results revealed that the 2-week four-form-based OTC program could significantly reduce the knee pain level in people with knee OA. Additionally, our OTC program appears to be about 50% more effective in reducing knee pain than the existing TC-based program, which uses 10 TC forms over 12 weeks (1.59 vs. 1.06 in Hedge's g). The findings in this study may inform the development of OTC-based knee pain reduction programs and the design of relevant clinical trials to establish OTC's effectiveness, safety, and dose-response relationship in easing knee OA pain.
Objectives
To examine whether combined center‐ and home‐based Tai Chi training can improve cognitive ability and reduce physiological fall risk in older adults with amnestic mild cognitive impairment ...(a‐MCI).
Design
Randomized controlled trial.
Setting
Chiang Mai, Thailand.
Participants
Adults aged 60 and older who met Petersen's criteria for multiple‐domain a‐MCI (N = 66).
Intervention
Three weeks center‐based and 12 weeks home‐based Tai Chi (50 minutes per session, 3 times per week).
Measurements
Cognitive tests, including Logical Memory (LM) delayed recall, Block Design, Digit Span forward and backward, and Trail‐Making Test Part B–A (TMT B–A), and fall risk index using the Physiological Profile Assessment (PPA).
Results
At the end of the trial, performance on LM, Block Design, and TMT B–A were significantly better for the Tai Chi group than the control group after adjusting for baseline test performance. The Tai Chi group also had significantly better composite PPA score and PPA parameter scores: knee extension strength, reaction time, postural sway, and lower limb proprioception.
Conclusion
Combined center‐ and home‐based Tai Chi training three times per week for 15 weeks significantly improved cognitive function and moderately reduced physiological fall risk in older adults with multiple‐domain a‐MCI. Tai Chi may be particularly beneficial to older adults with this condition.
Researchers have reported measurable improvements in emotional and physical health among adults post-stroke after participating in complementary and integrative health techniques. The aim of this ...manuscript was to systematically review the effectiveness of active complementary and integrative health interventions as a treatment modality for adults post-stroke.
For this review, active interventions were defined as those that required participants to be in control of initiating their own body movement. Five active complementary and integrative health techniques were reviewed and included: Feldenkrais Method, qigong, Pilates, Tai Chi, and yoga. A key word search was conducted in Medline, Cochrane Library, EBSCO, Google Scholar, and PubMed. Inclusion criteria for studies were (1) randomized controlled trials on the effects of active complementary and integrative health interventions, (2) all participants had to be post-stroke, and (3) studies appeared in English in a peer-reviewed journal.
Articles in this review included one Qigong, five Pilates, nine Tai Chi, and five yoga studies. All 20 manuscripts reported improvements for participants. Participants in Pilates experienced improvements in quality of life. Improvements in functional balance, standing and dynamic balance, reaction time, maximum excursion, and quality of life were reported in the Pilates studies. Participants in the TC studies experienced a range of positive results including center of gravity, increased reaction time, improved aerobic endurance, fewer falls, sway length and velocity, functional reach, dynamic gait, walking speed, and static and dynamic balance. Improvements after participation in the yoga manuscripts consisted of reduced depression, decreased state and trait anxiety, improved balance, reduction in fear of falling, and enhanced quality of life.
Based on the small number of randomized controlled trials, this systematic review reported the effectiveness of four active mind-body interventions for individuals post-stroke. The strongest evidence was for the use of Tai Chi, followed by Pilates and yoga.
Implications for rehabilitation
Clinicians should consider the benefits of qigong, Pilates, Tai Chi, and yoga to best meet individual patient needs and goals.
Clinicians who offer qigong, Pilates, Tai Chi, and/or yoga should be qualified to instruct the specific active complementary and integrative health technique or refer patients to those who are qualified.
Locate qigong, Pilates, Tai Chi, and yoga classes that are appropriate for people post-stroke in the community to help integrate patients into a program after treatment.
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