Effect of regular Tai Chi and jogging exercise on neuromuscular reaction in older people

Effects of Tai Chi on Postural Control in People with Peripheral Neuropathy: A Systematic Review with Meta-Analysis

BACKGROUND

Effects of Tai Chi on people with peripheral neuropathy (PN) are not yet apparent. This systematic review was conducted to evaluate the effects of Tai Chi on postural control in people with PN.

METHODS

Literature was screened in seven databases for relevant randomized controlled trials. The reports and methodological quality were evaluated. A meta-analysis was performed using RevMan5.4 software.

RESULTS

Ten reports were included, involving a total of 344 subjects. The meta-analysis found that Tai Chi therapy for people with PN resulted in a smaller sway area, in the double-leg stance with eyes closed test (SMD = -2.43, I² = 0%), than that observed in the control group, greater distance covered in the six-minute walking test (SMD = -0.46, I² = 49%) and faster performance in the timed-up-and-go test (SMD = 0.68, I² = 50%), than the baseline.

CONCLUSIONS

Tai chi effectively enhanced dynamic postural control in people with PN. However, no better effects on postural control from Tai Chi than from other rehabilitation approaches were observed in this study. Further high-quality trials are needed to better understand Tai Chi's effects on individuals with PN.

Effects of 12 weeks of Tai Chi on neuromuscular responses and postural control in elderly patients with sarcopenia: a randomized controlled trial

Objective

To explore the effect of 12 weeks of Tai Chi on neuromuscular responses and postural control in elderly patients with sarcopenia.

Methods

One hundred and twenty-four elderly patients with sarcopenia from ZheJiang Hospital and surrounding communities were selected, however, 64 were later disqualified. Sixty elderly patients with sarcopenia were randomly assigned to the Tai Chi group (n = 30) and the control group (n = 30). Both groups received 45-min health education sessions once every 2 weeks for 12 weeks, and the Tai Chi group engaged in 40-min simplified eight-style Tai Chi exercise sessions 3 times per week for 12 weeks. Two assessors who had received professional training and were unaware of the intervention allocation assessed the subjects within 3 days prior to the intervention and within 3 days after completion of the intervention. They chose the unstable platform provided by the dynamic stability test module in ProKin 254 to evaluate the patient's postural control ability. Meanwhile, surface EMG was utilized to assess the neuromuscular response during this period.

Results

After 12 weeks of intervention, the Tai Chi group showed a significant decrease in neuromuscular response times of the rectus femoris, semitendinosus, anterior tibialis, and gastrocnemius and overall stability index (OSI) compared to before the intervention (p < 0.05), while there was no significant difference in the control group for these indicators before and after intervention (p > 0.05). In addition, these indicators in the Tai Chi group were significantly lower than those in the control group (p < 0.05). The changes in neuromuscular response times of the rectus femoris, semitendinosus, anterior tibialis, and gastrocnemius were positively correlated with the changes in OSI (p < 0.05) in the Tai Chi group, but there were no significant correlations between changes in neuromuscular response times of the aforementioned muscles and changes in OSI in the control group (p < 0.05).

Conclusion

Twelve-weeks of Tai Chi exercise can improve the neuromuscular response of the lower extremities in elderly patients with sarcopenia, shorten their neuromuscular response time when balance is endangered, enhance their dynamic posture control ability, and ultimately reduce the risk of falls.

Effects of taichi on physical and psychological health of college students: A systematic review

Background: Increasing studies have documented taichi’s usefulness in physical and psychological health in various participants, especially patients or the elderly. However, there is a need for a systematic review to evaluate its effects and health benefits among college students.

Objective:The present study aims to evaluate the current literature surrounding the effects of taichi on physical and psychological health among college students and identify the experimental areas for future research to establish guidelines for learning and teaching taichi in university.

Methods: The literature search involved several databases (PubMed, EBSCOhost, Web of Science, Scopus, and China National Knowledge Infrastructure). Subsequent research utilised the Preferred Reporting Items for Systematic Reviews and PRISMA checklist. In addition, the “QualSyst” tool assessed the quality of full-text articles.

Results: A total of 22 articles were analysed, out of which eight were strong, and 14 were of moderate quality. It is challenging to conduct a meta-analysis since the research contents were distributed differently. The general finding demonstrated that Taichi interventions have beneficial effects on college students. For example, the physical and psychological health benefits compared to other control groups include balance, leg strength, flexibility, cardiopulmonary functions, reducing stress, anxiety, and depression, and improving attention. However, there are some uncertain parameters in a state of poor or no evidence, such as upper strength, mood, and psychoticism.

Conclusion: Overall, this study shows that Taichi exercise is beneficial for college students compared to the control group. Evidence of health benefits for females is more than males. In addition, the current evidence showed that the effectiveness of taichi does not match some other sports such as Pilates, Yoga, Mindfulness courses, and even bodybuilding exercise. This research analyzed the mind-body mechanism of included studies. It revealed that it is difficult for college students, as a beginner of Taichi, to regulate an even breathing and quiet mind while maintaining low posture movements. Therefore, this study assumes that relaxation theories and approaches of Taichi that are easier to understand and closer to Chinese traditional Taichi theory are more appropriate in the research trials compared with coordination theory.

Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021278032.

Comparisons of tai chi and Iyengar yoga intervention effects on muscle strength, balance, and confidence in balance

BACKGROUND

The aim of the study is to compare a 16-week tai chi and Iyengar yoga program effects on muscle strength, static and dynamic balance, and balance confidence in elderly people.

METHODS

A total of 48 participants (≥60 years old) without mobility-impairing neurological disease, dementia, cardiovascular disease/symptoms during moderate exercise, poorly controlled hypertension, or balance-impairing drug use. Participants were divided into a tai chi group, an Iyengar yoga group, and a control group (eight males and eight females per group), using a restricted randomization scheme generated by software. While the former two undertook 16-week exercise programs, the control group received general education. Maximum concentric strength was measured with an isokinetic dynamometer. The one-legged stand with eyes closed, "8 feet up and go," and Activities-specific Balance Confidence (ABC) scale were used to assess static balance, dynamic balance, and balance confidence in daily activities, respectively.

RESULTS

Both programs improved all measures significantly with tai chi being more effective for increasing knee flexor strength (P=0.045) and extensor strength (P=0.032) and ABC score (P=0.034); Iyengar yoga was more effective for improving static balance (P=0.014) and dynamic balance (P=0.025; all P values here vs. the other program).

CONCLUSIONS

Tai chi and Iyengar yoga can improve strength, balance, and balance confidence among older people. Both are suitable exercise choices for older adults.

Tai Chi training's effect on lower extremity muscle co-contraction during single- and dual-task gait: Cross-sectional and randomized trial studies

BACKGROUND

Tai Chi (TC) mind-body exercise has been shown to reduce falls and improve balance and gait, however, few studies have evaluated the role of lower extremity muscle activation patterns in the observed benefits of TC on mobility.

PURPOSE

To perform an exploratory analysis of the association between TC training and levels of lower extremity muscle co-contraction in healthy adults during walking under single-task (ST) and cognitive dual-task (DT) conditions.

METHODS

Surface electromyography of the anterior tibialis and lateral gastrocnemius muscles was recorded during 90 sec trials of overground ST (walking normally) and DT (walking with verbalized serial subtractions) walking. A mean co-contraction index (CCI), across all strides, was calculated based on the percentage of total muscle activity when antagonist muscles were simultaneously activated. A hybrid study design investigated long-term effects of TC via a cross-sectional comparison of 27 TC experts and 60 age-matched TC-naïve older adults. A longitudinal comparison assessed the shorter-term effects of TC; TC-naïve participants were randomly allocated to either 6 months of TC training or to usual care.

RESULTS

Across all participants at baseline, greater CCI was correlated with slower gait speed under DT (β(95% CI) = -26.1(-48.6, -3.7)) but not ST (β(95% CI) = -15.4(-38.2, 7.4)) walking. Linear models adjusting for age, gender, BMI and other factors that differed at baseline indicated that TC experts exhibited lower CCI compared to TC naives under DT, but not ST conditions (ST: mean difference (95% CI) = -7.1(-15.2, 0.97); DT: mean difference (95% CI) = -10.1(-18.1, -2.4)). No differences were observed in CCI for TC-naive adults randomly assigned to 6 months of TC vs. usual care.

CONCLUSION

Lower extremity muscle co-contraction may play a role in the observed benefit of longer-term TC training on gait and postural control. Longer-duration and adequately powered randomized trials are needed to evaluate the effect of TC on neuromuscular coordination and its impact on postural control.

TRIAL REGISTRATION

The randomized trial component of this study was registered at ClinicalTrials.gov (NCT01340365).

Delayed peroneal muscle reaction time in male amateur footballers during a simulated prolonged football protocol

Peroneal muscle fatigue could result in ankle inversion sprain injuries. This study investigated the peroneal muscle reaction time during a simulated prolonged football protocol. Nine male footballers completed a 105-minute simulated prolonged football protocol. The peroneal muscle reaction time to an ankle inversion perturbation was measured every 15 minutes by a surface electromyography system sampling at 1000 Hz. One-way repeated ANOVA with post-hoc paired t-test showed a steady upward trend starting from 48.9 ms at baseline to 57.1 ms at the end of the first half, followed by a recovery back to 50.9 ms at the start of the second half and a further delay in the last 30 minutes to 60.2 ms at the end of the protocol. Delayed peroneal muscle reaction was found after 30 minutes of the first half and 15 minutes of the second half of a football match. The risk of ankle sprain could increase in the latter minutes in each half protocol. Thus, prevention injury training strategies should focus on these specific durations in football matches.

Benefits of tai ji quan practice on neuromuscular functions in older adults: A Systematic Review and meta-analysis

BACKGROUND AND PURPOSE

Tai Ji Quan (TJQ) practice has been recommended for reducing falls in older adults, but a gap exists in our understanding of the neuromuscular mechanisms underlying TJQ practice benefits. This study aims to quantify and validate neuromuscular mechanisms underlying TJQ practice benefits in older adults.

MATERIALS AND METHODS

This review and analysis followed the PRISMA framework. All meta-analyses were performed in R.

RESULTS

For healthy older adults, TJQ practice was found to decrease muscle onset latency. Higher leg muscle activations were found during TJQ gait in comparison to normal gait. A significant interaction between TJQ practice time and age of the cohort was observed in muscle onset latency. For adults with pre-existing health conditions, TJQ practice has similar neuromuscular benefits as conventional rehabilitation methods.

CONCLUSION

Neuromuscular function improvements associated with TJQ practice provide a mechanism for reducing falls in older adults with and without pre-existing health conditions.

Effects of different periods of Tai Chi exercise on the kinesthesia of the lower limb joints of elderly women

This study investigated the effects of different periods of Tai Chi exercise on knee and ankle joint kinesthesia. A total of 20 Tai Chi practitioners and 19 controls completed the final test. Customized devices were used to measure the kinesthesia of the knee and ankle joints at the start, after 24 weeks and after 48 weeks of the intervention. Results showed that the 24-week Tai Chi intervention considerably improved the kinesthesia of the knee flexion and extension and ankle dorsiflexion. The 48-week Tai Chi intervention improved the kinesthesia towards knee flexion and extension, ankle dorsiflexion and plantar flexion. Moreover, the 48-week Tai Chi intervention had better kinesthesia towards knee extension and ankle dorsiflexion compared with the 24-week Tai Chi intervention. Our results suggest that long-term (48 weeks versus 24 weeks) Tai Chi exercise benefits the knee and ankle kinesthesia of elderly women.

Mobility as the Purpose of Postural Control

Counteracting the destabilizing force of gravity is usually considered to be the main purpose of postural control. However, from the consideration of the mechanical requirements for movement, we argue that posture is adjusted in view of providing impetus for movement. Thus, we show that the posture that is usually adopted in quiet standing in fact allows torque for potential movement. Moreover, when performing a movement—either voluntarily or in response to an external perturbation—we show that the postural adjustments are organized both spatially and temporally so as to provide the required torque for the movement. Thus, when movement is performed skillfully, the force of gravity is not counteracted but actually used to provide impetus to movement. This ability to move one's weight so as to exploit the torque of gravity seems to be dependent on development and skill learning, and is impaired in aging.

Effects of regular Tai Chi practice and jogging on neuromuscular reaction during lateral postural control in older people

This study examined the effects of regular Tai Chi practice and jogging on the neuromuscular activity of the trunk, hip, and ankle joint muscles of older people during lateral postural perturbation. A total of 42 older people participated in the study and formed the Tai Chi, jogging, and sedentary control groups. Electromyography signals were collected from the peroneus longus, anterior tibialis, gluteus medius, and erector spinae during unpredictable mediolateral perturbation. The Tai Chi group exhibited significantly faster latencies of the tibialis anterior and erector spinae than the control group. The jogging group showed a significantly shorter neuromuscular reaction time of the erector spinae than the control group. No significant difference was observed between the Tai Chi and jogging groups. Long-term regular Tai Chi practice enhanced the neuromuscular reaction of the erector spinae and tibialis anterior to lateral perturbation and will help timely posture correction when lateral postural distributions occur.

Effects of therapeutic Tai chi on functional fitness and activities of daily living in patients with Parkinson disease

The purpose of the study is to investigate the effects of therapeutic Tai chi (TTC) on the functional fitness status and activities of daily living (ADL) of patients with Parkinson disease (PD). The participants were clinically stable PDs in Hoehn and Yahr stage 1–2. These patients were randomly assigned to either the TTC group (n=11) or the control (CON) group (n=9). The TTC exercised at the clinic 2 times a week and performed home-based activity 1 time per week for 12 weeks. All the PDs were evaluated for functional fitness test and ADL screen before and after the 12-week trial. There was a significant Time × group interaction effect on the arm curl (P<0.01), functional reach (P<0.05), and stand on foot with eyes opened (P<0.05) of the functional fitness as compared to the CON. The results of the functional reach test in the CON worsened significantly during the 12-week intervention in comparison with those of the TTC (P<0.01). Also ADL showed significant changed in TCC (P<0.05). Tai chi training showed good effects on the functional fitness in PDs. This study suggests that further research into the based such as Tai chi intervention must be developed PD’s quality of life in the future.

The Effects of Traditional Chinese Exercise in Patients with Chronic Obstructive Pulmonary Disease: A Meta-Analysis

Background

Chronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. However, several studies that have assessed the role of traditional Chinese exercise in the management of this disease include broad variations in sample sizes and results. Therefore, this meta-analysis was conducted to assess the effects of traditional Chinese exercise on patients with COPD.

Methods

Two investigators independently identified and extracted data from selected articles. A computerized search of electronic databases through August 2015 was conducted. Mean differences (MDs) and 95% confidence intervals (CIs) were calculated to analyze the combined data. The methodological quality was evaluated using the Cochrane risk-of-bias tool. Heterogeneity was assessed with the I² test.

Results

Ten randomized, controlled trials (RCTs) involving 622 patients met the inclusion criteria. There were significant improvements in the 6-minute walking distance test (6 MWD;MWD = 12.10 m; 95% CI, 7.56–16.65 m; p<0.001); forced expiratory volume in one second (FEV1% predicted; WMD = 9.02; 95% CI, 6.80–11.23; p<0.00001); forced expiratory volume in 1 second/forced vital capacity (FEV(1)/FVC) ratio (Tiffenau Index; WMD = 6.67; 95% CI, 5.09–8.24; p<0.00001); and quality of life, as evaluated by the Chronic Respiratory Disease Questionnaire (CRDQ; WMD = 0.85 score; 95% CI, 0.52–1.18; p<0.00001).

Conclusions

Traditional Chinese exercise could provide an effective alternative method for managing COPD. Larger and higher-quality trials are required.

Tai Chi as a form of exercise training in people with chronic obstructive pulmonary disease

Tai Chi is an ancient Chinese martial art which incorporates elements of strengthening, balance, postural alignment and concentration. The benefits of Tai Chi in the healthy population have been widely examined. In comparison, only three studies have evaluated the effects of Tai Chi in people with chronic obstructive pulmonary disease (COPD). Existing evidence suggests that the exercise intensity of Tai Chi reaches a moderate level in people with COPD. Furthermore, a short-term program of Tai Chi improves exercise capacity, health-related quality of life, balance and quadriceps strength in people with mild to moderate COPD. More studies are warranted to examine the effects of different styles of Tai Chi and the long-term benefits of Tai Chi as an exercise regimen for people with COPD.

Proprioception: where are we now? A commentary on clinical assessment, changes across the life course, functional implications and future interventions

Proprioception, the sense of where one is in space, is essential for effective interaction with the environment. A lack of or reduction in proprioceptive acuity has been directly correlated with falls and with reduced functional independence in older people. Proprioceptive losses have also been shown to negatively correlate with functional recovery post stroke and play a significant role in other conditions such as Parkinson's disease. However, despite its central importance to many geriatric syndromes, the clinical assessment of proprioception has remained remarkably static. We look at approaches to the clinical assessment of proprioception, changes in proprioception across the life course, functional implications of proprioception in health and disease and the potential for targeted interventions in the future such as joint taping, and proprioception-specific rehabilitation and footwear.

Therapeutic effects of tai chi in patients with Parkinson's disease

Objective. The purpose of the study was to investigate the effects of a 12-week program of therapeutic Tai Chi on the motor function and physical function of idiopathic Parkinson's disease patients (PDs). Methods. The participants were 22 clinically stable PDs in Hoehn-Yahr stages 1-2 randomly assigned to a therapeutic Tai Chi group (TTC, N = 11) or a control group (CON, N = 9). Two subjects in control group did not complete the study for personal reasons. TTC was performed three days a week (60 min/session). Motor symptoms by the UPDRS were assessed, and tests of physical function were administered before and after the 12-week trial. Results. The TTC group, as compared to the CON group, showed changes in the mentation, behavior, mood, and motor scales of the UPDRS (P < 0.05, P < 0.01, resp.), with no significant main effects on the activities of daily living scale (ADL). However, there was a significant interaction between the time and intervention group on ADL (P < 0.05). There were no significant main effects for any of the physical function variables. There were significant interaction effects in balance and agility (P < 0.05, resp.). Conclusions. This study showed that TTC training had modest positive effects on the functional status of Parkinson's disease patients.

A systems biology approach to studying Tai Chi, physiological complexity and healthy aging: design and rationale of a pragmatic randomized controlled trial

INTRODUCTION

Aging is typically associated with progressive multi-system impairment that leads to decreased physical and cognitive function and reduced adaptability to stress. Due to its capacity to characterize complex dynamics within and between physiological systems, the emerging field of complex systems biology and its array of quantitative tools show great promise for improving our understanding of aging, monitoring senescence, and providing biomarkers for evaluating novel interventions, including promising mind-body exercises, that treat age-related disease and promote healthy aging.

MATERIAL AND METHODS

An ongoing, two-arm randomized clinical trial is evaluating the potential of Tai Chi mind-body exercise to attenuate age-related loss of complexity. A total of 60 Tai Chi-naïve healthy older adults (aged 50-79) are being randomized to either six months of Tai Chi training (n=30), or to a waitlist control receiving unaltered usual medical care (n=30). Our primary outcomes are complexity-based measures of heart rate, standing postural sway and gait stride interval dynamics assessed at 3 and 6months. Multiscale entropy and detrended fluctuation analysis are used as entropy- and fractal-based measures of complexity, respectively. Secondary outcomes include measures of physical and psychological function and tests of physiological adaptability also assessed at 3 and 6months.

DISCUSSION

Results of this study may lead to novel biomarkers that help us monitor and understand the physiological processes of aging and explore the potential benefits of Tai Chi and related mind-body exercises for healthy aging.

Tai chi in patients with heart failure with preserved ejection fraction

Although exercise is an important component of heart failure management, optimal regimens, particularly in heart failure with preserved ejection fraction (HFPEF), are uncertain. Tai chi (TC) is a mind-body exercise that may have potential benefits but has not been studied in this population. The authors randomized 16 patients with HFPEF to either 12 weeks TC or aerobic exercise. Assessments included peak oxygen uptake, 6-minute walk, quality of life, echocardiography, mood, and self-efficacy at baseline and at 12 weeks. Cardiorespiratory measures during exercise were obtained to characterize training intensities. Baseline characteristics were as follows: age 66±12 years, E/A ratio 1.3±0.7, and E/e' ratio 15.9±4.8. Overall, adherence was excellent (89% attendance). Change in peak oxygen uptake was similar between groups after 12 weeks, but 6-minute walk distance increased more after TC (69±46 m vs 10±31 m, P=.02). While both groups had improved Minnesota Living With Heart Failure scores and self-efficacy, Profile of Mood States (POMS)-Depression scores improved more with TC (-1.7±2.8 vs 1.6±3, P=.05). Cardiorespiratory assessment during TC showed lower oxygen uptake (4.3 mL/kg/min vs 9.4 mL/kg/min, P<.01), respiratory rate, and heart rate. TC is feasible and safe in HFPEF. Therepeutic endpoints appear similar with TC relative to aerobic exercise despite a lower aerobic training workload.

Tai chi diminishes oxidative stress in Mexican older adults

OBJECTIVE

To determine the effect of Tai Chi on oxidative stress in a population of elderly Mexican subjects.

DESIGN

It was carried out a quasi-experimental study with a sample of 55 healthy subjects randomly divided into two age-matched groups: (i) a control group with 23 subjects and (ii) an experimental group with 32 subjects. The experimental group received daily training in Tai Chi for 50 min.

MEASUREMENTS

It was measured before and after 6-month of exercise period: thiobarbituric acid reactive substances (TBARS), total antioxidant status (TAS), superoxide dismutase (SOD), and glutathione peroxidase (GPx).

RESULTS

It was found that the experimental group exhibited a statistically significant decrease in glucose levels, total cholesterol, low-density lipoprotein cholesterol (LDLC), and systolic blood pressure, as well as an increase in SOD and GPx activity and TAS compared with the control group (p < 0.05).

CONCLUSIONS

Our findings suggest that the daily practice of Tai Chi is useful for reducing OxS in healthy older adults.

A randomized controlled trial of Tai chi for balance, sleep quality and cognitive performance in elderly Vietnamese

OBJECTIVE

To evaluate the effects of Tai chi exercise on balance, sleep quality, and cognitive performance in community-dwelling elderly in Vinh city, Vietnam.

DESIGN

A randomized controlled trial.

PARTICIPANTS

One hundred two subjects were recruited.

INTERVENTION

Subjects were divided randomly into two groups. The Tai chi group was assigned 6 months' Tai chi training. The control group was instructed to maintain their routine daily activities.

OUTCOME MEASURES

The Falls Efficacy Scale (FES), Pittsburgh Sleep Quality Index (PSQI), and Trail Making Test (TMT) were used as primary outcome measures.

RESULTS

Participants in the Tai chi group reported significant improvement in TMT (part A) (F [1, 71] = 78.37, P < 0.001) and in TMT (part B), (F [1, 71] = 175.00, P < 0.001) in comparison with the control group. Tai chi participants also reported better scores in FES (F [1, 71] = 96.90, P < 0.001) and in PSQI (F [1,71] = 43.69, P = 0.001) than the control group.

CONCLUSION

Tai chi is beneficial to improve balance, sleep quality, and cognitive performance of the elderly.

Effect of green tea and Tai Chi on bone health in postmenopausal osteopenic women: a 6-month randomized placebo-controlled trial

Postmenopausal women with osteopenia received green tea polyphenols (GTP) supplement and/or Tai Chi exercise for 6 months. Bone turnover biomarkers, calcium metabolism, and muscle strength were measured. This study showed that GTP supplementation and Tai Chi exercise increased bone formation biomarkers and improved bone turnover rate. Tai Chi exercise increased serum parathyroid hormone. GTP supplementation, Tai Chi exercise, and the combination of the two all improved muscle strength in postmenopausal women with osteopenia.

INTRODUCTION

This study evaluated the effect of GTP supplementation and Tai Chi (TC) exercise on serum markers of bone turnover (bone-specific alkaline phosphatase, BAP, and tartrate-resistant acid phosphatase, TRAP), calcium metabolism, and muscle strength in postmenopausal osteopenic women.

METHODS

One hundred and seventy-one postmenopausal osteopenic women were randomly assigned to four groups: (1) placebo (500 mg starch/day), (2) GTP (500 mg GTP/day), (3) placebo + TC (placebo plus TC training at 60 min/session, three sessions/week), and (4) GTP + TC (GTP plus TC training). Overnight fasting blood and urine samples were collected at baseline, 1, 3, and 6 months for biomarker analyses. Muscle strength was evaluated at baseline, 3, and 6 months. One hundred and fifty subjects completed the 6-month study.

RESULTS

Significant increases in BAP level due to GTP intake (at 1 month) and TC (at 3 months) were observed. Significant increases in the change of BAP/TRAP ratio due to GTP (at 3 months) and TC (at 6 months) were also observed. Significant main effect of TC on the elevation in serum parathyroid hormone level was observed at 1 and 3 months. At 6 months, muscle strength significantly improved due to GTP, TC, and GTP + TC interventions. Neither GTP nor TC affected serum TRAP, serum and urinary calcium, and inorganic phosphate.

CONCLUSION

In summary, GTP supplementation and TC exercise increased BAP and improved BAP/TRAP ratio. TC exercise increased serum parathyroid hormone. GTP supplementation, TC exercise, and the combination of the two all improved muscle strength in postmenopausal women with osteopenia.

The effects of Tai Chi training on physical fitness, perceived health, and blood pressure in elderly Vietnamese

Objective

Evaluating the effects of Tai Chi exercise on physical fitness, blood pressure, and perceived health in community-dwelling elderly.

Design

A randomized controlled trial.

Setting

Community-dwelling elderly in Vinh city, Vietnam.

Participants

Ninety-six community-dwelling participants aged 60 to 79 years (68.9 ± 5.1 years) were recruited.

Intervention

Subjects were divided randomly into two groups: Tai Chi and Control groups. Participants in the Tai Chi group (aged 69.02 ± 5.16 years) attended a 60-minute Tai Chi practice session twice a week for 6 months. The session consisted of a 15-minute warm-up and a 15-minute cool-down period. The Control group (aged 68.72 ± 4.94 years) maintained routine daily activities.

Outcome measures

The Senior Fitness Test and Short-Form 36® (SF-36®) are primary outcome measures.

Results

After 24 weeks of the Tai Chi training program, the intervention group showed significant decrease in systole of 12 mmHg and heart rate 6.46 bpm. Body mass index and waist–hip ratio were also reduced by 1.23 and 0.04, respectively. The Senior Fitness Test and SF-36 showed significant improvement.

Conclusion

In this randomized controlled trial study, Tai Chi is beneficial to improve systole blood pressure, heart rate, body mass index, waist–hip ratio, perceived health, and physical fitness. Assessment of the effects of Tai Chi may be focused more on chronic disease with a long-term training program in the future.

Tai chi and rheumatic diseases

Tai chi is a complex multicomponent mind-body exercise. Many studies have provided evidence that tai chi benefits patients with a variety of chronic disorders. This form of mind-body exercise enhances cardiovascular fitness, muscular strength, balance, and physical function and seems to be associated with reduced stress, anxiety, and depression and improved quality of life. Thus, despite certain limitations in the evidence, tai chi can be recommended to patients with osteoarthritis, rheumatoid arthritis, and fibromyalgia as a complementary and alternative medical approach. This article overviews the current knowledge about tai chi to better inform clinical decision making for rheumatic patients.

Effects of an unstable shoe construction on balance in women aged over 50 years

BACKGROUND

Shoes with an unstable sole construction are commonly used as a therapeutic tool by physiotherapists and are widely available from shoe and sporting goods retailers. The aim of this study was to investigate the effects of using an unstable shoe (Masai Barefoot Technology) on standing balance, reactive balance and stability limits.

METHODS

Thirty-one subjects agreed to participate in the study and underwent balance tests on three different occasions. After test occasion one (baseline) 20 subjects received Masai Barefoot Technology shoes and were requested to wear them as much as possible for the remaining eight weeks of the study. Three specific balance tests were administered on each test occasion using a Pro Balance Master (NeuroCom International Inc., Oregon, USA). Tests included; a modified sensory organization test, reactive balance test and limits of stability test.

FINDINGS

Subjects in the intervention group significantly improved their performance on elements of all three tests however results on these variables were not demonstrated to be significantly better than the control group. No significant differences were observed across testing occasions in the control group.

INTERPRETATION

Results from the present study suggest that, for this group of individuals, use of unstable footwear may improve certain aspects of balance.

The neural adjustment of postural response through community-based daily exercises in elderly persons

BACKGROUND

Reflecting the rapidly aging population, community-based interventions in the form of physical exercise have been introduced to promote the health of elderly persons and prevent falls. Postural response is the critical neural response for preventing falls. The objective of this study was to assess the effect of long-term daily exercise on neural adjustment in postural response elucidated by sudden postural perturbation.

METHODS

Twenty-six community-based elderly persons (13 men and women; 69.8+/-0.5 years old) participated in this study. Daily exercise was composed of walking for longer than 30 min, stretching, muscle strengthening and balance exercise, and was continued for 3 months. Postural responses were induced by fore or aft horizontal displacement of a platform with a force plate. Center of pressure on the force plate and electromyography of the rectus femoris, tibia anterior, biceps femoris and gastrocnemius were measured in postural response.

FINDINGS

Following the 3 months of physical intervention, the amplitude and timing of the center of pressure excursion did not change, whereas the amplitude of muscular activities of the lower leg muscles required for the response significantly decreased. Furthermore, the onset of muscular activation of the lower leg muscles was significantly shortened following the intervention.

INTERPRETATION

In conclusion, we showed that a program composed of 3 months of comprehensive exercise modulated the output of the postural response through a neural adjustment in the timing and amplitude of the muscular activation.

Changes in muscle strength, endurance, and reaction of the lower extremities with Tai Chi intervention

This study examines the effects of a 16-week Tai Chi (TC) training program on the muscle strength, endurance, and reaction time of the lower extremities of elderly people. A total of 40 elderly individuals (aged 60 years) completed the study. They were divided into two groups: the TC group (11 men and 11 women) underwent a supervised TC exercise program for 16 weeks, while the control group (9 men and 9 women) received general education for a comparable time period. Pre- and post-intervention measurements were conducted. An isokinetic dynamometer was used to measure the maximum concentric strength and dynamic endurance of the knee flexors and the extensors, and the maximum concentric strength of the ankle plantarflexors and dorsiflexors. The neuromuscular response of the rectus femoris, semitendinosus, gastrocnemius, and anterior tibialis muscles was measured by the onset latency to sudden perturbations using an electromyography system. After 16 weeks, the TC group showed a 19.9% increase in muscle strength of the knee flexors (p<.000) that was significantly greater than that in the control group (p=.046). There was also a significant decrease in semitendinosus muscle latency (6.6%, p=.014) that was significantly shorter than that in the control group (p=.042). No significant training effects were found in other measures. These results suggest that improving biomechanical characteristics of lower extremity muscles may need longer TC intervention for elderly people.

Asian martial arts and resiliency

This article reviews characteristics of resilience and various types of Asian martial arts and illustrates how Asian martial arts help to cultivate resiliency. Cultivation of internal energy (eg. chi kung), training the breath, meditative techniques and spiritual development, metaphors and models in Asian martial arts, and training ‘heart’ designed to enhance resiliency are mechanisms for how Asian marital arts cultivate resilience. Finally, a brief review of the health and mental health benefits of Asian martial arts is presented.

Challenges inherent to t'ai chi research: part II-defining the intervention and optimal study design

Although a growing body of clinical research has begun to evaluate the efficacy and safety of t'ai chi as a therapeutic tool for a variety of health conditions, little attention has been devoted to evaluating "how" t'ai chi is scientifically studied, and the advantages or limitations of different methodological approaches. In a companion to this paper (Part I), we argued that t'ai chi is a complex, multicomponent intervention, which poses unique challenges regarding the distinction of specific versus nonspecific effects and limitations regarding the use of reductionistic research frameworks. In this second, companion paper, we discuss additional obstacles inherent in precisely defining the t'ai chi intervention in an experimental paradigm. These challenges include t'ai chi's pluralism, the concept of t'ai chi dosage, and long- versus short-term evaluations of t'ai chi's efficacy and safety. To address these challenges, and with a goal to provide complete and unbiased evidence, we propose a pluralistic methodological approach to clinical research that includes controlled randomized trials of fixed protocols, community-based pragmatic trials, cross-sectional studies of long-term practitioners, and studies that integrate qualitative methods.

Biomechanics of Tai Chi: a review

Tai Chi Chuan is a favourite form of exercise throughout the world and has drawn increasing research interest from international scientists. Biomechanical research into Tai Chi has grown substantially and has provided evidence of the beneficial effects of Tai Chi exercise on health, fitness, and prevention of falls. This paper reviews studies that have explored the biomechanical aspects of Tai Chi, such as balance, kinematics, kinetics, strength, and neuromuscular activities.

Efeitos do Tai Chi Chuan na incidência de quedas, no medo de cair e no equilíbrio em idosos: uma revisão sistemática de ensaios clínicos aleatorizados

Resumo O processo de envelhecimento é um dos fatores que, através da deterioração do equilíbrio, influenciam o aumento do número de quedas e resultam em sérias complicações, como o medo de cair. O Tai Chi Chuan é uma arte marcial milenar oriental considerada um exercício de intensidade leve a moderada. A prática do Tai Chi Chuan na população idosa apresenta efeitos positivos no controle do equilíbrio, na incidência de quedas e no medo de cair. Sendo assim, o objetivo deste estudo foi realizar uma revisão sistemática que evidenciasse o efeito do Tai Chi Chuan na incidência de quedas, no medo de cair e no equilíbrio em idosos. Foram pesquisados ensaios clínicos aleatórios nas bases de dados Medline, Lilacs, Cochrane e PEDro. Dois revisores avaliaram a qualidade dos estudos e realizaram a extração dos dados de forma independente. Foram selecionados seis artigos, que abrangeram 816 participantes. Uma análise dos resultados demonstrou uma resposta positiva do Tai Chi Chuan na redução da incidência de quedas e no medo de cair em idosos sedentários e que vivem na comunidade. O mesmo efeito não foi observado em relação à melhora da estabilidade postural.

A perturbation-based balance training program for older adults: study protocol for a randomised controlled trial

Background

Previous research investigating exercise as a means of falls prevention in older adults has shown mixed results. Lack of specificity of the intervention may be an important factor contributing to negative results. Change-in-support (CIS) balance reactions, which involve very rapid stepping or grasping movements of the limbs, play a critical role in preventing falls; hence, a training program that improves ability to execute effective CIS reactions could potentially have a profound effect in reducing risk of falling. This paper describes: 1) the development of a perturbation-based balance training program that targets specific previously-reported age-related impairments in CIS reactions, and 2) a study protocol to evaluate the efficacy of this new training program.

Methods/Design

The training program involves use of unpredictable, multi-directional moving-platform perturbations to evoke stepping and grasping reactions. Perturbation magnitude is gradually increased over the course of the 6-week program, and concurrent cognitive and movement tasks are included during later sessions. The program was developed in accordance with well-established principles of motor learning, such as individualisation, specificity, overload, adaptation-progression and variability. Specific goals are to reduce the frequency of multiple-step responses, reduce the frequency of collisions between the stepping foot and stance leg, and increase the speed of grasping reactions. A randomised control trial will be performed to evaluate the efficacy of the training program. A total of 30 community-dwelling older adults (age 64–80) with a recent history of instability or falling will be assigned to either the perturbation-based training or a control group (flexibility/relaxation training), using a stratified randomisation that controls for gender, age and baseline stepping/grasping performance. CIS reactions will be tested immediately before and after the six weeks of training, using platform perturbations as well as a distinctly different method of perturbation (waist pulls) in order to evaluate the generalisability of the training effects.

Discussion

This study will determine whether perturbation-based balance training can help to reverse specific age-related impairments in balance-recovery reactions. These results will help to guide the development of more effective falls prevention programs, which may ultimately lead to reduced health-care costs and enhanced mobility, independence and quality of life.

A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people

BACKGROUND

The beneficial role of exercise in improving bone mineral density, muscle strength and balance, has been documented predominantly in younger populations. These findings may not apply to elderly populations with limited ability to perform exercises of high intensity.

OBJECTIVE

To examine the effects of Tai Chi (TC) and resistance exercise (RTE) on bone mineral density (BMD), muscle strength, balance and flexibility in community living elderly people.

DESIGN

Randomised controlled trial, using blocked randomization with stratification by sex.

SETTING

A community in the New Territories Region of Hong Kong, China.

SUBJECTS

One hundred eighty subjects (90 men, 90 women) aged 65-74, were recruited through advertisements in community centres.

METHODS

Subjects were assigned to participate in TC, RTE three times a week, or no intervention (C) for 12 months. Measurements were carried out at baseline, 6 and 12 months. Analyses of covariance (ANCOVA) adjusted for age, and baseline values of variables that were significantly different between groups: i.e. smoking and flexibility for men; quadriceps strength for women.

RESULTS

Compliance was high (TC 81%, RTE 76%). In women, both TC and RTE groups had less BMD loss at total hip compared with controls. No effect was observed in men. No difference in either balance, flexibility or the number of falls was observed between either intervention or controls after 12 months.

CONCLUSION

The beneficial effects of TC or RTE on musculoskeletal health are modest and may not translate into better clinical outcomes.