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Zhao H, Teng J, Song G, Fu X, Pan X, Shen S, Yan Y, Liu C. The optimal exercise parameters of Tai Chi on the effect of glucose and lipid metabolism in patients with type 2 diabetes mellitus: A meta-analysis. Complement Ther Med 2023; 79:102995. [PMID: 37858683 DOI: 10.1016/j.ctim.2023.102995] [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: 05/03/2023] [Revised: 09/14/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVES To explore the optimal exercise parameters of Tai Chi for improving glucose and lipid metabolism in type 2 diabetes mellitus (T2DM) patients. METHODS This meta-analysis was conducted in accordance with the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Six databases were retrieved, with retrieval dates ranging from the establishment of the databases to December 2022. Data extraction and study quality assessment were independently performed by two researchers according to the Physical Therapy Evidence Database (PEDro) scale. The effects of different Tai Chi exercise parameters on glucose and lipid metabolism in T2DM patients were analyzed by subgroup analyses and meta-regressions. RESULTS A total of sixteen randomized controlled trials were included in the meta-analysis. The results indicated that Tai Chi had a significant and moderate impact on fasting blood glucose in T2DM patients, as well as a significant and large impact on glycosylated hemoglobin. Tai Chi had a significant and moderate impact on triglyceride, and a small, non-significant improvement on total cholesterol. The intervention frequency and duration of a single session were identified as predictors of the impact of Tai Chi on triglyceride. The optimal exercise parameters identified were the 24-style simplified Tai Chi, with a recommended exercise duration of 45-60 min per session, performed 5-7 times per week, and continued for at least 4-7 weeks. CONCLUSIONS Tai Chi can significantly improve the glucose and lipid metabolism in T2DM patients, and the 24-style simplified Tai Chi with high exercise frequency and short duration may be the optimal exercise parameter for enhancing glucose and lipid metabolism. PROSPERO Registration number: CRD42023395282.
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Affiliation(s)
- Haotian Zhao
- Department of Physical Education, Jiangnan University, Wuxi, China
| | - Jin Teng
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Ge Song
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Xuancheng Fu
- Department of Chemistry, Syracuse University, New York, USA
| | - Xinliang Pan
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Siqin Shen
- Faculty of Sports Science, Ningbo University, Ningbo, China; Faculty of Engineering, University of Pannonia, Veszprém, Hungary
| | - Yi Yan
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Chang Liu
- School of Sport Science, Beijing Sport University, Beijing, China.
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Effects of adding exercise to usual care in patients with either hypertension, type 2 diabetes or cardiovascular disease: a systematic review with meta-analysis and trial sequential analysis. Br J Sports Med 2022:bjsports-2022-106002. [DOI: 10.1136/bjsports-2022-106002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 12/05/2022]
Abstract
ObjectiveTo assess the beneficial and harmful effects of adding exercise to usual care for people with hypertension, type 2 diabetes mellitus and/or cardiovascular disease.DesignSystematic review with meta-analysis and trial sequential analysis of randomised clinical trials.Data sourcesThe CENTRAL, MEDLINE, EMBASE, Science Citation Index Expanded on Web of Science and BIOSIS searched from inception to July 2020.Eligibility criteria for selecting studiesWe included all randomised clinical trials adding any form of trialist defined exercise to usual care versus usual care in participants with either hypertension, type 2 diabetes or cardiovascular disease irrespective of setting, publication status, year and language.Outcome and measuresThe primary outcomes were all-cause mortality, serious adverse events and quality of life.Data extraction and synthesisFive independent reviewers extracted data and assessed risk of bias in pairs. Our methodology was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Grading of Recommendations Assessment, Development and Evaluation and Cochrane Risk of Bias-version 1.ResultsWe included 950 trials, of which 248 trials randomising 21 633 participants reported on our predefined outcomes. All included trials were at high risk of bias. The major types of exercise reported were dynamic aerobic exercise (126/248 trials), dynamic resistance exercise (25/248 trials), and combined aerobic and resistance exercise (58/248 trials). The study participants were included due to cardiovascular diseases (189/248 trials), type 2 diabetes (41/248 trials) or hypertension (16/248 trials). The median intervention period was 3 months (IQR: 2–4 months) and the median follow-up period was 6 months (IQR: 3–8 months) after randomisation. Meta-analyses and trial sequential analyses showed evidence of a beneficial effect of adding exercise to usual care when assessing all-cause mortality (risk ratio (RR) 0.82; 95% CI 0.73 to 0.93; I2=0%, moderate certainty of evidence) and serious adverse events (RR 0.79; 95% CI 0.71 to 0.88; I2=0%, moderate certainty of evidence). We did not find evidence of a difference between trials from different economic regions, type of participants, type of exercise or duration of follow-up. Quality of life was assessed using several different tools, but the results generally showed that exercise improved quality of life, but the effect sizes were below our predefined minimal important difference.ConclusionsA short duration of any type of exercise seems to reduce the risk of all-cause mortality and serious adverse events in patients with either hypertension, type 2 diabetes or cardiovascular diseases. Exercise seems to have statistically significant effects on quality of life, but the effect sizes seem minimal.PROSPERO registration numberCRD42019142313.
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Cai Y, Liu X, Zhao A, Mao J, Guo X, Li G, Yang J, Wu Y, Fei Y. Effects of Tai Chi on health outcomes in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2022. [DOI: 10.1016/j.jtcms.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Shi H, Wang S, Zhang Y, Liu P, Dong C, Wang D, Si G, Wang W, Li Y. The Effects of Tai Chi Exercise for Patients with Type 2 Diabetes Mellitus: An Overview of Systematic Reviews and Meta-Analyses. J Diabetes Res 2022; 2022:6587221. [PMID: 35799947 PMCID: PMC9256439 DOI: 10.1155/2022/6587221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/20/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Tai chi (TC) is a potential complementary treatment for type 2 diabetes mellitus (T2DM). This overview systematically summarizes and evaluates the existing evidence of TC in the treatment of T2DM. METHODS Systematic reviews (SRs)/meta-analyses (MAs) on TC interventions for T2DM were comprehensively searched in seven databases. Methodological quality, risk of bias, reporting quality, and quality of evidence were assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. RESULTS Eight published SRs/MAs were included in our study. Based on the methodology and quality of evidence assessment, all SRs/MAs are considered to be of very low quality, and only 1 SR/MA has been assessed as low risk of bias, and none of the SR/MA has been fully reported on the checklist. A total of 65 outcome indicators extracted from the included SRs/MAs were evaluated, and only 1 item was assessed as high quality. CONCLUSIONS TC may be an effective and safe complementary treatment for T2DM. However, this conclusion must be treated with caution because the quality of the evidence provided by the included SRs/MAs is generally low.
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Affiliation(s)
- Hongshuo Shi
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | | | - Yufeng Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Pulin Liu
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chengda Dong
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Dan Wang
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Guomin Si
- Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Wenbo Wang
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yujie Li
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Wang Y, Yan J, Zhang P, Yang P, Zhang W, Lu M. Tai Chi Program to Improve Glucose Control and Quality of Life for the Elderly With Type 2 Diabetes: A Meta-analysis. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580211067934. [PMID: 35282699 PMCID: PMC9111975 DOI: 10.1177/00469580211067934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To systematically evaluate the effects of Tai chi for improving elderly patients with type 2 diabetes. METHODS According to PRISMA checklist, we conducted this standard meta-analysis. The multiple databases like Pubmed, Embase, and Cochrane databases were used to search for the relevant studies, and full-text articles involved in the evaluation of Tai chi in improving elderly patients with type 2 diabetes. Review manager 5.2 was adopted to estimate the effects of the results among selected articles. Forest plots, sensitivity analysis and funnel plot for the articles included were also conducted. RESULTS Finally, 7 relevant studies were eventually satisfied the included criteria. We found that Tai chi group had lower glucose than control group (mean difference (MD)=-12.47, 95%CI [-21.20, -3.73], P=.005; I2 = 32%), Tai chi group had higher activities-specific balance confidence (ABC) scale than control group (MD =9.26 with 95%CI [6.68, 11.83], P < .001) and Tai chi group had higher single limb standing test score than control group (MD = 8.38, 95%CI [4.02, 12.74], P = .001). The study was robust and limited publication bias was observed in this study. CONCLUSION Since we found Tai chi had better performance than usual care in improving old diabetes patients' glucose and life quality, the study supports that Tai chi can help old diabetes patients from several aspects including disease indicators, independence and life quality.
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Affiliation(s)
- Yanmei Wang
- Nursing Department, Gongli Hospital, Shanghai, China
| | - Jianjun Yan
- Nursing Department, Gongli Hospital, Shanghai, China
| | - Peng Zhang
- School of Clinical Medicine, Shanghai University and Health
Sciences, Shanghai, China
| | - Pei Yang
- Department of Nursing, Ningxia Medical
University, Yinchuan, Ningxia
| | - Wenhui Zhang
- Department of Nursing, Ningxia Medical
University, Yinchuan, Ningxia
| | - Min Lu
- Nursing Department, Gongli Hospital, Shanghai, China
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Fogaça LZ, Portella CFS, Ghelman R, Abdala CVM, Schveitzer MC. Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map. Front Public Health 2021; 9:659075. [PMID: 34988045 PMCID: PMC8722380 DOI: 10.3389/fpubh.2021.659075] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 11/08/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes. Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects. Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia. Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.
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Affiliation(s)
| | | | - Ricardo Ghelman
- Brazilian Academic Consortium for Integrative Health (CABSIn), São Paulo, Brazil
| | - Carmen Verônica Mendes Abdala
- BIREME (Latin American and Caribbean Center on Health Sciences Information) - Pan American Health Organization/World Health Organization (PAHO/WHO), São Paulo, Brazil
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A Meta-Analysis of the Effects of Tai Chi on Glucose and Lipid Metabolism in Middle-Aged and Elderly Diabetic Patients: Evidence from Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6699935. [PMID: 33824678 PMCID: PMC8007338 DOI: 10.1155/2021/6699935] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/02/2021] [Accepted: 03/06/2021] [Indexed: 12/18/2022]
Abstract
This research review aimed to evaluate the effect of practicing Tai Chi on glucose and lipid metabolism in middle-aged and elderly diabetic patients. Furthermore, it aimed to provide a theoretical basis for the practice of Tai Chi as a way to improve glucose and lipid metabolism in middle-aged and elderly diabetic patients. Therefore, we searched for randomized controlled trials on the practice of Tai Chi in middle-aged and elderly diabetic patients in Chinese- and English-language electronic databases, such as Web of Science, PubMed, the Cochrane Library, EMBASE, Google Scholar, CNKI, Wanfang Database, and Weipu. We collected articles published no later than August 1, 2020. The methodological quality of the included studies was evaluated according to the standards of the Cochrane Collaboration System Evaluation Manual (version 5.1.0). Finally, 14 articles were included, showing an average Physiotherapy Evidence Database scale score of 6.57. The articles were meta-analyzed using Stata 14.0 software, showing that practicing Tai Chi improved middle-aged and elderly diabetic patients' fasting blood glucose (WMD = −0.60, 95% CI [−1.08, −0.12], p=0.015), glycosylated hemoglobin (WMD = −0.87, 95% CI [−1.60, −0.14], p=0.019), total cholesterol (WMD = −0.48, 95% CI [−0.83, −0.14], p=0.006), triglycerides (WMD = −0.21, 95% CI [−0.37, −0.04], p=0.014), and low-density lipoprotein cholesterol level significantly (WMD = −0.32, 95% CI [−0.63,−0.00], p=0.050). Conversely, patients' high-density lipoprotein cholesterol levels (WMD = 0.09, 95% CI [−0.01, 0.17], p=0.136) showed no obvious improvement. In conclusion, practicing Tai Chi in sessions lasting longer than 50 minutes (at least three times per week, for at least 12 weeks) can effectively improve glucose and lipid metabolism in middle-aged and elderly diabetic patients. However, several other factors affect glucose and lipid metabolism; therefore, further high-quality research is needed. Protocol registration number: INPLASY2020120107.
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Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5558805. [PMID: 33777155 PMCID: PMC7972853 DOI: 10.1155/2021/5558805] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 12/22/2022]
Abstract
Objectives This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations. Methods A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs. Results A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions. Conclusions We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.
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Jahantigh Akbari N, Hosseinifar M, Naimi SS, Mikaili S, Rahbar S. The efficacy of physiotherapy interventions in mitigating the symptoms and complications of diabetic peripheral neuropathy: A systematic review. J Diabetes Metab Disord 2020; 19:1995-2004. [PMID: 33553048 PMCID: PMC7843894 DOI: 10.1007/s40200-020-00652-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Diabetic peripheral neuropathy (DPN) leads to decreased sole sensation and balance disorder, all of which increase the risk of falls and socioeconomic costs. Since the physiotherapists do not use the same manner to lessen the complications of this problem. Therefore, this review study was directed to appraise physiotherapy intervention efficiencies in diminishing DPN's symptoms and complications. METHOD A database search of Pubmed, Elsevier, Google Scholar, and Embase was performed to determine DPN's published documents. Finally, studies of DPN and treatments available in this field, particularly physiotherapy that included electrotherapy, exercise therapy, and other therapies, were identified. RESULT According to a database search on August 1, 2019, from 1989 to 2019, in the last 30 years, about 968 articles were found, 345 of which were free full text available, and finally, 19 articles were approved. These articles examined the effects of physiotherapy interventions, including exercise therapy, electrotherapy, and other treatment techniques on DPN patients. CONCLUSIONS The results showed that most diabetic peripheral neuropathy patients suffer from muscle weakness, pain, loss of balance, and lower limb dysfunction. As a result, their daily activity and Life satisfaction are gradually impaired. Exercise therapy, electrotherapy, and other physiotherapy methods have been used to reduce the mentioned cases. Among these interventions, exercise therapy has been the most effective. Although there was little evidence of aerobic exercise in these patients, further studies should be done on other therapies' effects.
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Affiliation(s)
- Narges Jahantigh Akbari
- Department of Physical Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosseinifar
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sedigheh Sadat Naimi
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Mikaili
- Department of Physical Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soulmaz Rahbar
- Department of Physiotherapy, School of Rehabilitation, Hamadan University of Medical Sciences, Hamadan, Iran
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Rijal A, Nielsen EE, Hemmingsen B, Neupane D, Gæde PH, Olsen MH, Jakobsen JC. Adding exercise to usual care in patients with hypertension, type 2 diabetes mellitus and/or cardiovascular disease: a protocol for a systematic review with meta-analysis and trial sequential analysis. Syst Rev 2019; 8:330. [PMID: 31847918 PMCID: PMC6918663 DOI: 10.1186/s13643-019-1233-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 11/12/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Hypertension, type 2 diabetes mellitus and cardiovascular disease are among the leading causes of mortality globally. Exercise is one of the commonly recommended interventions/preventions for hypertension, type 2 diabetes mellitus and cardiovascular disease. However, the previous reviews have shown conflicting evidence on the effects of exercise. Our objective is to assess the beneficial and harmful effects of adding exercise to usual care for people with hypertension, type 2 diabetes mellitus and/or cardiovascular disease. METHODS This protocol for a systematic review was undertaken using the recommendations of The Cochrane Collaboration, the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and the eight-step assessment procedure suggested by Jakobsen et al. We plan to include all relevant randomised clinical trials and cluster-randomised trials assessing the effects of adding exercise to usual care for people with hypertension, type 2 diabetes mellitus and/or cardiovascular disease. We will search the Cochrane Central Register of Controlled Trials (CENTRAL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Latin American and Caribbean Health Sciences Literature (LILACS), Science Citation Index Expanded on Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science Journal Database (VIP) and BIOSIS. We will systematically assess the risks of random errors using Trial Sequential Analysis as well as risks of bias of all included trials. We will create a 'Summary of Findings' table in which we will present our primary and secondary outcomes, and we will assess the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). DISCUSSION The present systematic review will have the potential to aid patients, clinicians and decision-makers recommending exercise and thereby, benefit patients with hypertension, type 2 diabetes mellitus and/or cardiovascular disease. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019142313.
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Affiliation(s)
- Anupa Rijal
- Department of Internal Medicine, Holbæk Hospital, Holbæk, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Emil Eik Nielsen
- Department of Internal Medicine, Holbæk Hospital, Holbæk, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Bianca Hemmingsen
- Department of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark
| | - Dinesh Neupane
- Welch Center for Prevention, Epidemiology, and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Peter Haulund Gæde
- Department of Cardiology and Endocrinology, Næstved-Slagelse-Ringsted (NSR) Hospital, Slagelse, Denmark
| | - Michael Hecht Olsen
- Department of Internal Medicine, Holbæk Hospital, Holbæk, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Center for Individualized Medicine in Arterial Diseases, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Janus Christian Jakobsen
- Department of Internal Medicine, Holbæk Hospital, Holbæk, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Copenhagen Trial Unit, Rigshospitalet, Copenhagen, Denmark
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Xia TW, Yang Y, Li WH, Tang ZH, Li ZR, Qiao LJ. Different training durations and styles of tai chi for glucose control in patients with type 2 diabetes: a systematic review and meta-analysis of controlled trials. Altern Ther Health Med 2019; 19:63. [PMID: 30871517 PMCID: PMC6419417 DOI: 10.1186/s12906-019-2475-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 03/06/2019] [Indexed: 05/04/2023]
Abstract
Background Physical activity is an important part of the diabetes management plan. However, the effects caused by different training durations and styles of Tai Chi have not been evaluated. We conducted an updated systematic review of the effects of Tai Chi on patients with type 2 diabetes based on different training durations and styles. Methods We performed a search for Chinese and English studies in 8 databases. Two reviewers independently selected the eligible trials and conducted a critical appraisal of the methodological quality. Results Seventeen trials were included. Tai Chi was found to have reduced fasting blood glucose (FBG) [SMD = − 0.54, 95% CI (− 0.91, − 0.16), P = 0.005] and HbA1c [SMD = − 0.68, 95% CI (− 1.17, − 0.19), P = 0.006] overall, compared with a control group. Considering the subgroup analysis, the pooled results showed that 24 movements or Yang-style Tai Chi did not significantly reduce FBG after a duration of ≤3 months [SMD = − 0.46, 95% CI (− 1.42, 0.50), P = 0.35] or > 3 months [SMD = − 0.50, 95% CI (− 1.49, 0.49), P = 0.32], nor did it reduce HbA1c [SMD = − 1.22, 95% CI (− 2.90, 0.47), P = 0.16] after a duration > 3 months in all studies. However, other styles of Tai Chi significantly reduced FBG [SMD = − 0.90, 95% CI (− 1.28, − 0.52), P < 0.00001] and HbA1c [SMD = − 0.90, 95% CI (− 1.28, − 0.52), P < 0.00001] after a duration > 3 months, while no significant reduction in FBG [SMD = − 0.34, 95% CI (− 0.76, 0.08), P = 0.12] or HbA1c [SMD = − 0.34, 95% CI (− 0.76, 0.08), P = 0.12] was found after a duration ≤3 months. Conclusions Tai Chi seems to be effective in treating type 2 diabetes. Different training durations and styles result in variable effectiveness. The evidence was insufficient to support whether long-term Tai Chi training was more effective.
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Wu S, Chen J, Wang S, Jiang M, Wang X, Wen Y. Effect of Tai Chi Exercise on Balance Function of Stroke Patients: A Meta-Analysis. Med Sci Monit Basic Res 2018; 24:210-215. [PMID: 30504762 PMCID: PMC6289026 DOI: 10.12659/msmbr.911951] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background Tai Chi is an ancient form of physical activity that has been shown to improve cardiovascular function, but to date there had been no comprehensive systematic review on the effect of Tai Chi exercise on balance function of patients with stroke. This study evaluated the effect of Tai Chi exercise on balance function in stroke patients. Material/Methods PubMed, Cochrane library, and China National Knowledge Information databases and the Wan Fang medical network were searched to collect the articles. The random-effects model was used to assess the effect of Tai Chi exercise on balance function of stroke patients. Results Six studies were chosen to perform the meta-analysis according to the inclusion and exclusion criteria. There were significant improvements of balance on Berg Balance Scale score (MD=4.823, 95% CI: 2.138–7.508), the standing balance with fall rates (RR=0.300, 95%CI: 0.120–0.770), functional reach test and dynamic gait index in Tai Chi intervention group compared to the control intervention group. However, the short physical performance battery for balance (SPBB) showed Tai Chi did not significantly improve the ability of balance for stroke patients (MD=0.293, 95%CI: −0.099~0.685). Conclusions Tai Chi exercise might have a significant impact in improving balance efficiency by increasing BBS score and reducing fall rate.
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Affiliation(s)
- Shouzhi Wu
- School of Public Foundation, Wannan Medical College, Wuhu, Anhui, China (mainland)
| | - Jian Chen
- Hunan Provincial People's Hospital, Changsha, Hunan, China (mainland)
| | - Shuyi Wang
- School of Laboratory Medicine, Wannan Medical College, Wuhu, Anhui, China (mainland)
| | - Mingfei Jiang
- School of Laboratory Medicine, Wannan Medical College, Wuhu, Anhui, China (mainland)
| | - Ximei Wang
- School of Laboratory Medicine, Wannan Medical College, Wuhu, Anhui, China (mainland)
| | - Yufeng Wen
- School of Laboratory Medicine, Wannan Medical College, Wuhu, Anhui, China (mainland)
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Tai Chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: A randomised controlled trial. Int J Nurs Stud 2018; 88:44-52. [DOI: 10.1016/j.ijnurstu.2018.08.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/25/2018] [Accepted: 08/23/2018] [Indexed: 12/21/2022]
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14
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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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15
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Wang Y, Shan W, Li Q, Yang N, Shan W. Tai Chi Exercise for the Quality of Life in a Perimenopausal Women Organization: A Systematic Review. Worldviews Evid Based Nurs 2017; 14:294-305. [PMID: 28742289 DOI: 10.1111/wvn.12234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Improvement of the quality of life in perimenopausal women has recently become an important global health issue. Extensive research reports provide evidence of Tai Chi for the quality of life, but no systematic review has individually investigated Tai Chi as a main intervention on the quality of life in perimenopausal women. OBJECTIVE To assess clinical evidence of Tai Chi for the quality of life in perimenopausal women. METHODS Studies related to the effect of Tai Chi on the quality of life in perimenopausal women in the databases of China and abroad were searched. RevMan version 5.2 software was used, and the Medical Outcomes Study 36-item short form health survey (SF-36) and bone mineral density (BMD) were selected as evaluation indices. RESULTS Five trials were included. The results of this study showed that Tai Chi had a significant effect on bodily pain, general health, vitality, mental health of SF-36, and the spine dimension of BMD, as supported by the following data: bodily pain (Standard Mean Difference [SMD] = -3.63; 95% confidence interval [CI] [-6.62, -0.64]; p = .02); general health (SMD = -5.08; 95% CI [-7.60, -2.56]; p < .0001); vitality (SMD = -5.67; 95% CI [-8.54, -2.81], p = .0001); mental health (SMD = -2.51; 95% CI [-4.82, -0.20], p = .03); and spine dimension of BMD (SMD = -0.06; 95% CI [-0.10, -0.01]; p = .01). However, Tai Chi had no effect on physical function, emotional health, social function, role-physical of SF-36, and the hip dimension of BMD, as supported by the following data: physical function (SMD = -1.79; 95% CI [-5.15, 1.57]; p = .30); emotional health (SMD = -2.90; 95% CI [-7.23, 1.43], p = .19]; social function (SMD = -2.23, 95% CI [-5.08, 0.61], p = .12; role-physical (SMD = - 1.18; 95% CI [-4.84, 2.47], p = .53; and hip dimension of BMD (SMD = -0.01; 95% CI [-0.03, 0.01]; p = .31). LINKING EVIDENCE TO ACTION This systematic review found significant evidence for Tai Chi improving bodily pain, general health, vitality, mental health of SF-36, and the spine dimension of BMD in patients with perimenopausal syndrome. Findings suggest that Tai Chi might be recommended as effective and safe adjuvant treatment for patients with perimenopausal syndrome. More high-quality randomized controlled trials are urgently needed to confirm these results.
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Affiliation(s)
- Ying Wang
- Nurse Practitioner, Nursing School of Chengde Medical University, Chengde City, Hebei Province, China
| | - Weichao Shan
- Associate Professor, Affiliated Hospital of Chengde Medical University, Chengde City, Hebei Province, China
| | - Qing Li
- Lecturer, Nursing School of Chengde Medical University, Chengde City, Hebei Province, China
| | - Na Yang
- Teaching Assistant, Nursing School of Chengde Medical University, Chengde City, Hebei Province, China
| | - Weiying Shan
- Professor, Science and Technology Department of Chengde Medical University, Chengde City, Hebei Province, China
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16
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Solloway MR, Taylor SL, Shekelle PG, Miake-Lye IM, Beroes JM, Shanman RM, Hempel S. An evidence map of the effect of Tai Chi on health outcomes. Syst Rev 2016; 5:126. [PMID: 27460789 PMCID: PMC4962385 DOI: 10.1186/s13643-016-0300-y] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 07/14/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND This evidence map describes the volume and focus of Tai Chi research reporting health outcomes. Originally developed as a martial art, Tai Chi is typically taught as a series of slow, low-impact movements that integrate the breath, mind, and physical activity to achieve greater awareness and a sense of well-being. METHODS The evidence map is based on a systematic review of systematic reviews. We searched 11 electronic databases from inception to February 2014, screened reviews of reviews, and consulted with topic experts. We used a bubble plot to graphically display clinical topics, literature size, number of reviews, and a broad estimate of effectiveness. RESULTS The map is based on 107 systematic reviews. Two thirds of the reviews were published in the last five years. The topics with the largest number of published randomized controlled trials (RCTs) were general health benefits (51 RCTs), psychological well-being (37 RCTs), interventions for older adults (31 RCTs), balance (27 RCTs), hypertension (18 RCTs), fall prevention (15 RCTs), and cognitive performance (11 RCTs). The map identified a number of areas with evidence of a potentially positive treatment effect on patient outcomes, including Tai Chi for hypertension, fall prevention outside of institutions, cognitive performance, osteoarthritis, depression, chronic obstructive pulmonary disease, pain, balance confidence, and muscle strength. However, identified reviews cautioned that firm conclusions cannot be drawn due to methodological limitations in the original studies and/or an insufficient number of existing research studies. CONCLUSIONS Tai Chi has been applied in diverse clinical areas, and for a number of these, systematic reviews have indicated promising results. The evidence map provides a visual overview of Tai Chi research volume and content. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42014009907.
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Affiliation(s)
| | | | - Paul G Shekelle
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,VA Evidence-based Synthesis Program (ESP) Center, Los Angeles, CA, USA.,University of California, Los Angeles, CA, USA.,Evidence-based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Isomi M Miake-Lye
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,VA Evidence-based Synthesis Program (ESP) Center, Los Angeles, CA, USA
| | - Jessica M Beroes
- VA Evidence-based Synthesis Program (ESP) Center, Los Angeles, CA, USA
| | - Roberta M Shanman
- Evidence-based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Susanne Hempel
- Evidence-based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA.
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17
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Hamasaki H. Martial Arts and Metabolic Diseases. Sports (Basel) 2016; 4:sports4020028. [PMID: 29910276 PMCID: PMC5968920 DOI: 10.3390/sports4020028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 04/28/2016] [Accepted: 05/04/2016] [Indexed: 12/14/2022] Open
Abstract
Different forms of martial arts are practiced worldwide, each with various intensities of physical activity. These disciplines are potentially an effective exercise therapy for metabolic diseases. Tai chi is the most well-studied style of martial arts and has shown evidence of its effect on metabolic diseases; however, little evidence is available regarding the association between other styles of martial arts and metabolic health. To summarize and evaluate the effects of martial arts on metabolic diseases, eligible articles were searched by using Pubmed. To date, systematic reviews provide no definite conclusion on the effectiveness of tai chi for treating metabolic diseases because of a small numbers of subjects, short durations of clinical trials, and some biases involved in testing. However, there are several clinical studies on subjects with metabolic diseases, which show that tai chi improves obesity, glycemic control, blood pressure control, and lipid profiles. Currently, some limited evidence suggests that other martial arts, such as kung fu and karate, may be beneficial for body composition, glycemic control, and arterial stiffness. To clarify the effectiveness of martial arts for treating metabolic diseases, well-designed prospective studies, preferably with a larger number of subjects and of longer duration, are warranted.
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Affiliation(s)
- Hidetaka Hamasaki
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, 1-7-1 Kohnodai, Chiba 272-8516, Japan.
- Hamasaki Clinic, 2-21-4 Nishida, Kagoshima 890-0046, Japan.
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19
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Armstrong MJ, Sigal RJ. Physical activity clinical practice guidelines: what's new in 2013? Can J Diabetes 2015; 37:363-6. [PMID: 24321715 DOI: 10.1016/j.jcjd.2013.07.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 07/16/2013] [Accepted: 07/24/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Marni J Armstrong
- Department of Cardiovascular and Respiratory Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
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20
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Tai chi chuan for the primary prevention of stroke in middle-aged and elderly adults: a systematic review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:742152. [PMID: 25784950 PMCID: PMC4345078 DOI: 10.1155/2015/742152] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/04/2015] [Indexed: 11/17/2022]
Abstract
Background. Stroke is a major healthcare problem with serious long-term disability and is one of the leading causes of death in the world. Prevention of stroke is considered an important strategy. Methods. Seven electronic databases were searched. Results. 36 eligible studies with a total of 2393 participants were identified. Primary outcome measures, TCC exercise combined with other intervention had a significant effect on decreasing the incidence of nonfatal stroke (n = 185, RR = 0.11, 95% CI 0.01 to 0.85, P = 0.03) and CCD (n = 125, RR = 0.33, 95% CI 0.11 to 0.96, P = 0.04). For the risk factors of stroke, pooled analysis demonstrated that TCC exercise was associated with lower body weight, BMI, FBG level, and decreasing SBP, DBP, plasma TC, and LDL-C level regardless of the intervention period less than half a year or more than one year and significantly raised HDL-C level in comparison to nonintervention. Compared with other treatments, TCC intervention on the basis of the same other treatments in patients with chronic disease also showed the beneficial effect on lowering blood pressure. Conclusion. The present systematic review indicates that TCC exercise is beneficially associated with the primary prevention of stroke in middle-aged and elderly adults by inversing the high risk factors of stroke.
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Lee MS, Jun JH, Lim HJ, Lim HS. A systematic review and meta-analysis of tai chi for treating type 2 diabetes. Maturitas 2015; 80:14-23. [DOI: 10.1016/j.maturitas.2014.09.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 09/20/2014] [Indexed: 02/08/2023]
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Armstrong MJ, Colberg SR, Sigal RJ. Moving beyond cardio: the value of resistance training, balance training, and other forms of exercise in the management of diabetes. Diabetes Spectr 2015; 28:14-23. [PMID: 25717274 PMCID: PMC4334083 DOI: 10.2337/diaspect.28.1.14] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IN BRIEF Traditionally, aerobic training has been a central focus of exercise promotion for diabetes management. However, people with diabetes have much to gain from other forms of exercise. This article reviews the evidence and recommendations on resistance, balance, and flexibility training, as well as other, less traditional, forms of exercise such as yoga and Tai Chi.
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Affiliation(s)
- Marni J. Armstrong
- Department of Cardiovascular and Respiratory Sciences,
University of Calgary, Calgary, Alberta, Canada
| | - Sheri R. Colberg
- Human Movement Sciences Department, Old Dominion
University, Norfolk, VA
| | - Ronald J. Sigal
- Departments of Medicine, Cardiac Sciences, and Community
Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Du S, Dong J, Zhang H, Jin S, Xu G, Liu Z, Chen L, Yin H, Sun Z. Taichi exercise for self-rated sleep quality in older people: A systematic review and meta-analysis. Int J Nurs Stud 2015; 52:368-79. [DOI: 10.1016/j.ijnurstu.2014.05.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 05/16/2014] [Accepted: 05/19/2014] [Indexed: 12/12/2022]
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24
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Colberg SR. Exercise as medicine for diabetes: prescribing appropriate activities and avoiding potential pitfalls: preface. Diabetes Spectr 2015; 28:10-3. [PMID: 25717272 PMCID: PMC4334086 DOI: 10.2337/diaspect.28.1.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Sheri R Colberg
- Old Dominion University and Eastern Virginia Medical School, Norfolk, VA
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Ernst E, Lee MS. Do randomised studies of traditional Asian therapies generate different results than non-randomised trials? Int J Clin Pract 2014; 68:655-7. [PMID: 24750528 DOI: 10.1111/ijcp.12417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- E Ernst
- Complementary Medicine, Peninsula Medical School, University of Exeter, Exeter, UK.
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Sigal RJ, Armstrong MJ, Colby P, Kenny GP, Plotnikoff RC, Reichert SM, Riddell MC. Physical activity and diabetes. Can J Diabetes 2013; 37 Suppl 1:S40-4. [PMID: 24070962 DOI: 10.1016/j.jcjd.2013.01.018] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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