Tai Chi Chuan exercise related change in brain function as assessed by functional near-infrared spectroscopy

Effect of 24-form simplified Tai Chi on executive inhibitory control of college students: a randomized controlled trial of EEG

Background

College students, undergoing crucial cognitive development, face challenges during the COVID-19 pandemic that impact their executive functions. While existing research indicates positive effects of Tai Chi (TC) on college students' cognitive abilities, there is a scarcity of studies investigating its impact on executive functions and frontal brain activity.

Objective

This study aimed to compare the effects of 24-form simplified TC training on college students' executive functions and frontal brain electrical activity. The hypothesis posited that the TC group would exhibit superior performance compared to the control group during COVID-19 pandemic.

Method

Seventy college students were randomly assigned to either TC group or control group, engaging in 36 sessions (3 sessions per week, 45 min each) over 12 weeks. Executive inhibitory control was assessed using the Stroop Color and Word Test, and resting brain electrical activity in the frontal area was recorded through Electroencephalography.

Result

ACC was influenced by group, group-time interaction, and Stroop task-time interaction. RT was affected by time, task condition, task condition-time interaction, and task condition-group interaction. Notably, the TC group showed improved ACC (from 96.54 ± 3.27% to 98.90 ± 1.32%) and decreased RT (from 0.73 ± 0.12 to 0.66 ± 0.07 s), particularly in the inconsistent task. Regarding EEG band power, significant Group and Time interaction effects were found in F3-θ, F3-α, F3-β, F4-θ, and F4-α. Moreover, within the TC group, significant increases in F3-θ band power (from 4.66 ± 3.55 to 7.71 ± 8.44) and F4-θ band power (from 4.41 ± 2.82 to 8.61 ± 9.51) (10-3·μV·Hz) were noted pre-and post-tests. In the control group, significant decreases were observed in F3-α band power (from 5.18 ± 4.61 to 2.79 ± 2.11) and F4-α band power (from 5.57 ± 6.58 to 2.48 ± 1.95) (10-3·μV·Hz).

Conclusion

The pandemic-induced panic may impact frontal lobe brain activity in college students. TC training not only improves executive inhibitory control but may also enhance localized brain activity, suggesting its potential as a holistic intervention for cognitive and neurological well-being during stressful periods.

Applications of functional near-infrared spectroscopy in non-drug therapy of traditional Chinese medicine: a review

Non-drug therapies of traditional Chinese medicine (TCM), including acupuncture, massage, tai chi chuan, and Baduanjin, have emerged as widespread interventions for the treatment of various diseases in clinical practice. In recent years, preliminary studies on the mechanisms of non-drug therapies of TCM have been mostly based on functional near-infrared spectroscopy (fNIRS) technology. FNIRS is an innovative, non-invasive tool to monitor hemodynamic changes in the cerebral cortex. Our review included clinical research conducted over the last 10 years, establishing fNIRS as a reliable and stable neuroimaging technique. This review explores new applications of this technology in the field of neuroscience. First, we summarize the working principles of fNIRS. We then present preventive research on the use of fNIRS in healthy individuals and therapeutic research on patients undergoing non-drug therapies of TCM. Finally, we emphasize the potential for encouraging future advancements in fNIRS studies to establish a theoretical framework for research in related fields.

Effects of transcranial magnetic stimulation on dynamic functional networks in stroke patients as assessed by functional near-infrared spectroscopy: a randomized controlled clinical trial

Studies have shown that there is heterogeneity in the efficacy bewteen the low-frequency (LF) and high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS), but the neural mechanisms underlying the differences in efficacy remain unclear. This study aimed to investigate the specific effects of LF- and HF-rTMS on cortial functional network and the process of neural regulation. A total of sixty-eight patients with hemiplegic motor impairment after stroke were randomly allocated to one of three groups: the LF-rTMS, HF-rTMS, and sham groups. Tissue concentrations of oxyhaemoglobin and deoxyhaemoglobin oscillations in cerebral cortex regions were measured by functional near-infrared spectroscopy (fNIRS) in the resting and rTMS states. Four specific time-windows were divided from the trial duration to observe dynamic changes in cortical haemodynamic responses. Compared with sham, LF-rTMS significantly induced the activation of the contralesional superior frontal cortex and premotor cortex, and continuously regulated ipsilesional hemisphere functional networks in stroke patients. However, HF-rTMS did not induce a significant neurovascular coupling response. Our study provided evidence that LF- and HF-rTMS interventions induced different neurovascular coupling responses and demonstrated the cortical functional network change process of rTMS in specific time-windows. These findings may help to understand the differences in the efficacy of rTMS modalities.

Neurobiomechanical mechanism of Tai Chi to improve upper limb coordination function in post-stroke patients: a study protocol for a randomized controlled trial

BACKGROUND

Upper limb dysfunction seriously affects the ability of stroke patients to perform activities of daily living. As a popular exercise therapy, Tai Chi may become an alternative intervention. However, the neurophysiological mechanism by which Tai Chi improves upper limb dysfunction in stroke patients is still unclear, which limits its further promotion and application. Therefore, conducting a strict randomized clinical trial is necessary to observe how Tai Chi affects upper limb dysfunction in stroke patients and to explore its neurophysiological mechanism.

METHODS/DESIGN

This report describes a randomized, parallel-controlled trial with distributive concealment and evaluator blinding. A total of 84 eligible participants will be randomly assigned to the Tai Chi group or the control group in a 1:1 ratio. The participants in the Tai Chi group will receive 4 weeks of Tai Chi training: five 60-min sessions a week for a total of 20 sessions. The participants in the control group will not receive Tai Chi training. Both groups will receive medical treatment and routine rehabilitation training. The primary outcome measure is the mean change in the Fugl-Meyer Assessment Upper Extremity (FMA-UE) scale score between baseline and 4 weeks; the secondary outcomes are the mean changes in kinematic characteristics and the Wolf Motor Function Test (WMFT) and Stroke Impact Scale (SIS) scores. In addition, the corticomuscular coupling level and near-infrared brain functional imaging will be monitored to explore the mechanism by which Tai Chi improves upper limb function of stroke patients.

DISCUSSION

This randomized controlled trial will examine the effectiveness of Tai Chi in stroke patients with upper limb dysfunction and explore the neurophysiological mechanism. Positive results will verify that Tai Chi can improve upper limb function of stroke patients.

TRIAL REGISTRATION

Chinese Clinical Trial Registration Center, ChiCTR2200061376 (retrospectively registered). Registered June 22, 2022. http://www.chictr.org.cn/listbycreater.aspx . Manuscript Version: 3.0 Manuscript Date: October 10, 2023.

Effects and mechanisms of Tai Chi on mild cognitive impairment and early-stage dementia: a scoping review

BACKGROUND

Dementia is associated with cognitive and functional decline that significantly impacts quality of life. There is currently no cure for dementia, thus, it is important to manage dementia in the early stages and delay deterioration. Previous studies have documented a range of health benefits of Tai Chi in people with early-stage dementia, however, none have systematically integrated these effects with their underlying mechanisms. The aims of this study were to (1) identify the neurocognitive, psychological, and physical health benefits of Tai Chi oi people with early-stage dementia, and (2) explore the underlying mechanisms of these effects.

METHODS

We searched systematic reviews (SRs) and randomised control trials (RCTs) on Tai Chi for adults aged 50 years and older with mild cognitive impairment (MCI) or early-stage dementia in MEDLINE, PubMed, Cochrane Library, EMBASE, and major Chinese databases. No language or publication restrictions were applied. Risk of bias was assessed.

RESULTS

Eight SRs with meta-analyses and 6 additional published RCTs revealed inconsistent findings of Tai Chi on improving global cognitive function, attention and executive function, memory and language, and perceptual-motor function. There was no significant between-group difference in depressive symptoms. The results from the RCTs showed that Tai Chi can reduce arthritis pain and slow the progress of dementia. No studies on MCI or early-stage dementia investigating the underlying mechanisms of Tai Chi were identified. Instead, nine mechanistic studies on healthy adults were included. These suggested that Tai Chi may improve memory and cognition via increased regional brain activity, large-scale network functional connectivity, and regional grey matter volume.

CONCLUSION

The effects of Tai Chi on neurocognitive outcomes in people with MCI and early-stage dementia are still inconclusive. Further high-quality clinical trials and mechanistic studies are needed to understand if and how Tai Chi may be applied as a successful intervention to delay deterioration and improve the quality of life in people with an increased risk of cognitive decline.

Understanding Yin-Yang Philosophic Concept Behind Tai Chi Practice

Yin-yang theorizes that everything in the world is interoppositionally unified with 2 dynamic opposites (yin and yang), interrooted, interchangeable, and interconvertible. Tai chi (TC) movements and postures are essentially yin-yang concept-based. However, there is still a lack of understanding of yin-yang concepts and applications among people practicing TC. So, in this concept review, we aimed to provide basic understanding of the yin-yang concept and characteristics behind TC practice. Terms derived from the yin-yang concept in TC practice may include blood/qi (energy), stability/mobility, closing/opening moves, expiration/inspiration, solid/empty stance, and defensive/offensive hand movements and postures. These yin-yang attributes are interrestricted and dependent on maintaining a dynamic mind-body harmony. With the yin-yang application, TC can be considered a self-controlled balance perturbation exercise to challenge the stability-mobility (yin-yang) to a new level of harmony. As a health promotion holistic intervention, TC can facilitate the flow in blood/qi pathways or meridians to improve medical conditions. As an integrative mind-body exercise, TC can activate different body parts and brain regions to participate in and coordinate the combined physical and mental activities.

Long-term Tai Chi training reduces the fusion illusion in older adults

Sound-induced flash illusion (SiFI) is an auditory-dominated audiovisual integration phenomenon that can be used as a reliable indicator of audiovisual integration. Although previous studies have found that Tai Chi exercise has a promoting effect on cognitive processing, such as executive functions, the effect of Tai Chi exercise on early perceptual processing has yet to be investigated. This study used the classic SiFI paradigm to investigate the effects of long-term Tai Chi exercise on multisensory integration in older adults. We compared older adults with long-term Tai Chi exercise experience with those with long-term walking exercise. The results showed that the accuracy of the Tai Chi group was higher than that of the control group under the fusion illusion condition, mainly due to the increased perceptual sensitivity to flashes. However, there was no significant difference between the two groups in the fission illusion. These results indicated that the fission and fusion illusions were affected differently by Tai Chi exercise, and this was attributable to the association of the participants' flash discriminability with them. The present study provides preliminary evidence that long-term Tai Chi exercise improves older adults' multisensory integration, which occurs in early perceptual processing.

Mitigating effects and mechanisms of Tai Chi on mild cognitive impairment in the elderly

Mild cognitive impairment (MCI) is a major public health concern that endangers health and decreases the quality of life of the elderly around the world. A recent clinical guideline has recommended regular exercise (twice per week) for patients with MCI as part of an overall approach to management. Tai Chi, a form of light-to-moderate-intensity mind-body exercise, is particularly suitable for seniors. This review aims to summarize epidemiological studies related to the effects of Tai Chi on symptom remission in older adults with MCI and reveal the potential mechanisms. Evidence suggested that Tai Chi can improve cognitive functions and alleviate the accompanying symptoms of MCI in the elderly potentially by activating the expression of signals in different brain regions, altering their connectivity, increasing the brain volume, and modulating brain-derived neurotropic and inflammation factors. Studies comparing various types of Tai Chi may contribute to the identification of paradigms that have appropriate intensities and difficulty and exert good effects on older people with MCI. In addition, studies are warranted to determine the frequency and duration of training that can optimize the beneficial effects of Tai Chi on MCI.

Tai Chi for spatiotemporal gait features and dynamic balancing capacity in elderly female patients with non-specific low back pain: A six-week randomized controlled trial

BACKGROUND

Non-specific low back pain (NS-LBP) is a serious public health problem. Tai Chi is promising in reducing the risk of falls and alleviating symptoms in this population.

OBJECTIVE

To investigate the effect of Tai Chi on gait and dynamic balance in elderly women with NS-LBP.

METHODS

20 women (age > 65 yr.) with NS-LBP were randomly assigned to a Tai Chi group (n= 10) or a control group (n= 10). The Tai Chi group practiced Tai Chi exercise 3 times a week for 6 weeks. Each session lasted 60 minutes. Pain, spatiotemporal gait features and dynamic balancing capacity were assessed at 0 and 6 weeks.

RESULTS

Compared to the control group at 6 weeks, the Tai Chi group had a significant decrease in VAS (p= 0.027) and stride width (p= 0.019), significant improvement in gait velocity, stride length (p< 0.001). Regarding dynamic balance capacity, the Tai Chi group had significant improvements in anterior (Left: p= 0.001; Right: p= 0.038), postero-lateral (Left: p< 0.001; Right: p= 0.038), and postero-medial (Left: p= 0.015; Right: p= 0.018).

CONCLUSION

6-week Tai Chi can relieve pain and improve gait and dynamic balance in elderly women with NS-LBP, which suggests Tai Chi could be a promising rehabilitation intervention to reduce the risk of falls in this population.

Effects of different exercise intensities of race-walking on brain functional connectivity as assessed by functional near-infrared spectroscopy

Introduction

Race-walking is a sport that mimics normal walking and running. Previous studies on sports science mainly focused on the cardiovascular and musculoskeletal systems. However, there is still a lack of research on the central nervous system, especially the real-time changes in brain network characteristics during race-walking exercise. This study aimed to use a network perspective to investigate the effects of different exercise intensities on brain functional connectivity.

Materials and methods

A total of 16 right-handed healthy young athletes were recruited as participants in this study. The cerebral cortex concentration of oxyhemoglobin was measured by functional near-infrared spectroscopy in the bilateral prefrontal cortex (PFC), the motor cortex (MC) and occipital cortex (OC) during resting and race-walking states. Three specific periods as time windows corresponding to different exercise intensities were divided from the race-walking time of participants, including initial, intermediate and sprint stages. The brain activation and functional connectivity (FC) were calculated to describe the 0.01-0.1 Hz frequency-specific cortical activities.

Results

Compared to the resting state, FC changes mainly exist between MC and OC in the initial stage, while PFC was involved in FC changes in the intermediate stage, and FC changes in the sprint stage were widely present in PFC, MC and OC. In addition, from the initial-development to the sprint stage, the significant changes in FC were displayed in PFC and MC.

Conclusion

This brain functional connectivity-based study confirmed that hemodynamic changes at different exercise intensities reflected different brain network-specific characteristics. During race-walking exercise, more extensive brain activation might increase information processing speed. Increased exercise intensity could facilitate the integration of neural signals such as proprioception, motor control and motor planning, which may be an important factor for athletes to maintain sustained motor coordination and activity control at high intensity. This study was beneficial to understanding the neural mechanisms of brain networks under different exercise intensities.

Modulating swallowing-related functional connectivity and behavior via modified pharyngeal electrical stimulation: A functional near-infrared spectroscopy evidence

Introduction

Modified pharyngeal electrical stimulation (mPES) is a novel therapeutic modality for patients with neurogenic dysphagia. However, the underlying neural mechanism remains poorly understood. This study aimed to use functional near-infrared spectroscopy (fNIRS) to explore the influence of mPES on swallowing-related frequency-specific neural networks and ethology.

Methods

Twenty-two healthy right-handed volunteers participated in the study. Each participant was randomly assigned to either the sham or the mPES group and provided a 10-min intervention program every day for 5 days. Oxyhemoglobin and deoxyhemoglobin concentration changes verified by fNIRS were recorded on days 1, 3, and 5. Five characteristic frequency signals (0.0095-2 Hz) were identified using the wavelet transform method. To calculate frequency-specific functional connectivity, wavelet phase coherence (WPCO) was adopted. Furthermore, behavioral performance was assessed pre- and post-mPES using a 150 ml-water swallowing stress test.

Results

Compared with sham stimulation on day 1, the significantly decreased WPCO values were mainly associated with the dorsolateral prefrontal lobe, Broca's area, and middle temporal lobe. Compared with the sham mPES on day 1, the mPES showed a noticeable effect on the total swallow duration. Compared with the baseline, the WPCO values on days 3 and 5 showed a stepwise decrease in connectivity with the application of mPES. Furthermore, the decreased WPCO was associated with a shortened time per swallow after mPES.

Conclusions

The mPES could modulate swallowing-related frequency-specific neural networks and evoke swallowing cortical processing more efficiently. This was associated with improved performance in a water swallowing stress test in healthy participants.

Brain Functional Connectivity in Middle-Aged Hong Chuan Tai Chi Players in Resting State

Tai Chi is an effective strategy for slowing cognitive decline, although the underlying mechanism remains unclear. We designed a cross-sectional study to examine brain functional connectivity in middle-aged Hong Chuan Tai Chi practitioners. Eighteen middle-aged Hong Chuan Tai Chi practitioners and 22 age-matched Tai Chi-naïve controls completed functional near-infrared spectroscopy (fNIRS) tests to evaluate oxyhemoglobin changes in the prefrontal cortex (PFC), motor cortex (MC), and occipital cortex (OC) in five frequency intervals (I, 0.6-2 Hz; II, 0.145-0.6 Hz; III, 0.052-0.145 Hz; IV, 0.021-0.052 Hz; V, 0.0095-0.021 Hz). Wavelet phase coherence was used to analyze the match between the instantaneous phases of the two signals to accurately measure brain functional connectivity. Global cognition was measured using the Montreal Cognitive Assessment scale. Compared with the control group, Hong Chuan Tai Chi practitioners had better global cognition (p < 0.01) and showed higher functional connectivity of the PFC, MC, and OC in intervals I, III, VI, and V in the resting state within the same brain hemispheres or between the left and right hemispheres. Our findings revealed that middle-aged Hong Chuan Tai Chi practitioners had higher functional connectivity of the PFC, MC, and OC across both brain hemispheres in cardiac activity, myogenic activity, sympathetic nervous system, and endothelial cell metabolic activities which may contribute to higher global cognition.

Effects of robot-assisted task-oriented upper limb motor training on neuroplasticity in stroke patients with different degrees of motor dysfunction: A neuroimaging motor evaluation index

Introduction

Although robot-assisted task-oriented upper limb (UL) motor training had been shown to be effective for UL functional rehabilitation after stroke, it did not improve UL motor function more than conventional therapy. Due to the lack of evaluation of neurological indicators, it was difficult to confirm the robot treatment parameters and clinical efficacy in a timely manner. This study aimed to explore the changes in neuroplasticity induced by robot-assisted task-oriented UL motor training in different degrees of dysfunction patients and extract neurological evaluation indicators to provide the robot with additional parameter information.

Materials and methods

A total of 33 adult patients with hemiplegic motor impairment after stroke were recruited as participants in this study, and a manual muscle test divided patients into muscle strength 0–1 level (severe group, n = 10), 2–3 level (moderate group, n = 14), and 4 or above level (mild group, n = 9). Tissue concentration of oxyhemoglobin and deoxyhemoglobin oscillations in the bilateral prefrontal cortex, dorsolateral prefrontal cortex (DLPFC), superior frontal cortex (SFC), premotor cortex, primary motor cortex (M1), primary somatosensory cortex (S1), and occipital cortex were measured by functional near-infrared spectroscopy (fNIRS) in resting and motor training state. The phase information of a 0.01 −0.08 Hz signal was identified by the wavelet transform method. The wavelet amplitude, lateralization index, and wavelet phase coherence (WPCO) were calculated to describe the frequency-specific cortical changes.

Results

Compared with the resting state, significant increased cortical activation was observed in ipsilesional SFC in the mild group and bilateral SFC in the moderate group during UL motor training. Patients in the mild group demonstrated significantly decreased lateralization of activation in motor training than resting state. Moreover, the WPCO value of motor training between contralesional DLPFC and ipsilesional SFC, bilateral SFC, contralesional, S1, and ipsilesional M1 showed a significant decrease compared with the resting state in the mild group.

Conclusion

Robot-assisted task-oriented UL motor training could modify the neuroplasticity of SFC and contribute to control movements and continuous learning motor regularity for patients. fNIRS could provide a variety of real-time sensitive neural evaluation indicators for the robot, which was beneficial to formulating more reasonable and effective personalized prescriptions during motor training.

The Effects of Tai Chi on the Executive Functions and Physical Fitness in Middle-Aged Adults with Depression: A Randomized Controlled Trial

Objective

The present study examined the effects of Tai Chi exercise on the executive functions (EFs) and physical fitness of middle-aged adults with depression.

Methods

A total of 39 middle-aged adults with depression (M_age = 50.59, SD = 7.38) were randomly assigned to the Tai Chi group (n = 20) or the waiting-list control group (n = 19). The Tai Chi group engaged in two 90 min sessions of Tai Chi exercise per week for 12 weeks; the waiting-list control group was asked to maintain their usual daily routines for 12 weeks. Depression symptoms, EFs (i.e., inhibitory control, planning, working memory, and cognitive flexibility), and physical fitness (i.e., cardiovascular fitness, muscular strength, muscular endurance, power, and flexibility) were evaluated at the baseline (pretest), 6-week (mid-test), and 12-week (post-test) marks.

Results

Both groups showed decreased depression symptoms over time. Compared with the control group, the Tai Chi group showed decreased reaction times for incongruent conditions in the Stroop test from pretest to mid- and post-test, and shorter reaction time for incongruent conditions in the Stroop test than the control group at post-test; the Tai Chi group performed significantly better than the control group in overall total move score of Tower of London (TOL). The Tai Chi group also showed increased total correct scores of TOL from pretest to mid- and post-test, and greater total correct scores of TOL than the control group at post-test. Additionally, results indicated that Tai Chi exercise comprehensively improved physical fitness from pretest to mid- and post-test. Greater performance in terms of cardiovascular fitness, muscular strength, and power was also found in the Tai Chi group at post-test than in the control group.

Conclusions

These findings suggest that the 12-week Tai Chi exercise improved inhibitory control, planning and working memory aspects of executive functions, and physical fitness in middle-aged adults with depression.

Effects of simultaneous use of m-NMES and language training on brain functional connectivity in stroke patients with aphasia: A randomized controlled clinical trial

Introduction

The m-NMES had been demonstrated to redistribute brain resources and induce plastic changes in the stroke patients. However, the physiological mechanism and clinical efficacy of m-NMES combination with existing clinical rehabilitation programs remains unclear in patients with aphasia after stroke. This study aimed to investigate the effects of simultaneous use of m-NMES and language training (m-NMES-LT) with on cerebral oscillations and brain connection, as well as the effect on clinical efficacy.

Materials and methods

Total 21 right–handed adult patients with aphasia were randomly assigned to language training (LT) group and m-NMES-LT group, and tissue concentration of oxyhemoglobin and deoxyhemoglobin oscillations were measured by functional near-infrared spectroscopy in resting and treatment state during three consecutive weeks. Five characteristic frequency signals (I, 0.6–2 Hz; II, 0.145–0.6 Hz; III, 0.052–0.145 Hz; IV, 0.021–0.052 Hz; and V, 0.0095–0.021 Hz) were identified using the wavelet method. The wavelet amplitude (WA) and wavelet phase coherence (WPCO) were calculated to describe the frequency-specific cortical activities.

Results

The m-NMES-LT induced significantly higher WA values in contralesional PFC in intervals I, II, and V, and ipsilesional MC in intervals I-V than the resting state. The WPCO values between ipsilesional PFC-MC in interval III-IV, and between bilateral MC in interval III-IV were significantly higher than resting state. In addition, there was a significant positive correlation between WPCO and Western Aphasia Battery in m-NMES-LT group.

Conclusion

The language training combined with neuromuscular electrical stimulation on median nerve could improve and achieve higher clinical efficacy for aphasia. This is attributed to the m-NMES-LT could enhance cortical activation and brain functional connectivity in patients with aphasia, which was derived from myogenic, neurogenic, and endothelial cell metabolic activities.

Brain Functional Connectivity in the Resting State and the Exercise State in Elite Tai Chi Chuan Athletes: An fNIRS Study

This study aimed to reveal the characteristics of multi-circuit brain synergy between elite tai chi chuan athletes in resting and exercise states and to provide neuroimaging evidence of improvements in brain function by motor skill training. Functional near-infrared spectroscopy (fNIRS) was used to compare the brain activity of professional tai chi chuan athletes (expert group) and beginners (novice group) in resting and exercise states, and to assess functional connectivity (FC) between the prefrontal lobe and the sensorimotor zone. In the resting state, the FC between the left prefrontal lobe and the right sensorimotor area in the expert group was significantly lower than that in the novice group (P &lt; 0.05). In the exercise state, the patterns of FC between the left prefrontal lobe and right sensorimotor area, the right prefrontal lobe and left sensorimotor area, and the left and right sensorimotor areas in the expert group were significantly lower than that in the novice group (P &lt; 0.05). From the resting state to the locomotor state, the expert group experienced a greater absolute value of functional connection increment between the left prefrontal cortex and right sensorimotor area, and between the left sensorimotor area and right sensorimotor area (P &lt; 0.05). This was positively correlated with the self-evaluation results of motor performance behavior. Under sports conditions, professional athletes’ multi-circuit brain FC strength is significantly reduced, and their elite motor skill performance supports the neural efficiency hypothesis. This may be related to the high adaptation of the brain to specific tasks and the improvement of the integration of somatic perception processing and motor function.

Trends in Research on Traditional Chinese Health Exercises for Improving Cognitive Function: A Bibliometric Analysis of the Literature From 2001 to 2020

Although previous studies have investigated the ability of traditional Chinese health exercises (TCHEs) to improve cognitive function, few have utilized bibliometric analyses to address this topic. We aimed to investigate the current status of and developmental trends in this field from 2001 to 2020. We searched the Web of Science Core Collection (WoSCC) for all research publications on cognitive function in relation to TCHEs. CiteSpace V was used to analyze the number of papers, countries, institutions, journals, authors, and citations. We identified hotspots and trends in the field by drawing co-citation reference and co-occurrence keyword maps. From 2001 to 2020, 406 relevant articles were published in the WoSCC, with a gradual increase in the annual number of publications. The three countries/regions with the most publications were the Chinese mainland, the United States, and Canada. Six universities from China and four from the United States were identified as the top 10 institutions. Most research was conducted at universities. Evidence-based Complementary and Alternative Medicine was identified as the most productive journal. Together, these findings indicate that TCHEs have received increasing attention as a method for improving cognition.

Effectiveness of Taijiquan in treating insomnia: A systematic review and meta-analysis of randomized controlled studies

BACKGROUND

Sleep efficiency of <80% based on actigraphy was defined as insomnia as self-reported difficulty falling asleep or waking up at night three to four times per week. It is known that adequate sleep is very important for human wellbeing, affecting people's work and life, insomnia will seriously damage our daily life. There is no recognized non-drug treatment. Studies have found that Taijiquan has a positive effect on insomnia patients. This systematic review and meta-analysis will evaluate the effect of Taijiquan on insomnia.

METHODS

To find all randomized controlled trials exploring the effects of Taijiquan on insomnia patients in Chinese and English, eight databases (Pubmed, Embase, Cochrane library, Web of Science, CNKI, CBM, VIP, and Wanfang Data) were searched. The retrieval time is from database construction to October 2021. Searches were conducted in both English and Chinese language. A meta-analysis by mean difference (MD) and 95% confidence interval (CI) was performed with RevMan 5.3. The risk of bias for each study was accounted for according to the Cochrane Handbook. Our primary outcome was Pittsburg Sleep Quality Index. We explored sources of heterogeneity by comparing effect sizes across different types of etiology, country, control group, and intervention type. The protocol was pre-registered with PROSPERO, CRD42021284511.

RESULTS

Twenty-one RCTs published between 2004 and 2021 with 2,022 participants were included in this study. Twenty-one randomized controlled studies showed that Tai Chi significantly improved PSQI scores in patients with cancer, muscle fibrosis, and sub-health insomnia [MD = -1.16, 95% CI (-1.62, -0.71), P < 0.01]; There is insufficient evidence of improvement in patients with cerebrovascular disease [MD = -0.54, 95% CI (-1.58, 0.51), P = 0.31]; 8-form, 10-form or 24-form Yang's Taijiquan had the same effect in improving PSQI [MD = -1.33, 95% CI (-1.85, -0.81), P < 0.01]. When there is no treatment, exercise, exercise and health education as the control, taijiquan has a significant effect on insomnia treatment, and there is no difference in efficacy compared with cognitive behavioral therapy and health education (usual care) alone.

CONCLUSIONS

The results of the study showed that Taijiquan significantly improved sleep quality in healthy adults and patients with chronic diseases, which suggests that Taijiquan may be considered as an alternative behavioral therapy in the treatment of insomnia. In the future, more high-quality, well-controlled randomized trials are needed to better inform clinical decisions.

Tai Chi and Yoga for Improving Balance on One Leg: A Neuroimaging and Biomechanics Study

The one-leg stance is frequently used in balance training and rehabilitation programs for various balance disorders. There are some typical one-leg stance postures in Tai Chi (TC) and yoga, which are normally used for improving balance. However, the mechanism is poorly understood. Besides, the differences of one-leg stance postures between TC and yoga in training balance are still unknown. Therefore, the aim of the present study was to investigate cortical activation and rambling and trembling trajectories to elucidate the possible mechanism of improving one-leg stance balance, and compare the postural demands during one-leg stance postures between TC and yoga. Thirty-two healthy young individuals were recruited to perform two TC one-leg stance postures, i.e., right heel kick (RHK) and left lower body and stand on one leg (LSOL), two yoga postures, i.e., one-leg balance and Tree, and normal one-leg standing (OLS). Brain activation in the primary motor cortex, supplementary motor area (SMA), and dorsolateral prefrontal cortex (DLPFC) was measured using functional near-infrared spectroscopy. The center of pressure was simultaneously recorded using a force platform and decomposed into rambling and trembling components. One-way repeated-measures analysis of variance was used for the main effects. The relative concentration changes of oxygenated hemoglobin (ΔHbO) in SMA were significantly higher during RHK, LSOL, and Tree than that during OLS (p < 0.001). RHK (p < 0.001), LSOL (p = 0.003), and Tree (p = 0.006) all showed significantly larger root mean square rambling (RmRMS) than that during OLS in the medial–lateral direction. The right DLPFC activation was significantly greater during the RHK than that during the Tree (p = 0.023), OLB (p < 0.001), and OLS (p = 0.013) postures. In conclusion, the RHK, LSOL, and Tree could be used as training movements for people with impaired balance. Furthermore, the RHK in TC may provide more cognitive training in postural control than Tree and OLB in yoga. Knowledge from this study could be used and implemented in training one-leg stance balance.

An Overview on Cognitive Function Enhancement through Physical Exercises

This review is extensively focused on the enhancement of cognitive functions while performing physical exercises categorized into cardiovascular exercises, resistance training, martial arts, racquet sports, dancing and mind-body exercises. Imaging modalities, viz. functional magnetic resonance imaging (fMRI), functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG), have been included in this review. This review indicates that differences are present in cognitive functioning while changing the type of physical activity performed. This study concludes that employing fNIRS helps overcome certain limitations of fMRI. Further, the effects of physical activity on a diverse variety of the population, from active children to the old people, are discussed.

Brain Function Changes Induced by Intermittent Sequential Pneumatic Compression in Patients With Stroke as Assessed by Functional Near-Infrared Spectroscopy

OBJECTIVE

Intermittent sequential pneumatic compression (ISPC) can effectively promote cerebral perfusion and collateral blood supply in patients with stroke. However, the effects of ISPC on cerebral oscillations are still unclear.

METHODS

The tissue concentration of oxyhemoglobin and deoxyhemoglobin oscillations were measured by functional near-infrared spectroscopy under resting and ISPC conditions in 27 right-handed adult patients with stroke. Five characteristic frequency signals (I, 0.6-2 Hz; II, 0.145-0.6 Hz; III, 0.052-0.145 Hz; IV, 0.021-0.052 Hz; and V, 0.0095-0.021 Hz) were identified using the wavelet method. The wavelet amplitude (WA) and laterality index (LI) were calculated to describe the frequency-specific cortical activities.

RESULTS

The ISPC state of patients with ischemic stroke showed significantly increased WA values of the ipsilesional motor cortex (MC) in the frequency intervals III (F37 = 8.017), IV (F37 = 6.347), and V (F37 = 5.538). There was no significant difference in the WA values in the ISPC state compared with the resting state in patients with hemorrhagic stroke. Also, the LI values of the prefrontal cortex and MC in patients decreased more obviously in the ISPC state than in the resting state despite no significant difference.

CONCLUSION

The significantly increased WA values in the frequency intervals III, IV, and V in the MC of patients with ischemic stroke might be related to cortical activity in the MC in addition to increased cerebral perfusion. The decreased LI values in the prefrontal cortex and MC indicated that the ISPC may have had a positive effect on the functional rehabilitation of these regions.

IMPACT

This study provides a method for assessing the effects of ISPC on cerebral oscillations, and the results benefit the optimization of ISPC parameters in personalized treatment for the functional recovery of patients with stroke.

Can Tai Chi Improve Cognitive Function? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Tai Chi (TC) is a traditional Chinese martial art with demonstrated beneficial effects on physical and mental health. In this study, the authors performed a systematic review to assess the efficiency of TC in different populations' cognitive function improvement. Design: The present systematic review utilized the Chinese National Knowledge Infrastructure (1915-), Wanfang (1998-), VIP (1989-), Chinese Biomedicine databases (1978-), PubMed (1950-), Web of Science (1900-), Cochrane Library (1948-), Embase (1974-), EBSCOhost (1922-), and OVID (1996-) databases to search and identify relevant articles published in English and Chinese from the beginning of coverage through October 17, 2020. Randomized controlled trials (RCTs) published from the beginning of coverage through October 17, 2020 in English and Chinese were retrieved from many indexing databases. Selected studies were graded according to the Cochrane Handbook for Systematic Reviews of Intervention 5.1.0. The outcome measures of cognitive function due to traditional TC intervention were obtained. Meta-analysis was conducted by using RevMan 5.4 software. We follow the PRISMA 2020 guidelines. Results: Thirty-three RCTs, with a total of 1808 participants, were included. The study showed that TC could progress global cognition when assessed in middle-aged as well as elderly patients suffering from cognitive and executive function impairment. The findings are as follows: Montreal Cognitive Assessment Scale: mean difference (MD) = 3.23, 95% CI = 1.88-4.58, p < 0.00001, Mini-Mental State Exam: MD = 3.69, 95% CI = 0.31-7.08, p = 0.03, Trail Making Test-Part B: MD = -13.69, 95% CI = -21.64 to -5.74, p = 0.0007. The memory function of older adults assessed by the Wechsler Memory Scale was as follows: MD = 23.32, 95% CI = 17.93-28.71, p < 0.00001. The executive function of college students evaluated by E-prime software through the Flanker test was as follows: MD = -16.32, 95% CI = -22.71 to -9.94, p < 0.00001. Conclusion: The TC might have a positive effect on the improvement of cognitive function in middle-aged and elderly people with cognitive impairment as well as older adults and college students.

Spectral Analysis of Muscle Hemodynamic Responses in Post-Exercise Recovery Based on Near-Infrared Spectroscopy

Spectral analysis of blood flow or blood volume oscillations can help to understand the regulatory mechanisms of microcirculation. This study aimed to explore the relationship between muscle hemodynamic response in the recovery period and exercise quantity. Fifteen healthy subjects were required to perform two sessions of submaximal plantarflexion exercise. The blood volume fluctuations in the gastrocnemius lateralis were recorded in three rest phases (before and after two exercise sessions) using near-infrared spectroscopy. Wavelet transform was used to analyze the total wavelet energy of the concerned frequency range (0.005–2 Hz), which were further divided into six frequency intervals corresponding to six vascular regulators. Wavelet amplitude and energy of each frequency interval were analyzed. Results showed that the total energy raised after each exercise session with a significant difference between rest phases 1 and 3. The wavelet amplitudes showed significant increases in frequency intervals I, III, IV, and V from phase 1 to 3 and in intervals III and IV from phase 2 to 3. The wavelet energy showed similar changes with the wavelet amplitude. The results demonstrate that local microvascular regulators contribute greatly to the blood volume oscillations, the activity levels of which are related to the exercise quantity.

Tai Chi for Chronic Illness Management: Synthesizing Current Evidence from Meta-Analyses of Randomized Controlled Trials

An umbrella review of systematic reviews and meta-analyses of randomized controlled trials (RCTs) was conducted to evaluate the existing evidence of Tai Chi as a mind-body exercise for chronic illness management. MEDLINE/PubMed and Embase databases were searched from inception until March 31, 2019, for meta-analyses of at least two RCTs that investigated health outcomes associated with Tai Chi intervention. Evidence of significant outcomes (P value < 0.05) was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. This review identified 45 meta-analyses of RCTs and calculated 142 summary estimates among adults living with 16 types of chronic illnesses. Statistically significant results (P value < 0.05) were identified for 81 of the 142 outcomes (57.0%), of which 45 estimates presenting 30 unique outcomes across 14 chronic illnesses were supported by high (n = 1) or moderate (n = 44) evidence. Moderate evidence suggests that Tai Chi intervention improved physical functions and disease-specific outcomes compared with nonactive controls and improved cardiorespiratory fitness compared with active controls among adults with diverse chronic illnesses. Between-study heterogeneity and publication bias were observed in some meta-analyses.

Effects of Tai Chi Chuan on Cognitive Function in Older Adults with Cognitive Impairment: A Systematic and Meta-Analytic Review

This systematic and meta-analytic review aimed to investigate the effects of Tai Chi Chuan (TCC) on the cognitive function of the elderly with cognitive impairment and to analyze the moderators of these effects. We searched eight electronic databases for randomized controlled trials on the effects of TCC on cognitive function, published up to June 14, 2020. The PEDro scale was used to evaluate the methodological quality of the included literature. Stata14.0 software was used for meta-analysis, subgroup analysis, and publication bias testing. A total of 19 studies and 1,970 samples were included. The methodological quality of the included literature was fair to good, and there was no publication bias. Overall, the research shows that the effect of TCC on the elderly with cognitive impairment is statistically significant (SMD = 0.31, p < 0.0001). Five of the cognitive function subdomains were significant moderators [Q (5) = 15.66, p=0.008], and the effect size (ES) was the largest for global cognitive function (SMD = 0.41), followed by executive function (SMD = 0.33), memory (SMD = 0.31), and verbal fluency (SMD = 0.27). Regarding the exercise prescription variables, results were significantly moderated by the length of exercise training [Q (2) = 6.00, p=0.05], with ESs largest for moderate length (SMD = 0.41), followed by short length (SMD = 0.40) and long length (SMD = 0.29). However, the results were not moderated by session time or frequency. TCC can improve multiple cognitive functions of the elderly with cognitive impairment. The intervention effects are moderated by exercise length, but not by exercise session time and frequency.

The Effect of Tai Chi for Improving Sleep Quality: A Systematic Review and Meta-analysis

BACKGROUND

Sleep quality is a major concern around the world, yet currently there are no recognized non-pharmacological treatments. A systematic review and meta-analysis investigated Tai Chi's effect on patients with sleep complaints, both those with insomnia and those with other conditions.

METHODS

4 English language databases (MEDLINE, EMBASE, PsycINFO, and CENTRAL) and 4 Chinese databases (CNKI, CBM, VIP, and Wanfang Data) were searched from database inception through June 23, 2019. Searches were conducted in both English and Chinese language. Meta-analysis by mean difference (MD) and 95% confidence interval (CI) was performed with RevMan 5.3. Risk of bias for each study was accounted for according to the Cochrane Handbook.

RESULTS

Twenty randomized controlled studies from five countries covering 1,703 patients were included and divided into two control groups. Tai Chi had a significant effect on the Pittsburgh Sleep Quality Index (PSQI) compared with non-treatment and active treatment groups. Moreover, the articles were divided into groups according to Tai Chi styles. Both 24-form Yang-style Tai Chi and 8-form Yang-style Tai Chi had significant effects on PSQI.

LIMITATIONS

One limitation of our work was that there were some forms of insomnia for which conclusions could not be drawn. Also, no relationship between efficacy and any of the factors could be elucidated.

CONCLUSIONS

Compared with non-therapeutic and other active treatments, Tai Chi has a positive effect on improving sleep quality. In-depth analysis showed that 24-form and 8-form Yang style Tai Chi have significant positive effects on sleep quality, as assessed by PSQI.

Effect of Tai Chi on post-stroke non-motor disorders: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

To evaluate the state of evidence for the beneficial and harmful effects of Tai Chi on non-motor disorders in post-stroke patients.

DESIGN

Systematic review and meta-analysis of published studies.

SUBJECTS

Stroke survivors who received conventional rehabilitation therapy or Tai Chi training.

DATA SOURCES

We searched seven electronic literature databases and one clinical registry platform to collect data from randomized controlled trials published up to July 26, 2020.

RESULTS

A total of 11 randomized controlled trials with 723 stroke survivors met the inclusion criteria, of which six were included in the meta-analysis. Among the 11 studies, one was assessed as "low", eight were assessed as "moderate", and only two were assessed as "high" for the assessment of methodologic quality. Compared to patients who received conventional rehabilitation therapy, those who received Tai Chi training showed greater improvement in scores of depression (standardized mean difference (SMD) [95% confidence interval (CI)] = 0.36 [0.10, 0.61], Grading of Recommendations Assessment, Development, and Evaluation [GRADE]: very low). There were no differences in the improvements in post-stroke global mental disorders (mean difference (MD [95% CI] = 6.15 [-3.05, 15.36], GRADE: moderate) or sleep disorders (MD [95% CI] = 0.33 [-1.51, 1.81], GRADE: low) between Tai Chi and control groups.

CONCLUSION

Tai Chi may alleviate post-stroke depression in stroke survivors but has no clear effects on post-stroke cognitive and sleep disorders.