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Chen W, Li M, Li H, Lin Y, Feng Z. Tai Chi for fall prevention and balance improvement in older adults: a systematic review and meta-analysis of randomized controlled trials. Front Public Health 2023; 11:1236050. [PMID: 37736087 PMCID: PMC10509476 DOI: 10.3389/fpubh.2023.1236050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/17/2023] [Indexed: 09/23/2023] Open
Abstract
Background and objective As the population ages, the health of older adults is becoming a public health concern. Falls are a significant threat to their health due to weakened balance. This study aims to investigate the beneficial effects of Tai Chi on fall prevention and balance improvement in older adults. Methods We conducted a systematic review and meta-analysis of randomized controlled trials related to Tai Chi, falls, and balance ability, searching PubMed, Embase, and Cochrane Library databases from their establishment until December 31, 2022. Two independent reviewers performed the search, screening of results, extraction of relevant data, and assessment of study quality. This study followed the PRISMA guidelines for systematic review and meta-analysis. Results Totally 24 RCTs were included for meta-analysis, and the results showed that Tai Chi can effectively reduce the risk of falls in older adults (RR: 0.76, 95% CI: 0.71 to 0.82) and decrease the number of falls (MD [95% CI]: -0.26 [-0.39, -0.13]). Tai Chi can also improve the balance ability of older adults, such as the timed up and go test (MD [95% CI]: -0.69 [-1.09, -0.29]) and the functional reach test (MD [95% CI]: 2.69 [1.14, 4.24]), as well as other balance tests such as single-leg balance test, Berg balance scale, and gait speed (p < 0.05). Subgroup analysis showed that Tai Chi is effective for both healthy older adults and those at high risk of falls (p < 0.001), and its effectiveness increases with the duration and frequency of exercise. In addition, the effect of Yang-style Tai Chi is better than that of Sun-style Tai Chi. Conclusion Tai Chi is an effective exercise for preventing falls and improving balance ability in older adults, whether they are healthy or at high risk of falling. The effectiveness of Tai Chi increases with exercise time and frequency. Yang-style Tai Chi is more effective than Sun-style Tai Chi. Systematic review registration https://clinicaltrials.gov/, identifier CRD42022354594.
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Affiliation(s)
- Weidong Chen
- Department of Integrated Traditional Chinese and Western Medicine Nutrition, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Min Li
- College and Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Hai Li
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanzhao Lin
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhoushan Feng
- Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangzhou, China
- Guangzhou Key Laboratory of Neonatal Intestinal Diseases, Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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The effect of Tai Chi in elderly individuals with sarcopenia and frailty: A systematic review and meta-analysis of randomized controlled trials. Ageing Res Rev 2022; 82:101747. [PMID: 36223875 DOI: 10.1016/j.arr.2022.101747] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND The potential role of Tai Chi in improving sarcopenia and frailty has been shown in randomized controlled trials (RCTs). This systematic review and meta-analysis aimed to examine the effect of Tai Chi on muscle mass, muscle strength, physical function, and other geriatric syndromes in elderly individuals with sarcopenia and frailty. METHODS Systematic searches of the PubMed, Cochrane Library, PEDro, EMBASE, Web of Science, CINAHL, and Medline databases for RCTs published between 1989 and 2022 were conducted; the database searchers were supplemented with manual reference searches. The inclusion criteria were as follows: (1) the study was designed as a RCT; (2) Tai Chi was one of the intervention arms; (3) the participants had a minimum age of ≥ 60 years and were diagnosed with frailty or sarcopenia, and the diagnostic guidelines or criteria were mentioned; (4) the number of participants in each arm was ≥ 10; and (5) the outcome reports included ≥ 1 item from the following primary or secondary outcomes. The exclusion criteria were as follows: (1) non-RCT studies; (2) nonhuman subjects; (3) participants aged < 60 years; (4) no description of the diagnostic guidelines or criteria for frailty or sarcopenia in the text; and (5) reported outcomes not among the following primary or secondary outcomes. The primary outcomes were muscle mass, grip strength and muscle performance (gait speed, 30-second chair stand test (30CST), sit-to-stand test (SST), Timed up and go test (TUGT), balance, and the Short Physical Performance Battery (SPPB)). The secondary outcomes included the number of falls and fear of falling (FOF), diastolic blood pressure (DBP), Mini-Mental State Examination (MMSE) score, and depression and quality of life (QOL) assessments. RESULTS Eleven RCTs were conducted from 1996 to 2022 in 5 countries that investigated 1676 sarcopenic or frail elderly individuals were included in the review. There were 804 participants in the Tai Chi exercise cohort and 872 participants in the control cohort (nonexercised (n = 5)/ exercise (n = 8)). The mean age of participants was 70-89.5 years and the numbers of participants from each arm in each study were 10-158. The majority of the participants practiced Yang-style Tai Chi (n = 9), and the numbers of movement ranged from 6 to 24. The prescriptions of training were 8-48 weeks, 2-7 sessions per weeks, and 30-90 min per session. Most studies used Tai Chi expert as instructor (n = 8). The lengths of follow-up period were 8-48 weeks. The results from our meta-analysis revealed significant improvements for Tai Chi compared to control group (nonexercise/ exercise) on measures of the 30CST (weighted mean difference (WMD): 2.36, 95% confidence interval (CI) 1.50-3.21, p < 0.00001, I2 = 87%), the TUGT (WMD: -0.72, 95% CI -1.10 to -0.34, p = 0.0002, I2 =0%), numbers of fall (WMD: -0.41, 95% CI -0.64 to -0.17, p = 0.0006, I2 =0%) and FOF (standardized MD (SMD): -0.50, 95% CI -0.79 to -0.22, p = 0.0006, I2 = 57%); and for Tai Chi compared to 'nonexercise' controls on measures of SST (WMD: -2.20, 95% CI -2.22 to -2.18, p < 0.00001), balance (SMD: 9.85, 95% CI 8.88-10.82, p < 0.00001), DBP (WMD: -7.00, 95% CI -7.35 to -6.65, p < 0.00001), MMSE (WMD: 1.91, 95% CI 1.73-2.09, p < 0.00001, I2 =0%), depression (SMD: -1.37, 95% CI -1.91 to -0.83, p < 0.00001) and QOL (SMD: 10.72, 95% CI 9.38-12.07, p < 0.00001). There were no significant differences between Tai Chi and control groups on any of the remaining 4 comparisons: body muscle mass (WMD: 0.53, 95% CI -0.18 to 1.24; P = 0.14; I2 =0%), grip strength (WMD: -0.06, 95% CI -1.98 to 1.86; P = 0.95; I2 =0%), gait speed (WMD: 0.05, 95% CI -0.11 to 0.20; P = 0.55; I2 =99%), and SPPB (WMD: 0.55, 95% CI -0.04 to 1.14; P = 0.07). The variables of bias summary, Tai Chi instructor, Tai Chi movements, and Tai Chi training duration without significant association with the 30CST or the TUGT through meta-regression analyses. CONCLUSIONS Our results demonstrated that patients with frailty or sarcopenia who practiced Tai Chi exhibited improved physical performance in the 30-second chair stand test, the Timed up and go test, number of falls and fear of falling. However, there was no difference in muscle mass, grip strength, gait speed, or Short Physical Performance Battery score between the Tai Chi and control groups. Improvements in the sit-to-stand test, balance, diastolic blood pressure, Mini-Mental State Examination score, and depression and quality of life assessments were found when comparing the Tai Chi cohort to the nonexercise control cohort rather than the exercise control cohort. To explore the effectiveness of Tai Chi in sarcopenic and frail elderly individuals more comprehensively, a standardized Tai Chi training prescription and a detailed description of the study design are suggested for future studies.
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Liu X, Jiang C, Fan R, Liu T, Li Y, Zhong D, Zhou L, Liu T, Li J, Jin R. The effect and safety of Tai Chi on bone health in postmenopausal women: A meta-analysis and trial sequential analysis. Front Aging Neurosci 2022; 14:935326. [PMID: 36177477 PMCID: PMC9513206 DOI: 10.3389/fnagi.2022.935326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTai Chi may be a promising exercise to prevent and control bone loss in postmenopausal women. This meta-analysis and trial sequential analysis aimed to evaluate the effect and safety of Tai Chi on bone health in postmenopausal women.MethodSeven databases were searched from their inceptions to 11 May 2022 to collect randomized controlled trials (RCTs) investigating the effect and safety of Tai Chi on bone health in postmenopausal women. Two independent reviewers identified the eligible studies, extracted data, and assessed the risk of bias of included studies using the revised Cochrane risk-of-bias tool for randomized trials. The primary outcome was the bone mineral density (BMD), and secondary outcomes included bone turnover markers and calcaneus quantitative ultrasound. Subgroup analyses were conducted based on the duration of Tai Chi. Sensitivity analyses and publication bias assessment were performed. RevMan software (version 5.4.1) and R software (version 3.6.1) were used for data synthesis. The certainty of evidence was rated with the Grading of recommendations assessment, development, and evaluation (GRADE) system. We also performed the trial sequential analysis to evaluate the reliability of the evidence.ResultsA total of 25 reports involving 24 studies were included. Four studies were considered as high overall risk of bias, and the rest were some concerns. Among included studies, there were three comparisons including Tai Chi vs. non-intervention, Tai Chi vs. other exercises, and Tai Chi plus nutraceutical vs. nutraceutical. Compared with non-intervention, Tai Chi was more effective to improve BMD of lumbar spine (MD = 0.04, 95% CI 0.02 to 0.07, I2 = 0%, low certainty), femoral neck (MD = 0.04, 95% CI 0.02 to 0.06, I2 = 0%, low certainty), and trochanter (MD = 0.02, 95% CI 0.00 to 0.03, I2 = 0%, very low certainty), but there was no significant difference in increasing the BMD of Ward's triangle (MD = 0.02, 95% CI −0.01 to 0.04, I2 = 0%, very low certainty). Trial sequential analysis showed that the effect of Tai Chi vs. non-intervention on the BMD of lumbar spine and femoral neck was reliable, but the effect on the BMD of trochanter and Ward's triangle needed further verification. The subgroup analyses suggested that Tai Chi training for over 6 months had greater improvement in BMD of the lumbar spine, femoral neck, and trochanter than non-intervention. No significant differences were observed in the above outcomes of Tai Chi vs. other exercises, and Tai Chi plus nutraceutical vs. nutraceutical. There was insufficient evidence to support the effect of Tai Chi on bone turnover markers and calcaneus quantitative ultrasound. Few Tai Chi relevant adverse events occurred.ConclusionTai Chi may be an optional and safe exercise for improving BMD loss in postmenopausal women, and practicing Tai Chi for more than 6 months may yield greater benefits. However, more rigorously designed RCTs are required to verify the benefits and to explore the optimal protocol of Tai Chi exercise for bone health.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=309148, identifier: CRD42022309148.
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Affiliation(s)
- Xiaobo Liu
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chengzhi Jiang
- Department of Rehabilitation Medicine, Sichuan Science City Hospital, Mianyang, China
| | - Rong Fan
- Department of Rehabilitation Medicine, Nanbu County People's Hospital, Nanchong, China
| | - Tianyu Liu
- School of Sport and Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuxi Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Luxiang Zhou
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tao Liu
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Juan Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Juan Li
| | - Rongjiang Jin
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Integrated Traditional Chinese and Western Medicine Hospital of Panzhihua City, Panzhihua, China
- Rongjiang Jin
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Fogaça LZ, Portella CFS, Ghelman R, Abdala CVM, Schveitzer MC. Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map. Front Public Health 2022; 9:659075. [PMID: 34988045 PMCID: PMC8722380 DOI: 10.3389/fpubh.2021.659075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 11/08/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes. Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects. Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia. Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.
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Affiliation(s)
| | | | - Ricardo Ghelman
- Brazilian Academic Consortium for Integrative Health (CABSIn), São Paulo, Brazil
| | - Carmen Verônica Mendes Abdala
- BIREME (Latin American and Caribbean Center on Health Sciences Information) - Pan American Health Organization/World Health Organization (PAHO/WHO), São Paulo, Brazil
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Jia D, Zhou J, Xu Y. Effectiveness of Traditional Chinese Health-Promoting Exercise as an Adjunct Therapy for Drug Use Disorders: A Systematic Review and Meta-Analysis. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:294-308. [PMID: 35426734 DOI: 10.1089/jicm.2021.0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: Meta-analysis was used to quantitatively examine the effectiveness of Traditional Chinese Health-Promoting Exercise (TCE) as an adjuvant therapy for drug use disorders and rehabilitation based on previously published studies. Methods: Potential literature was retrieved by searching eight electronic databases (China National Knowledge Infrastructure [CNKI], Wanfang, Chinese Scientific Journal Database, China Biology Medicine [CBM], PubMed, Embase, Cochrane Library, and EBSCOhost) from January 2000 to May 2021, as well as through manual searches, including email. These literature reports comprised randomized, controlled trial studies and nonrandomized, controlled trial studies assessing the effects of TCE intervention on the physical and psychological (mental) health of drug addicts. The quality and bias risk of each study were assessed using the Cochrane bias risk assessment tool. The RevMan5.3 statistical software was employed to evaluate the methodological quality of the included studies, and sensitivity and subgroup analyses using the Stata16.0 MP software were performed to explore the sources of heterogeneity among the data. This study is registered on PROSPERO (CRD42021254124). Results: Data from 14 studies (1094 individuals with drug abuse) meeting the inclusion criteria were extracted for meta-analysis. Compared to the control group, TCE intervention induced significant improvements in the systolic blood pressure (standardized mean difference [SMD] = -0.42, p < 0.05), diastolic blood pressure (SMD = -0.34, p < 0.05), one-leg stand with eyes closed (SMD = 0.74, p < 0.05), Symptom Check List (SMD = -0.42, p < 0.05), anxiety scale (self-rating anxiety scale/STI) (SMD = -0.49, p < 0.05), and depression scale (self-rating depression scale/Beck Depression Inventory/Hamilton Depression Rating Scale for Depression) (SMD = -0.37, p < 0.05). Sensitivity and subgroup analyses of the individual outcome indicators with high heterogeneity (I2 ≥ 50%, p < 0.10) were performed to further explore the source of heterogeneity. The results of the sensitivity analysis showed that, after removing studies one by one, the heterogeneity of the data remained high (I2 > 50), and the difference of synthetic overall effect did not change (p < 0.05), indicating that the sensitivity was low and that the results were robust and reliable. The results of the subgroup analysis results indicated that the gender of the participants and the drug type were the sources of heterogeneity. Conclusion: As an effective mind-body movement intervention, long-term TCE is beneficial to improving the physical and mental health of drug addicts. The specific intervention methods are dependent on the gender of the addict and the drug type, and longer intervention times yielded greater impacts on their physical health.
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Affiliation(s)
- Dongming Jia
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- Zhejiang Police Vocational College, Hangzhou, China
| | - Jiaxin Zhou
- School of Physical Education, Hangzhou Normal University, Hangzhou, China
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Yuming Xu
- School of Physical Education, Hangzhou Normal University, Hangzhou, China
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
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Yang F, Liu W. Dynamic stability based identification of optimal Tai Chi forms for preventing falls among older adults with knee osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3:100216. [PMID: 36474764 PMCID: PMC9718140 DOI: 10.1016/j.ocarto.2021.100216] [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: 08/31/2021] [Revised: 09/26/2021] [Accepted: 09/28/2021] [Indexed: 10/20/2022] Open
Abstract
Objective Knee osteoarthritis increases the risk of falls among older adults. Tai Chi (TC) has been increasingly utilized to prevent falls in older adults. However, findings from previous studies are inconclusive, possibly due to a lack of scientifically sound methodologies to identify targeted TC forms, which likely maximize the training effects in preventing falls. It has been recently indicated that individual TC forms challenge body balance to varying degrees, providing us a foundation to select optimal TC forms. The objective of this preliminary study was to examine whether the challenge to body balance quantified by the range of dynamic stability is different between identified optimal TC forms (OTC) and commonly used TC (CTC) forms among older adults with knee osteoarthritis. Methods Eight older adults with knee osteoarthritis learned how to perform 24 TC forms correctly. Their full-body kinematics during the performance of 24 TC forms was collected. The range of composite dynamic stability was used as the selection criteria to identify eight OTC forms. The range of composite dynamic stability was then compared between the OTC forms and eight CTC forms. Results Overall, OTC forms showed a significantly larger range of composite dynamic stability than CTC forms (p = 0.021). Conclusion The selected OTC forms could impose a greater challenge on balance control among older adults than CTC forms. The finding in this study is significant as it could furnish a scientific basis for identifying the best TC forms to optimize the effectiveness of TC-based fall prevention interventions.
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Affiliation(s)
- Feng Yang
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA, 30303, USA
| | - Wei Liu
- School of Health Professions, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
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Individual analysis of dynamic stability for twenty-four Tai Chi forms among persons with knee osteoarthritis: A pilot study. Gait Posture 2021; 86:22-26. [PMID: 33668007 PMCID: PMC8085069 DOI: 10.1016/j.gaitpost.2021.02.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Tai Chi (TC) training has been increasingly used to prevent falls. However, the underlying biomechanical mechanisms of TC training which influence fall risk remain unknown. As a result, the selection of TC forms differs among studies, leading to inconsistent results. RESEARCH QUESTION Is dynamic stability different between the simplified 24 Yang-style TC forms among adults with knee osteoarthritis? METHODS Ten participants with mild to moderate knee osteoarthritis were recruited. Under one-on-one instruction by an experienced TC master, each participant learned how to correctly perform the 24-form TC movements. Participants' full-body kinematic and kinetic data was collected during walking trials and performance of the respective TC forms. Their dynamic stability was calculated in both sagittal and frontal planes and compared between each TC form and regular walking. RESULTS The results indicate that dynamic stability in both planes significantly varies among forms. Moreover, some forms pose a greater challenge to dynamic stability in comparison to others. The most challenging TC forms are Form 8 for stability in the sagittal plane and Form 10 in the frontal plane. Among all forms, Form 1 appears to be the least challenging. SIGNIFICANCE Our findings could provide foundational information to identify the best TC forms for optimizing the effectiveness of TC-based fall prevention interventions.
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Effect of Taijiquan Exercise on Rehabilitation of Male Amphetamine-Type Addicts. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:8886562. [PMID: 33293997 PMCID: PMC7690993 DOI: 10.1155/2020/8886562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/26/2020] [Accepted: 10/31/2020] [Indexed: 11/18/2022]
Abstract
Taijiquan is a traditional Chinese sport that is classified as a moderate exercise. Recent studies have evaluated the effectiveness of Taijiquan in substance abuse rehabilitation. Objective. To test the rehabilitation effect of Taijiquan exercise in patients with amphetamine (ATS) drug dependence. Methods. The effect of Taijiquan intervention was tested by parallel control experiment: Taijiquan group (n = 38) and control group (n = 38). The factors between the experimental groups were the group (Taijiquan group and the control group), and the factors within the group were the test time (before and after intervention). Repeated measurement analysis of variance was used to compare the two groups, and the factors that may affect the results were included in the covariance. Results. Taijiquan exercise promoted the balance control ability of ATS dependent patients (p = 0.014, η 2 = 0.064), increased the overall sense of health (p = 0.029, η 2 = 0.100), vitality (p = 0.030, η 2 = 0.056), and mental health (p = 0.016, η 2 = 0.061), improved trait anxiety (p = 0.028, η 2 = 0.053), and reduced drug craving (p = 0.048, η 2 = 0.048). Conclusion. Taijiquan exercise is beneficial to the physical and mental recovery of dependent patients, and the physical and mental benefits of exercise may have an effect on drug craving, which is of the most important significance for addicts to quit drugs and prevent relapse. The study is registered on the Chinese Clinical Trial Registry (No. ChiCTR1800015777).
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Chewning B, Hallisy KM, Mahoney JE, Wilson D, Sangasubana N, Gangnon R. Disseminating Tai Chi in the Community: Promoting Home Practice and Improving Balance. THE GERONTOLOGIST 2020; 60:765-775. [PMID: 30811543 DOI: 10.1093/geront/gnz006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Falls among older adults is a pressing public health challenge. Considerable research documents that longer tai chi courses can reduce falls and improve balance. However, longer courses can be challenging to implement. Our goal was to evaluate whether a short 6-week modified tai chi course could be effective at reducing falls risk if older adults designed a personal home practice plan to receive a greater tai chi "dose" during the 6 weeks. DESIGN A 3-city wait-listed randomized trial was conducted. Habituation Intention and Social Cognitive Theories framed the "coaching" strategy by which participants designed practice plans. RE-AIM and Treatment Fidelity Frameworks were used to evaluate implementation and dissemination issues. Three advisory groups advised the study on intervention planning, implementation, and evaluation. To measure effectiveness, we used Centers for Disease Control and Prevention recommended measures for falls risk including leg strength, balance, and mobility and gait. In addition, we measured balance confidence and executive function. RESULTS Program Implementation resulted in large class sizes, strong participant retention, high program fidelity and effectiveness. Participants reported practicing an average of 6 days a week and more than 25 min/day. Leg strength, tandem balance, mobility and gait, balance confidence, and executive function were significantly better for the experimental group than control group. CONCLUSION The tai chi short course resulted in substantial tai chi practice by older adults outside of class as well as better physical and executive function. The course reach, retention, fidelity, and implementation across 3 cities suggest strong potential for implementation and dissemination of the 6-week course.
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Affiliation(s)
- Betty Chewning
- Social and Administrative Sciences Division, School of Pharmacy
| | - Kristine M Hallisy
- Doctor of Physical Therapy Program, Department of Family Medicine and Community Health
| | - Jane E Mahoney
- Division of Geriatrics, Department of Medicine, School of Medicine and Public Health
| | - Dale Wilson
- Social and Administrative Sciences Division, School of Pharmacy
| | | | - Ronald Gangnon
- Population Health, Department of Population Health Sciences.,Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison
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Tai Chi for the Prevention of Falls Among Older Adults: A Critical Analysis of the Evidence. J Aging Phys Act 2020; 29:343-352. [PMID: 32839351 DOI: 10.1123/japa.2020-0155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/28/2020] [Accepted: 06/28/2020] [Indexed: 11/18/2022]
Abstract
Despite interest as to the benefits of Tai Chi, there remains a controversy over its effectiveness as an exercise intervention for preventing falls among older adults. This review synthesizes the evidence base with a focus on meta-analyses and randomized controlled trials with community-dwelling older adults. It provides a critical lens on the evidence and quality of the trials. High-quality evidence suggests that Tai Chi is an effective intervention for preventing falls in community settings; however, there is unclear evidence for long-term care facilities and an absence of evidence for hospital settings. When compared directly with other exercise interventions, Tai Chi may offer a superior strategy for reducing falls through its benefits on cognitive functioning. Using data from the current Cochrane review, a new synthesis is presented suggesting that 71-81% of community-dwelling older adults are adherent to class-based Tai Chi interventions. The practical opportunities and challenges for practitioners are discussed.
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Xu A, Zimmerman CS, Lazar SW, Ma Y, Kerr CE, Yeung A. Distinct Insular Functional Connectivity Changes Related to Mood and Fatigue Improvements in Major Depressive Disorder Following Tai Chi Training: A Pilot Study. Front Integr Neurosci 2020; 14:25. [PMID: 32581734 PMCID: PMC7295154 DOI: 10.3389/fnint.2020.00025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 04/15/2020] [Indexed: 11/29/2022] Open
Abstract
Objective: Tai chi (TC), a contemplative practice combining slow movements and deep breathing, has been shown to be clinically effective in alleviating depressive symptoms. Feelings of fatigue or low vitality often accompany major depressive disorder (MDD) though they are commonly overlooked and not well understood neurologically. By using resting state functional connectivity (rs-FC) using the insula as the seed, this study examines the relationship between mood and vitality symptoms in MDD and how they are impacted by TC training. Methods: Patients (N = 16) with MDD participated in a 10-week TC intervention. Self-report scores of vitality (using the SF-36 scale) and depressed mood (using the Beck Depression Inventory) as well as rs-fMRI were collected pre- and post-intervention. A seed-to-voxel approach was used to test whether changes in insular rs-FC were related to therapeutic improvement in MDD-related symptoms resulting from TC practice. Results: We found decreased self-reported depressed mood and increased vitality following the TC intervention. Furthermore, decreases in depressed mood were associated with increased rs-FC between the right anterior insula (AIC) and superior temporal gyrus and caudate (cluster-corrected p < 0.05). Increased vitality was associated with increased rs-FC between the right posterior insula (PIC) and regions associated with sensorimotor processes (cluster-corrected p < 0.05). Conclusion: These results provide support for differential changes in insula connectivity as neural correlates of symptom improvement in MDD.
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Affiliation(s)
- Anna Xu
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, United States
| | - Chloe S Zimmerman
- Department of Neuroscience, Brown University, Providence, RI, United States.,Alpert Medical School, Brown University, Providence, RI, United States
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Yan Ma
- Harvard Medical School, Boston, MA, United States.,Center for Dynamical Biomarkers, Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Catherine E Kerr
- Alpert Medical School, Brown University, Providence, RI, United States
| | - Albert Yeung
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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12
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Nyman SR, Ingram W, Sanders J, Thomas PW, Thomas S, Vassallo M, Raftery J, Bibi I, Barrado-Martín Y. Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia. Clin Interv Aging 2019; 14:2017-2029. [PMID: 31819385 PMCID: PMC6875562 DOI: 10.2147/cia.s228931] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 09/26/2019] [Indexed: 02/04/2023] Open
Abstract
Purpose To investigate the effect of Tai Chi exercise on postural balance among people with dementia (PWD) and the feasibility of a definitive trial on falls prevention. Patients and methods Dyads, comprising community-dwelling PWD and their informal carer (N=85), were randomised to usual care (n=43) or usual care plus weekly Tai Chi classes and home practice for 20 weeks (n=42). The primary outcome was the timed up and go test. All outcomes for PWD and their carers were assessed six months post-baseline, except for falls, which were collected prospectively over the six-month follow-up period. Results For PWD, there was no significant difference at follow-up on the timed up and go test (mean difference [MD] = 0.82, 95% confidence interval [CI] = -2.17, 3.81). At follow-up, PWD in the Tai Chi group had significantly higher quality of life (MD = 0.051, 95% CI = 0.002, 0.100, standardised effect size [ES] = 0.51) and a significantly lower rate of falls (rate ratio = 0.35, 95% CI =0.15, 0.81), which was no longer significant when an outlier was removed. Carers in the Tai Chi group at follow-up were significantly worse on the timed up and go test (MD = 1.83, 95% CI = 0.12, 3.53, ES = 0.61). The remaining secondary outcomes were not significant. No serious adverse events were related to participation in Tai Chi. Conclusion With refinement, this Tai Chi intervention has potential to reduce the incidence of falls and improve quality of life among community-dwelling PWD [Trial registration: NCT02864056].
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Affiliation(s)
- Samuel R Nyman
- Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole House, Talbot Campus, Poole, Dorset BH12 5BB, UK
| | - Wendy Ingram
- Peninsula Clinical Trials Unit, Peninsula Medical School, University of Plymouth, Plymouth, Devon PL4 8AA, UK
| | - Jeanette Sanders
- Peninsula Clinical Trials Unit, Peninsula Medical School, University of Plymouth, Plymouth, Devon PL4 8AA, UK
| | - Peter W Thomas
- Bournemouth University Clinical Research Unit, Faculty of Health and Social Sciences, Bournemouth University, Royal London House, Lansdowne Campus, Bournemouth, Dorset BH1 3LT, UK
| | - Sarah Thomas
- Bournemouth University Clinical Research Unit, Faculty of Health and Social Sciences, Bournemouth University, Royal London House, Lansdowne Campus, Bournemouth, Dorset BH1 3LT, UK
| | - Michael Vassallo
- Centre of Postgraduate Medical Research and Education, Faculty of Health and Social Sciences, Bournemouth University, Royal London House, Lansdowne Campus, Bournemouth, Dorset BH1 3LT, UK
| | - James Raftery
- Faculty of Medicine, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, UK
| | - Iram Bibi
- Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole House, Talbot Campus, Poole, Dorset BH12 5BB, UK
| | - Yolanda Barrado-Martín
- Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole House, Talbot Campus, Poole, Dorset BH12 5BB, UK
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13
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Lim KHL, Pysklywec A, Plante M, Demers L. The effectiveness of Tai Chi for short-term cognitive function improvement in the early stages of dementia in the elderly: a systematic literature review. Clin Interv Aging 2019; 14:827-839. [PMID: 31190769 PMCID: PMC6512568 DOI: 10.2147/cia.s202055] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/06/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: This systematic review examines intervention studies using Tai Chi in the early stages of dementia to determine the effectiveness of Tai Chi for the short-term improvement of cognitive functions for elderly persons with the disease. Methods: A keyword search was done in PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), and Cochrane Library databases using keywords such as Tai Chi, Dementia*, and cognition. A secondary search strategy consisting of a manual search in the reference lists of selected articles was also used. Results: A total of nine studies were reviewed including six randomized controlled trials, two non-randomized controlled trials, and one non-randomized prospective study. The studies suggest Tai Chi has impacts on global cognitive functions, visuospatial skills, semantic memory, verbal learning/memory, and self-perception of memory. The effects of Tai Chi on overall cognition for people with mild cognitive impairment are comparable to those in control groups which engaged in exercise. Conclusion: The studies reviewed affirm the potential of Tai Chi to improve short-term cognitive function in the elderly at the onset of dementia.
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Affiliation(s)
- Karine Huy-Leng Lim
- Centre Intégré Universitaire de Sante at Service Sociaux du Nord de l‘île de Montréal, Montréal, QC, Canada
| | - Alex Pysklywec
- Department of Geography and Planning, Queen’s University, Kingston, ON, Canada
| | - Michelle Plante
- Centre de Recherche de l’In Université de Montréalstitut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
| | - Louise Demers
- Centre de Recherche de l’In Université de Montréalstitut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
- École de Réadaptation, Université de Montréal, Montréal, QC, Canada
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14
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Zhong D, Xiao Q, He M, Li Y, Ye J, Zheng H, Xia L, Zhang C, Liang F, Li J, Jin R. Tai Chi for improving balance and reducing falls: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e15225. [PMID: 31027069 PMCID: PMC6831220 DOI: 10.1097/md.0000000000015225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION To investigate the effectiveness and safety of Tai Chi for improving balance and reducing falls on people. METHODS AND ANALYSIS The following databases will be searched: China Biology Medicine (CBM), China National Knowledge infrastructure (CNKI), Wan Fang Data, the Chinese Science and Technology Periodical Database (VIP), Medline, EMBASE, Web of Science, The Cochrane Library from inception to March 2019. All randomized controlled trials (RCTs) utilized Tai Chi to improve balance ability and reduce falls will be included. Primary outcomes are the fall-related indicators, including the number of falls, fall rate, and other fall-related outcomes. Additional outcomes include the Berg Balance Scale (BBS), standing-walk test, single-legged time, or other balance-related outcomes. Study selection, data extraction, and quality assessment will be performed independently by 2 reviewers. Assessment of risk of bias and data synthesis will be performed using Review Manager V5.3 software. ETHICS AND DISSEMINATION The findings of this systematic review will be disseminated through peer-reviewed publication or conference presentations.Trial registration number PROSPERO CRD42019127810.
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Affiliation(s)
| | - Qiwei Xiao
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Mingxing He
- School of Health Preservation and Rehabilitation
| | - Yuxi Li
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing Ye
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hui Zheng
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Lina Xia
- School of Health Preservation and Rehabilitation
| | - Chi Zhang
- School of Health Preservation and Rehabilitation
| | - Fanrong Liang
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Juan Li
- School of Health Preservation and Rehabilitation
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15
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Fall Prevention Mobile Clinic: A Novel Fall Prevention Program for Community-Dwelling Older Adults. Can J Aging 2018; 37:482-495. [PMID: 30176953 DOI: 10.1017/s0714980818000284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
ABSTRACTCauses of falls in older adults are common, multifactorial, and can lead to significant injury. This before-and-after study evaluated the benefits of a Fall Prevention Mobile Clinic (FPMC) in reducing the risk of falling in older adults in British Columbia, Canada. Four hundred seventy-six participants (average age of 83.6 years) enrolled in the study and were followed for 12 months after attending the FPMC. At 12-month follow-up, the mean percentage uptake of fall prevention recommendations was 48.8 per cent (SD = 25.7%), the Timed Up and Go mobility measure improved from a median of 19.04 seconds to 17.45 seconds and the number of participants falling decreased from 64.8 per cent (in the 12 months before attending the clinic) to 55.6 per cent (in the 12 months after attending the clinic) (p = .012). After attending the FPMC, participants acted on recommendations, improved mobility and decreased their risk of future falls.
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16
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Wang S, Long S, Wu W. Application of Traditional Chinese Medicines as Personalized Therapy in Human Cancers. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2018; 46:953-970. [DOI: 10.1142/s0192415x18500507] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Although lots of great achievements have been gained in the battle against cancer during the past decades, cancer is still the leading cause of death in the world including in developing countries such as China. Traditional Chinese medicine (TCM) is popular in Chinese and East Asian societies as well as some other Western countries and plays an active role in the modern healthcare system including patients with cancer, which may act as a potential effective strategy in treating human cancers. In this review, we aimed to introduce the mechanisms of TCM compound, as an option of individualized therapy, in treating cancer patients from the perspective of both Chinese and Western medicine. In the view of traditional Chinese medicine theory, individualized treatment for human cancers based on syndrome type benefits the cancer patients with personalized conditions. Balancing Qi, Xue, Yin and Yang, eliminating phlegm and removing dampness is how TCM compound functions on cancer patients. While in the view of Western medicine, inhibiting cancer cell growth and metastasis as well as improving immune status is how herbal compounds act on cancer patients. We also summarized the applications of TCM compound in human cancers, which will shed light on the clinical application of TCM compound on patients with cancer. TCM compound could be used as a complementary and alternative medicine (CAM) in human cancers. It could be applied in cancer patients with cancer-related fatigue (CRF). In addition, it is a good method for alleviating the side effects of both radiotherapy and chemotherapy. Therefore, TCM compound plays a critical role in treating patients with cancer, which has a promising strategy in the field of cancer management.
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Affiliation(s)
- Sumei Wang
- Department of Oncology, Guangdong Provincial Hospital of Chinese Medicine, The Second Clinical Medical College of Guangzhou University of Chinese, Medicine Guangzhou, Guangdong 510120, P. R. China
- The Postdoctoral Research Station, Guangzhou University of Chinese Medicine Guangzhou, Guangdong 510120, P. R. China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, Guangdong 510120, P. R. China
| | - Shunqin Long
- Department of Oncology, Guangdong Provincial Hospital of Chinese Medicine, The Second Clinical Medical College of Guangzhou University of Chinese, Medicine Guangzhou, Guangdong 510120, P. R. China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, Guangdong 510120, P. R. China
| | - Wanyin Wu
- Department of Oncology, Guangdong Provincial Hospital of Chinese Medicine, The Second Clinical Medical College of Guangzhou University of Chinese, Medicine Guangzhou, Guangdong 510120, P. R. China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, Guangdong 510120, P. R. China
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17
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Yu AP, Tam BT, Lai CW, Yu DS, Woo J, Chung KF, Hui SS, Liu JY, Wei GX, Siu PM. Revealing the Neural Mechanisms Underlying the Beneficial Effects of Tai Chi: A Neuroimaging Perspective. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2018. [PMID: 29542330 DOI: 10.1142/s0192415x18500131] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Tai Chi Chuan (TCC), a traditional Chinese martial art, is well-documented to result in beneficial consequences in physical and mental health. TCC is regarded as a mind-body exercise that is comprised of physical exercise and meditation. Favorable effects of TCC on body balance, gait, bone mineral density, metabolic parameters, anxiety, depression, cognitive function, and sleep have been previously reported. However, the underlying mechanisms explaining the effects of TCC remain largely unclear. Recently, advances in neuroimaging technology have offered new investigative opportunities to reveal the effects of TCC on anatomical morphologies and neurological activities in different regions of the brain. These neuroimaging findings have provided new clues for revealing the mechanisms behind the observed effects of TCC. In this review paper, we discussed the possible effects of TCC-induced modulation of brain morphology, functional homogeneity and connectivity, regional activity and macro-scale network activity on health. Moreover, we identified possible links between the alterations in brain and beneficial effects of TCC, such as improved motor functions, pain perception, metabolic profile, cognitive functions, mental health and sleep quality. This paper aimed to stimulate further mechanistic neuroimaging studies in TCC and its effects on brain morphology, functional homogeneity and connectivity, regional activity and macro-scale network activity, which ultimately lead to a better understanding of the mechanisms responsible for the beneficial effects of TCC on human health.
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Affiliation(s)
- Angus P Yu
- * School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Bjorn T Tam
- ‡ Department of Cell Biology and Physiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Christopher W Lai
- § Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Doris S Yu
- ∥ The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Jean Woo
- ** Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Ka-Fai Chung
- † Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Stanley S Hui
- †† Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Justina Y Liu
- ¶ School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Gao X Wei
- ‡‡ Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Parco M Siu
- * School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
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18
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Deverall E, Kvizhinadze G, Pega F, Blakely T, Wilson N. Exercise programmes to prevent falls among older adults: modelling health gain, cost-utility and equity impacts. Inj Prev 2018; 25:258-263. [PMID: 29363590 DOI: 10.1136/injuryprev-2016-042309] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 11/10/2017] [Accepted: 01/03/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Some falls prevention interventions for the older population appear cost-effective, but there is uncertainty about others. Therefore, we aimed to model three types of exercise programme each running for 25 years among 65+ year olds: (i) a peer-led group-based one; (ii) a home-based one and (iii) a commercial one. METHODS An established Markov model for studying falls prevention in New Zealand (NZ) was adapted to estimate incremental cost-effectiveness ratios (ICERs) in cost per quality-adjusted life-years (QALYs) gained. Detailed NZ experimental, epidemiological and cost data were used for the base year 2011. A health system perspective was taken and a discount rate of 3% applied. Intervention effectiveness estimates came from a Cochrane Review. RESULTS The intervention generating the greatest health gain and costing the least was the home-based exercise programme intervention. Lifetime health gains were estimated at 47 100 QALYs (95%uncertainty interval (UI) 22 300 to 74 400). Cost-effectiveness was high (ICER: US$4640 per QALY gained; (95% UI US$996 to 10 500)), and probably more so than a home safety assessment and modification intervention using the same basic model (ICER: US$6060). The peer-led group-based exercise programme was estimated to generate 42 000 QALYs with an ICER of US$9490. The commercially provided group programme was more expensive and less cost-effective (ICER: US$34 500). Further analyses by sex, age group and ethnicity (Indigenous Māori and non-Māori) for the peer-led group-intervention showed similar health gains and cost-effectiveness. CONCLUSIONS Implementing any of these three types of exercise programme for falls prevention in older people could produce considerable health gain, but with the home-based version being likely to be the most cost-effective.
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Affiliation(s)
- Eamonn Deverall
- Public Health Registrar, University of Otago, Wellington, New Zealand
| | - Giorgi Kvizhinadze
- Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE3), Department of Public Health, University of Otago, Wellington, New Zealand
| | - Frank Pega
- Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE3), Department of Public Health, University of Otago, Wellington, New Zealand
| | - Tony Blakely
- Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE3), Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE3), Department of Public Health, University of Otago, Wellington, New Zealand
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Viladrosa M, Lavedán A, Jürschik P, Mas-Alòs S, Planas-Anzano A, Masot O. Differences in fitness level between women aged 60 and over participating in three different supervised exercise programs and a sedentary group. J Women Aging 2017; 30:326-343. [PMID: 28783470 DOI: 10.1080/08952841.2017.1358976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to compare fitness levels in women aged 60 and over participating in a supervised exercise program (involving tai chi, recreational gymnastics, and/or aquatic fitness) with those in a sedentary group. An observational, descriptive, cross-sectional study was performed on a total of 171 women aged from 60 to 92 who attended public community clubs for older adults. The instruments used included the Senior Fitness Test, the Tinetti Balance Assessment Tool, the Katz Index, and the Lawton & Brody Activities of Daily Living Scale. Significant differences in fitness levels were observed when we compared the exercise groups with the sedentary group. Women with better fitness levels had a lower risk of suffering falls and greater autonomy in performing activities of daily living and instrumental activities of daily living. Agility and gait control were found to be independently associated with exercise groups.
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Affiliation(s)
- Maria Viladrosa
- a Department of Nursing and Physiotherapy , University of Lleida , Lleida , Spain.,b Arnau de Vilanova University Hospital of Lleida , Lleida , Spain
| | - Ana Lavedán
- a Department of Nursing and Physiotherapy , University of Lleida , Lleida , Spain
| | - Pilar Jürschik
- a Department of Nursing and Physiotherapy , University of Lleida , Lleida , Spain
| | - Sebastià Mas-Alòs
- a Department of Nursing and Physiotherapy , University of Lleida , Lleida , Spain.,c National Institute of Physical Education of Catalonia , University of Lleida , Lleida , Spain
| | - Antoni Planas-Anzano
- c National Institute of Physical Education of Catalonia , University of Lleida , Lleida , Spain
| | - Olga Masot
- a Department of Nursing and Physiotherapy , University of Lleida , Lleida , Spain
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20
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Lomas-Vega R, Obrero-Gaitán E, Molina-Ortega FJ, Del-Pino-Casado R. Tai Chi for Risk of Falls. A Meta-analysis. J Am Geriatr Soc 2017; 65:2037-2043. [PMID: 28736853 DOI: 10.1111/jgs.15008] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To analyze the effectiveness of tai chi for falls prevention. DESIGN Systematic review and meta-analysis. SETTING Pubmed, Scopus, CINHAL, and Physiotherapy Evidence Database (PEDro) were searched to May 26, 2016. PARTICIPANTS Older adult population and at-risk adults. INTERVENTION Randomized controlled trials analyzing the effect of tai chi versus other treatments on risk of falls. MEASUREMENTS The incidence rate ratio (IRR) for falls incidence and hazard ratio (HR) for time to first fall. RESULTS The search strategy identified 891 potentially eligible studies, of which 10 met the inclusion criteria. There was high-quality evidence of a medium protective effect for fall incidence over the short term (IRR = 0.57; 95% CI = 0.46, 0.70) and a small protective effect over the long term (IRR = 0.87; 95% CI = 0.77, 0.98). Regarding injurious falls, we found very low-quality evidence of a medium protective effect over the short term (IRR = 0.50; 95% CI = 0.33, 0.74) and a small effect over the long term (IRR = 0.72; 95% CI = 0.54, 0.95). There was no effect on time to first fall, with moderate quality of evidence (HR = 0.98; 95% CI = 0.69, 1.37). CONCLUSION In at-risk adults and older adults, tai chi practice may reduce the rate of falls and injury-related falls over the short term (<12 months) by approximately 43% and 50%, respectively. Tai chi practice may not influence time to first fall in these populations. Due to the low quality of evidence, more studies investigating the effects of tai chi on injurious falls and time to first fall are required.
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