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Toles M, Li Z, Bankole AO, Conklin JL, Vu T, Womack J. Characteristics of health care interventions in affordable senior housing: A scoping review. Geriatr Nurs 2023; 53:122-129. [PMID: 37536003 DOI: 10.1016/j.gerinurse.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 08/05/2023]
Abstract
AIMS Older adults in affordable senior housing often experience chronic illness and unmet health care needs. This review describes studies reporting the characteristics and primary outcomes of health care interventions for older adults living in affordable senior housing. DESIGN A scoping review METHODS: After a systematic search in three databases, a team of investigators screened 1,284 titles and abstracts and selected 31 records with reports on 28 studies for review. Narrative synthesis was used to describe studies of interventions in senior housing and primary outcomes. RESULTS Studies typically used observational designs and added clinical staff, such as nurses and social workers, to provide health care interventions in groups (n = 15) or with individuals (n = 13). Outcomes were classified in four groups: wellness, symptom management, health care use, and physical function. A subset of 23 studies (82.1%) reported effective interventions. IMPACT Findings identify innovative interventions to promote health in affordable senior housing.
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Affiliation(s)
- Mark Toles
- University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, Campus Box #7460, Chapel Hill, NC 27599-7460, USA.
| | - Zhaoying Li
- University of North Carolina at Chapel Hill, Department of Health Sciences, Division of Occupational Science and Occupational Therapy, Bondurant Hall, Campus Box #7120, Chapel Hill, NC 27599-7120, USA
| | - Ayomide Okanlawon Bankole
- University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, Campus Box #7460, Chapel Hill, NC 27599-7460, USA
| | - Jamie L Conklin
- University of North Carolina at Chapel Hill, Health Sciences Library, 335 S Columbia St., Chapel Hill, NC 27599, USA
| | - Thi Vu
- Yale University, School of Public Health, Department of Social and Behavioral Sciences, P.O. Box 208034, 60 College Street, New Haven, CT 06520-083, USA
| | - Jenny Womack
- Appalachian State University, Department of Rehabilitation Sciences, Levine Hall of Health Sciences, Suite 460, Boone, North Carolina, USA
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Park M, Song R, Ju K, Shin JC, Seo J, Fan X, Gao X, Ryu A, Li Y. Effects of Tai Chi and Qigong on cognitive and physical functions in older adults: systematic review, meta-analysis, and meta-regression of randomized clinical trials. BMC Geriatr 2023; 23:352. [PMID: 37280512 DOI: 10.1186/s12877-023-04070-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Older adults experience age-related declines in physical and cognitive functions due to interactions between aging and chronic diseases. Tai Chi and Qigong (TCQ) might be beneficial in improving the physical function and delaying the cognitive decline of this population. The potential underlying mechanism was explored to determine the effects of TCQ on cognitive function via direct or indirect pathways. PURPOSE The objective of this systematic review was to determine the effects of TCQ on cognitive and physical functions in older adults using meta-analysis, and to determine the impact of TCQ on cognitive function while controlling for physical function using a meta-regression approach. METHODS A systematic search of 13 electronic databases (in English, Korean, and Chinese languages) identified 10,292 potentially eligible studies published between inception and May 2022. The bias in individual studies was assessed using the Cochrane Risk of Bias (version 2.0) tool. The heterogeneity of the studies was evaluated using a 95% prediction interval, and the meta-analysis and meta-regression were implemented using the Comprehensive Meta-Analysis (version 3) software. RESULTS Our search identified 17 randomized studies (n = 2,365, mean age = 70.3 years). The results of the meta-analysis that used a random-effects model indicated that TCQ had significant effects on both cognitive (Hedges' g = 0.29, 95% confidence interval [CI] = 0.17 to 0.42) and physical (Hedges' g = 0.32, 95% CI = 0.19 to 0.44) functions. We used meta-regression to explore the effect size of TCQ in association with physical function level. The regression model was significant (Q = 25.01, p = .070), and 55% of the heterogeneity was explained by physical function as a moderator variable. The effects of TCQ on cognitive function remained significant in this model when controlling for the effect of physical function (β = 0.46, p = .011). CONCLUSION This meta-regression of 17 randomized studies strongly suggests that TCQ has beneficial effects on physical and cognitive functions in older adults. The effect of TCQ on cognitive function remained significant after taking into account the significant effects of physical function as a moderator. The findings imply the potential health benefits of TCQ by promoting cognitive function in older adults directly and indirectly through enhancing physical function. PROSPERO REGISTRATION NUMBER: *PROSPERO international prospective register of systematic reviews, registration ID CRD42023394358.
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Affiliation(s)
- Moonkyoung Park
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Rhayun Song
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea.
| | - Kyoungok Ju
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Jacqueline C Shin
- Indiana State University, Department of Psychology, Terre Haute, IN, 47802, USA
| | - Jisu Seo
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Xing Fan
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Xianqi Gao
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Ahyun Ryu
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Yuelin Li
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
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Wiedenmann T, Held S, Rappelt L, Grauduszus M, Spickermann S, Donath L. Exercise based reduction of falls in communitydwelling older adults: a network meta-analysis. Eur Rev Aging Phys Act 2023; 20:1. [PMID: 36707758 PMCID: PMC9883964 DOI: 10.1186/s11556-023-00311-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/16/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Traditional meta-analyses with pairwise direct comparison revealed that a variety of exercise-based training interventions can prevent falls in community-dwelling older adults. This network meta-analysis adds value by comparing and ranking different exercise training strategies based on their effects on fall risk reductions determined by analysis of direct and indirect comparisons. METHODS The studies included in this network meta-analysis were identified through a comprehensive search in five biomedical databases (PubMed, SportDiscus, CINAHL, Web of Science and EMBASE). We included (randomized) controlled trials (RCTs) that compared the occurance of fall events in older adults who received different interventional treatments. RESULTS Seventy six comparisons from 66 RCTs with 47.420 (61% male / 39% female) participants aged 77 ± 4 (68 - 88) years were included in this network meta-analysis. The network model revealed low heterogeneity (I2 = 28.0, 95%CI 1.0 to 47.7%) and inconsistency (Q between designs = 15.1, p = 0.37). Postural control training was found to be most effective in preventing falls (Postural Control Training: (home): Risk Ratio (RR) = 0.66, 95%-CI [0.49; 0.88], P-score = 0.97;Postural Control Training: RR = 0.82, 95%-CI [0.75; 0.91], P-score = 0.82). Combined and multifactorial interventions also display a robust but smaller effect (RR = 0.88-0.93, P-score = 0.65-0.47). CONCLUSION Physical activity that includes balance training presents itself to be the most effective. Multifactorial approaches are well investigated but could be slightly less effective than isolated postural control training.
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Affiliation(s)
- Tim Wiedenmann
- grid.27593.3a0000 0001 2244 5164Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, Am Sportpark Müngersdorf 6, 50933 Cologne, German Sport University Cologne, Cologne, Germany
| | - Steffen Held
- grid.27593.3a0000 0001 2244 5164Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, Am Sportpark Müngersdorf 6, 50933 Cologne, German Sport University Cologne, Cologne, Germany
| | - Ludwig Rappelt
- grid.27593.3a0000 0001 2244 5164Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, Am Sportpark Müngersdorf 6, 50933 Cologne, German Sport University Cologne, Cologne, Germany
| | - Martin Grauduszus
- grid.27593.3a0000 0001 2244 5164Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, Am Sportpark Müngersdorf 6, 50933 Cologne, German Sport University Cologne, Cologne, Germany
| | - Sofie Spickermann
- grid.27593.3a0000 0001 2244 5164Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, Am Sportpark Müngersdorf 6, 50933 Cologne, German Sport University Cologne, Cologne, Germany
| | - Lars Donath
- grid.27593.3a0000 0001 2244 5164Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, Am Sportpark Müngersdorf 6, 50933 Cologne, German Sport University Cologne, Cologne, Germany
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Traeger L, Styklunas GM, Park EY, Lee MT, Fricchione G, Park ER. Promoting Resilience and Flourishing Among Older Adult Residents in Community Living: A Feasibility Study. THE GERONTOLOGIST 2022; 62:1507-1518. [PMID: 35235940 DOI: 10.1093/geront/gnac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The Stress Management and Relaxation Training-Relaxation Response Resiliency Program (SMART-3RP) is a mind-body group intervention that integrates relaxation training with cognitive behavioral and positive psychology techniques. This study assessed SMART-3RP feasibility, acceptability, and preliminary efficacy for enhancing resilience and flourishing among older adults in continuing care retirement communities (CCRCs). RESEARCH DESIGN AND METHODS We conducted a prospective single-arm study of SMART-3RP groups delivered by clinicians at 4 CCRCs (n = 80). Eligible residents lived in community apartments. Participants completed pre- and postintervention surveys. We evaluated attendance (hypothesis: ≥60% attend ≥6 of 9 sessions), enrollment, and retention. Mixed methods were used to explore acceptability. Paired samples t-tests were conducted to explore changes in resilience, flourishing, and key intervention targets. RESULTS From March to June 2021, we screened 89 residents with 87 (98%) consenting to participate and 80 (90%) enrolling in the study. Among 80 participants (85% female; 98% non-Hispanic White; M age = 80 years [SD = 6]), 88% attended ≥6 sessions, and 89% completed the postintervention survey. Participants found meaning in participation and practiced skills in the context of challenges such as caregiving burden or bereavement. Survey results, showing increases in resilience, flourishing, and several intervention targets, aligned with participants' perceived intervention value. DISCUSSION AND IMPLICATIONS SMART-3RP was feasible and acceptable for CCRC residents; participants perceived value in practicing mind-body strategies in a group-based setting. Preliminary evidence suggested a pattern of improvements in resilience, flourishing, and intervention targets. Findings provide insights for mind-body interventions and recommendations for adaptations to late-in-life concerns and community settings. CLINICAL TRIALS REGISTRATION NUMBER NCT04720014.
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Affiliation(s)
- Lara Traeger
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Grace M Styklunas
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Health Promotion and Resiliency Intervention Research Program (HPRIR), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ellen Y Park
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Matthew T Lee
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, USA
| | - Gregory Fricchione
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Health Promotion and Resiliency Intervention Research Program (HPRIR), Massachusetts General Hospital, Boston, Massachusetts, USA
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Oddsson LIE, Bisson T, Cohen HS, Iloputaife I, Jacobs L, Kung D, Lipsitz LA, Manor B, McCracken P, Rumsey Y, Wrisley DM, Koehler-McNicholas SR. Extended effects of a wearable sensory prosthesis on gait, balance function and falls after 26 weeks of use in persons with peripheral neuropathy and high fall risk—The walk2Wellness trial. Front Aging Neurosci 2022; 14:931048. [PMID: 36204554 PMCID: PMC9531134 DOI: 10.3389/fnagi.2022.931048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/23/2022] [Indexed: 01/14/2023] Open
Abstract
Background We recently reported that individuals with impaired plantar sensation and high fall risk due to sensory peripheral neuropathy (PN) improved gait and balance function following 10 weeks of use of Walkasins®, a wearable lower limb sensory prosthesis that provides directional specific mechanical tactile stimuli related to plantar pressure measurements during standing and walking (RxFunction Inc., Eden Prairie, MN, United States). Here, we report 26-week outcomes and compare pre- and in-study fall rates. We expected improvements in outcomes and reduced fall rates reported after 10 weeks of use to be sustained. Materials and methods Participants had clinically diagnosed PN with impaired plantar sensation, high fall risk (Functional Gait Assessment, FGA score < 23) and ability to sense tactile stimuli above the ankle at the location of the device. Additional outcomes included 10 m Gait Speed, Timed Up and Go (TUG), Four-Stage Balance Test, and self-reported outcomes, including Activities-Specific Balance Confidence scale and Vestibular Disorders Activities of Daily Living Scale. Participants tracked falls using a calendar. Results We assessed falls and self-reported outcomes from 44 individuals after 26 weeks of device use; 30 of them conducted in-person testing of clinical outcomes. Overall, improvements in clinical outcomes seen at 10 weeks of use remained sustained at 26 weeks with statistically significant increases compared to baseline seen in FGA scores (from 15.0 to 19.2), self-selected gait speed (from 0.89 to 0.97 m/s), and 4-Stage Balance Test (from 25.6 to 28.4 s), indicating a decrease in fall risk. Non-significant improvements were observed in TUG and fast gait speed. Overall, 39 falls were reported; 31 of them did not require medical treatment and four caused severe injury. Participants who reported falls over 6 months prior to the study had a 43% decrease in fall rate during the study as compared to self-report 6-month pre-study (11.8 vs. 6.7 falls/1000 patient days, respectively, p < 0.004), similar to the 46% decrease reported after 10 weeks of use. Conclusion A wearable sensory prosthesis can improve outcomes of gait and balance function and substantially decreases incidence of falls during long-term use. The sustained long-term benefits in clinical outcomes reported here lessen the likelihood that improvements are placebo effects. Clinical trial registration ClinicalTrials.gov, identifier #NCT03538756.
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Affiliation(s)
- Lars I. E. Oddsson
- RxFunction Inc., Eden Prairie, MN, United States
- Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
- Recanati School for Community Health Professions, Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheba, Israel
- *Correspondence: Lars I. E. Oddsson,
| | - Teresa Bisson
- Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
- M Health Fairview, Minneapolis, MN, United States
| | | | - Ikechukwu Iloputaife
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States
| | - Laura Jacobs
- RxFunction Inc., Eden Prairie, MN, United States
| | - Doris Kung
- Baylor College of Medicine, Houston, TX, United States
| | - Lewis A. Lipsitz
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Patricia McCracken
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, MN, United States
| | | | | | - Sara R. Koehler-McNicholas
- Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, MN, United States
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Pinheiro MB, Oliveira JS, Baldwin JN, Hassett L, Costa N, Gilchrist H, Wang B, Kwok W, Albuquerque BS, Pivotto LR, Carvalho-Silva APMC, Sharma S, Gilbert S, Bauman A, Bull FC, Willumsen J, Sherrington C, Tiedemann A. Impact of physical activity programs and services for older adults: a rapid review. Int J Behav Nutr Phys Act 2022; 19:87. [PMID: 35836187 PMCID: PMC9284866 DOI: 10.1186/s12966-022-01318-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Knowledge of which physical activity programs are most effective for older adults in different sub-populations and contexts is limited. The objectives of this rapid review were to: 1) Overview evidence evaluating physical activity programs/services for older adults; and 2) Describe impact on physical activity, falls, intrinsic capacity (physical domain), functional ability (physical, social, and cognitive/emotional domains), and quality of life. Methods We conducted a rapid review of primary studies from 350 systematic reviews identified in a previous scoping review (March 2021: PEDro, MEDLINE, CINAHL, Cochrane Database). For Objective 1, we included intervention studies investigating physical activity programs/services in adults ≥ 60 years. Of these, we included good quality (≥ 6/10 PEDro scale) randomised controlled trials (RCTs) with ≥ 50 participants per group in Objective 2. Results Objective 1: Of the 1421 intervention studies identified from 8267 records, 79% were RCTs, 87% were in high income countries and 39% were good quality. Objective 2: We identified 87 large, good quality RCTs (26,861 participants). Overall activity promotion, structured exercise and recreation/sport had positive impacts (≥ 50% between-group comparisons positive) across all outcome domains. For overall activity promotion (21 intervention groups), greatest impacts were on physical activity (100% positive) and social outcomes (83% positive). Structured exercise (61 intervention groups) had particularly strong impacts on falls (91% positive), intrinsic capacity (67% positive) and physical functioning (77% positive). Recreation/sport (24 intervention groups) had particularly strong impacts on cognitive/emotional functioning (88% positive). Multicomponent exercise (39 intervention groups) had strong impacts across all outcomes, particularly physical activity (95% positive), falls (90% positive) and physical functioning (81% positive). Results for different populations and settings are presented. Conclusion Evidence supporting physical activity for older adults is positive. We outline which activity types are most effective in different populations and settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01318-9.
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Affiliation(s)
- Marina B Pinheiro
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia. .,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Juliana S Oliveira
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jennifer N Baldwin
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Leanne Hassett
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Nathalia Costa
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Heidi Gilchrist
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Belinda Wang
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Wing Kwok
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Bruna S Albuquerque
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Luiza R Pivotto
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ana Paula M C Carvalho-Silva
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sweekriti Sharma
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Steven Gilbert
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Adrian Bauman
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Fiona C Bull
- Physical Activity Unit, Department of Health Promotion, Division of Universal Health Coverage and Healthier Populations, World Health Organization (WHO), Geneva, Switzerland
| | - Juana Willumsen
- Physical Activity Unit, Department of Health Promotion, Division of Universal Health Coverage and Healthier Populations, World Health Organization (WHO), Geneva, Switzerland
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia. .,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. .,WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Charles Perkins Centre, The University of Sydney, Sydney, Australia.
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Ren FF, Chen FT, Zhou WS, Cho YM, Ho TJ, Hung TM, Chang YK. Effects of Chinese Mind-Body Exercises on Executive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:656141. [PMID: 34093345 PMCID: PMC8175659 DOI: 10.3389/fpsyg.2021.656141] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
Chinese mind-body exercises (CMBEs) are positively associated with executive function (EF), but their effects on EF, from synthesized evidence using systematic and meta-analytic reviews, have not been conducted. Therefore, the present systematic review with meta-analysis attempted to determine whether CMBEs affect EF and its sub-domains, as well as how exercise, sample, and study characteristics moderate the causal relationship between CMBEs and EF in middle-aged and older adults. Seven electronic databases were searched for relevant studies published from the inception of each database through June 2020 (PubMed, Web of Science, Embase, Cochrane Controlled Trials Register, Wanfang, China National Knowledge Infrastructure, and Weipu). Randomized controlled trials with at least one outcome measure of CMBEs on EF in adults of mean age ≥ 50 years with intact cognition or mild cognitive impairment (MCI) and with or without chronic diseases were included. A total of 29 studies (N = 2,934) ultimately were included in this study. The results indicated that CMBEs improved overall EF (Standardized Mean Differences = 0.28, 95% CI 0.12, 0.44), as well as its sub-domains of working memory and shifting. The beneficial effects of CMBEs on EF occurred regardless of type (Tai Chi, Qigong), frequency of group classes (≤2 time, 3-4 time, ≥5 times), session time (≤45 min, 46-60 min), total training time (≥150 to ≤300 min, >300 min), and length of the CMBEs (4-12 week, 13-26 week, and >26 week), in addition to that more frequent participation in both group classes and home practice sessions (≥5 times per week) resulted in more beneficial effects. The positive effects of CMBEs on EF were also demonstrated, regardless of participants mean age (50-65 years old, >65 years old), sex (only female, both), and cognitive statuses (normal, MCI, not mentioned), health status (with chronic disease, without chronic disease), as well as training mode (group class, group class plus home practice) and study language (English, Chinese). This review thus suggests that CMBEs can be used as an effective method with small to moderate and positive effects in enhancing EF, and that more frequent group classes and home practice sessions may increase these effects. However, certain limitations, including strictly design studies, limited ES (effect size) samples for specific variables, and possible biased publications, required paying particular attention to, for further exploring the effects of CMBEs on EF.
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Affiliation(s)
- Fei-Fei Ren
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Feng-Tzu Chen
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance, Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Wen-Sheng Zhou
- College of Physical Education, Nanjing Xiaozhuang University, Nanjing, China
| | - Yu-Min Cho
- Tzu Chi Medical Foundation, Alhambra, CA, United States
| | - Tsung-Jung Ho
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan.,Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Tsung-Min Hung
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan.,Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
| | - Yu-Kai Chang
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan.,Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
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8
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Perloff J, Thomas CP, Macklin E, Gagnon P, Tsai T, Isaza I, Wayne PM, Lipsitz L. The Impact of Tai Chi Exercise on Health Care Utilization and Imputed Cost in Residents of Low-Income Senior Housing. Glob Adv Health Med 2021; 10:2164956120985479. [PMID: 33598365 PMCID: PMC7841657 DOI: 10.1177/2164956120985479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study was designed to test the impact of Tai Chi (TC) on healthcare utilization and cost in older adults living in low-income senior housing. We hypothesized that TC would improve overall health enough to reduce the use of emergency department (ED) and inpatient services. DESIGN Cluster randomized controlled trial with randomization at the housing site level. SETTING Greater Boston, Massachusetts. PARTICIPANTS The study includes 6 sites with 75 individuals in the TC treatment condition and 6 sites with 67 individuals in the health education control condition. INTERVENTION Members of the treatment group received up to a year-long intervention with twice weekly, in-person TC exercise sessions along with video-directed exercises that could be done independently at home. The comparison group received monthly, in-person healthy aging education classes (HE). Study recruitment took place between August, 2015 and October, 2017. Key outcomes included acute care utilization (inpatient stays, observation stays and emergency department visits). In addition, the cost of utilization was estimated using the age, sex and race adjusted allowed amount from Medicare claims for a geographically similar population aged ≥ 65. RESULTS The results suggested a possible reduction in the rate of ED visits in the TC group vs. controls (rate ratio = 0.476, p-value = 0.06), but no findings achieved statistical significance. Adjusted estimates of imputed costs of ED and hospital care were similar between TC and HE, averaging approximately $3,000 in each group. CONCLUSION ED utilization tended to be lower over 6 to 12 months of TC exercises compared to HE in older adults living in low-income housing, although estimated costs of care were similar.
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Affiliation(s)
- Jennifer Perloff
- The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Cindy Parks Thomas
- The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Eric Macklin
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Peggy Gagnon
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
| | - Timothy Tsai
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
| | - Ilean Isaza
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
| | - Peter M Wayne
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Lewis Lipsitz
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Beth Israel Deaconess Medical Center Division of Gerontology, Boston, Massachusetts
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9
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Effects of 16-Form Wheelchair Tai Chi on the Autonomic Nervous System among Patients with Spinal Cord Injury. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:6626603. [PMID: 33354221 PMCID: PMC7737450 DOI: 10.1155/2020/6626603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/04/2020] [Accepted: 11/17/2020] [Indexed: 11/21/2022]
Abstract
Objective This study aims to investigate the effects of 16-form Wheelchair Tai Chi (WCTC16) on the autonomic nervous system among patients with spinal cord injury (SCI). Methods Twenty patients with chronic complete thoracic SCI were recruited. Equivital life monitoring system was used to record and analyze heart rate variability (HRV) of patients for five minutes before and after five consecutive sets of WCTC16, respectively. The analysis of HRV in the time domain included RR intervals, the standard deviation of all normal RR intervals (SDNN), and the root mean square of the differences between adjacent NN intervals (RMSSD). The analysis of HRV in the frequency domain included total power (TP), which could be divided into very-low-frequency area (VLFP), low-frequency area (LFP), and high-frequency area (HFP). The LF/HF ratio as well as the normalized units of LFP (LFPnu) and HFP (HFPnu) reflected the sympathovagal balance. Results There was no significant difference in RR interval, SDNN, RMSSD, TP, HEP, VLFP, and LFP of SCI patients before and after WCTC16 exercise (P > 0.05). LFPnu and HF peak decreased, while HFPnu and LF/HF increased in SCI patients after WCTC16 exercise. The differences were statistically significant (P < 0.001). Conclusion WCTC16 can enhance vagal activity and decrease sympathetic activity so that patients with chronic complete thoracic SCI can achieve the balanced sympathovagal tone.
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Oddsson LIE, Bisson T, Cohen HS, Jacobs L, Khoshnoodi M, Kung D, Lipsitz LA, Manor B, McCracken P, Rumsey Y, Wrisley DM, Koehler-McNicholas SR. The Effects of a Wearable Sensory Prosthesis on Gait and Balance Function After 10 Weeks of Use in Persons With Peripheral Neuropathy and High Fall Risk - The walk2Wellness Trial. Front Aging Neurosci 2020; 12:592751. [PMID: 33240077 PMCID: PMC7680959 DOI: 10.3389/fnagi.2020.592751] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 10/22/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Sensory peripheral neuropathy (PN) is associated with gait, balance problems and high fall risk. The walk2Wellness trial investigates effects of long-term, home-based daily use of a wearable sensory prosthesis on gait function, balance, quality of life and fall rates in PN patients. The device (Walkasins®, RxFunction Inc., MN, United States) partially substitutes lost nerve function related to plantar sensation providing directional tactile cues reflecting plantar pressure measurements during standing and walking. We tested the null hypothesis that the Functional Gait Assessment (FGA) score would remain unchanged after 10 weeks of use. METHODS Participants had PN with lost plantar sensation, gait and balance problems, an FGA score < 23 (high fall risk), and ability to sense tactile stimuli above the ankle. Clinical outcomes included FGA, Gait Speed, Timed Up&Go (TUG) and 4-Stage Balance Test. Patient-reported outcomes included Activities-Specific Balance Confidence (ABC) scale, Vestibular Disorders Activities of Daily Living Scale, PROMIS participation and satisfaction scores, pain rating, and falls. Evaluations were performed at baseline and after 2, 6, and 10 weeks. Subjects were not made aware of changes in outcomes. No additional balance interventions were allowed. RESULTS Forty-five participants of 52 enrolled across four sites completed in-clinic assessments. FGA scores improved from 15.0 to 19.1 (p < 0.0001), normal and fast gait speed from 0.86 m/s to 0.95 m/s (p < 0.0001) and 1.24 m/s to 1.33 m/s (p = 0.002), respectively, and TUG from 13.8 s to 12.5 s (p = 0.012). Four-Stage Balance Test did not improve. Several patient-reported outcomes were normal at baseline and remained largely unchanged. Interestingly, subjects with baseline ABC scores lower than 67% (high fall risk cut-off) increased their ABC scores (49.9% to 59.3%, p = 0.01), whereas subjects with ABC scores above 67% showed a decrease (76.6% to 71.8%, p = 0.019). Subjects who reported falls in the prior 6 months (n = 25) showed a decrease in the number of fall-risk factors (5.1 to 4.3, p = 0.023) and a decrease in fall rate (13.8 to 7.4 falls/1000 days, p = 0.014). Four pre-study non-fallers (n = 20) fell during the 10 weeks. CONCLUSION A wearable sensory prosthesis presents a new way to treat gait and balance problems and manage falls in high fall-risk patients with PN. TRIAL REGISTRATION ClinicalTrials.gov (#NCT03538756).
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Affiliation(s)
- Lars I. E. Oddsson
- RxFunction Inc., Eden Prairie, MN, United States
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
- Recaniti School for Community Health Professions, Ben Gurion University of the Negev, Beersheba, Israel
| | - Teresa Bisson
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
- M Health Fairview, Minneapolis, MN, United States
| | | | - Laura Jacobs
- RxFunction Inc., Eden Prairie, MN, United States
| | - Mohammad Khoshnoodi
- The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Doris Kung
- Baylor College of Medicine, Houston, TX, United States
| | - Lewis A. Lipsitz
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | | | | | | | - Sara R. Koehler-McNicholas
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
- Minneapolis VA Health Care System, Minneapolis, MN, United States
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11
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Weber M, Schnorr T, Morat M, Morat T, Donath L. Effects of Mind-Body Interventions Involving Meditative Movements on Quality of Life, Depressive Symptoms, Fear of Falling and Sleep Quality in Older Adults: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186556. [PMID: 32916879 PMCID: PMC7559727 DOI: 10.3390/ijerph17186556] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 12/11/2022]
Abstract
Background: The aim of the present systematic meta-analytical review was to quantify the effects of different mind–body interventions (MBI) involving meditative movements on relevant psychological health outcomes (i.e., quality of life (QoL), depressive symptoms, fear of falling (FoF) and sleep quality) in older adults without mental disorders. Methods: A structured literature search was conducted in five databases (Ovid, PsycINFO, PubMed, SPORTDiscus, Web of Science). Inclusion criteria were: (i) the study was a (cluster) randomized controlled trial, (ii) the subjects were aged ≥59 years without mental illnesses, (iii) an intervention arm performing MBI compared to a non-exercise control group (e.g., wait-list or usual care), (iv) psychological health outcomes related to QoL, depressive symptoms, FoF or sleep quality were assessed and (v) a PEDro score of ≥5. The interventions of the included studies were sub-grouped into Tai Chi/Qigong (TCQ) and Yoga/Pilates (YP). Statistical analyses were conducted using a random-effects inverse-variance model. Results: Thirty-seven randomized controlled trials (RCTs) (comprising 3224 participants) were included. Small to moderate-but-significant overall effect sizes favoring experimental groups (Hedges’ g: 0.25 to 0.71) compared to non-exercise control groups were observed in all outcomes (all p values ≤ 0.007), apart from one subdomain of quality of life (i.e., social functioning, p = 0.15). Interestingly, a significant larger effect on QoL and depressive symptoms with increasing training frequency was found for TCQ (p = 0.03; p = 0.004). Conclusions: MBI involving meditative movements may serve as a promising opportunity to improve psychological health domains such as QoL, depressive symptoms, FoF and sleep quality in older adults. Hence, these forms of exercise may represent potential preventive measures regarding the increase of late-life mental disorders, which need to be further confirmed by future research.
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Affiliation(s)
- Manuel Weber
- Institute of Movement and Sport Gerontology, German Sport University, 50933 Cologne, Germany; (M.W.); (T.S.); (T.M.)
| | - Thiemo Schnorr
- Institute of Movement and Sport Gerontology, German Sport University, 50933 Cologne, Germany; (M.W.); (T.S.); (T.M.)
| | - Mareike Morat
- Institute of Exercise Science and Sport Informatics, German Sport University, 50933 Cologne, Germany;
| | - Tobias Morat
- Institute of Movement and Sport Gerontology, German Sport University, 50933 Cologne, Germany; (M.W.); (T.S.); (T.M.)
| | - Lars Donath
- Institute of Exercise Science and Sport Informatics, German Sport University, 50933 Cologne, Germany;
- Correspondence: ; Tel.: +49-221-4982-7700
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12
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Sherman KJ, Wellman RD, Hawkes RJ, Phelan EA, Lee T, Turner JA. T'ai Chi for Chronic Low Back Pain in Older Adults: A Feasibility Trial. J Altern Complement Med 2020; 26:176-189. [PMID: 32013530 DOI: 10.1089/acm.2019.0438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Objectives: T'ai chi (TC) has been found effective for improving chronic low back pain (cLBP). However, such studies did not include adults over 65 years of age. This study was designed to evaluate the feasibility and acceptability of TC in this population compared with Health Education (HE) and with Usual Care (UC). Design: Feasibility randomized controlled trial. Settings/Location: Participants were recruited from Kaiser Permanente Washington and classes took place in a Kaiser facility. Patients: Adults 65 years of age and older with cLBP. Interventions: Twenty-eight participants were randomized to 12 weeks of TC followed by a 24-week tapered TC program, 12 were assigned to a 12-week HE intervention and 17 were assigned to UC only. Outcome Measures: Feasibility and acceptability were determined by recruitment, retention and 12-, 26-, and 52-week follow-up rates, instructor adherence to protocol, class attendance, TC home practice, class satisfaction, and adverse events. Results: Fifty-seven participants were enrolled in two cohorts of 28 and 29 during two 4-month recruitment periods. Questionnaire follow-up completion rates ranged between 88% and 93%. Two major class protocol deviations were noted in TC and none in HE. Sixty-two percent of TC participants versus 50% of HE participants attended at least 70% of the classes during the 12-week initial intervention period. Weekly rates of TC home practice were high among class attendees (median of 4.2 days) at 12 weeks, with fewer people practicing at 26 and 52 weeks. By 52 weeks, 70% of TC participants reported practicing the week before, with a median of 3 days per week and 15 min/session. TC participants rated the helpfulness of their classes significantly higher than did HE participants, but the groups were similarly likely to recommend the classes. Conclusion: The TC intervention is feasible in this population, while the HE group requires modifications in delivery.
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Affiliation(s)
- Karen J Sherman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA.,Department of Epidemiology, University of Washington, Seattle, WA
| | - Robert D Wellman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Rene J Hawkes
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Elizabeth A Phelan
- Department of Medicine and Health Services, University of Washington, Seattle, WA
| | - Tamsin Lee
- Department of Child, Family and Population Health Nursing, University of Washington, Seattle, WA
| | - Judith A Turner
- Department of Psychiatry and Behavioral Sciences and Rehabilitation Medicine, University of Washington, Seattle, WA
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