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Zhao W, Ju H, Zhu K. Meta-analysis of the intervention effects of tai chi on fasting blood glucose, blood pressure and triglyceride in middle-aged and elderly people. Aging Male 2024; 27:2282977. [PMID: 38259166 DOI: 10.1080/13685538.2023.2282977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 11/08/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Hypertension, hyperlipidemia, and hyperglycemia have emerged as global health concerns of paramount significance. With the burgeoning popularity of mind-body therapy, cardiovascular patients have increasingly exhibited a vested interest in the practice of Tai Chi. The objective of this study seeks to quantitatively assess the impact of Tai Chi interventions on blood pressure, lipid levels, and glucose concentrations among the elderly population, thereby explaining the optimal intervention protocol. METHODS An extensive search was conducted across multiple databases, including Web of Science, PubMed, CNKI, WANFANG DATA, RISS, KISS, and DBPIA, comprising English, Korean, and Chinese literature. The search strategy employed a retrieval method of subject term 1 + subject term 2, which included both full names and abbreviations of the terms. Specifically, "taijiquan" or "Tai Chi" were set as the Term 1, while Term 2 was set as "blood pressure," "BP," "Fasting blood glucose," "FBG," "Triglyceride," and "TG." Thereafter, the retrieved articles were filtered in accordance with the PICOS method. Risk of bias assessment was performed using RoB 2.0, while data analysis was conducted using Comprehensive Meta-Analysis 3.7. RESULTS A total of 57 studies, including 3,856 research subjects, were eligible for inclusion. The findings of the primary effect quantitative synthesis demonstrated that Tai Chi exerted an improvement on systolic blood pressure (SBP) (ES = -0.764, p < .001), diastolic blood pressure (DBP) (ES = -0.426, p = .001), triglyceride (TG) (ES = -0.452, p < .001), and fasting blood glucose concentrations (FBG) (ES = -0.552, p = .002) among middle-aged and elderly individuals. Subgroup analysis further revealed that the intervention effects were significantly influenced by the characteristics of the research subjects and the specific intervention protocol employed. CONCLUSION Tai Chi, as a gentle form of aerobic exercise, exerts a profound impact on reducing blood pressure, fasting blood glucose levels, and triglyceride concentrations among middle-aged and elderly individuals. Notably, the intervention effect is particularly pronounced among male patients afflicted with hypertension, hyperglycemia, and hyperlipidemia. Based on the collective advantages underscored by this research, we strongly recommend engaging in Tai Chi exercises for a minimum duration of 16 weeks, with each session lasting 30-50 min and conducted 6-7 times per week, without any restrictions on the style employed.
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Affiliation(s)
- Wenzheng Zhao
- Department of Sports Science, Kyonggi University, Suwon, South Korea
| | - Hanyu Ju
- Department of Sports Science, Kyonggi University, Suwon, South Korea
| | - Kaituo Zhu
- Department of Sports Science, Kyonggi University, Suwon, South Korea
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Rampengan DDCH, Gunawan FA, Rampengan JAH, Ramadhan RN, Iqhrammullah M, Yufika A. Effectiveness of Tai Chi as a non-invasive intervention for mild cognitive impairment in the elderly: A comprehensive review and meta-analysis. NARRA J 2024; 4:e724. [PMID: 38798853 PMCID: PMC11125395 DOI: 10.52225/narra.v4i1.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024]
Abstract
The aging population warrants the increase of mild cognitive impairment (MCI) prevalence, a condition that could progress to dementia. Efforts have been made to improve the MCI and prevent its progression, including the introduction of Tai Chi, a Chinese traditional exercise. The aim of this systematic review and meta-analysis was to evaluate the efficacy of Tai Chi in attenuating MCI among the elderly population. Records investigating the effect of Tai Chi exercise intervention on cognitive function among elderly patients were searched systematically from PubMed, ScienceDirect, Google Scholar, and Europe PMC as of April 13, 2023. The risk of bias (RoB 2.0) quality assessment was employed in the quality appraisal of the studies included. Review Manager 5.4.1 was used for data extraction and meta-analysis, where the standard mean difference (SMD) and 95% confidence interval (95%CI) were computed. Eight randomized control trials with a total of 1379 participants were included in this meta-analysis. Six trials assessed Montreal Cognitive Assessment scores, where its pooled analysis suggested that Tai Chi was as effective as conventional exercise (SMD=0.15, 95%CI: -0.11 to 0.40, p=0.26). However, pooled analysis of the Mini-Mental Status Examination suggested that Tai Chi intervention more effectively improved cognitive function and reduced the rate of cognitive impairment in elderly patients (SMD=0.36, 95%CI: 0.18 to 0.54, p<0.01) as compared to the control group. This systematic review and meta-analysis suggest that, in some extent, Tai Chi is efficacious in improving cognitive function and slowing down the rate of cognitive impairment among elderly patients.
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Affiliation(s)
| | | | | | - Roy N. Ramadhan
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Muhammad Iqhrammullah
- Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia
| | - Amanda Yufika
- Department of Family Medicine, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Physical Medicine and Rehabilitation Residency Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Lyu L, Li Y, Fan X, Seo J, Eunna O. The effect of Tai Chi exercise intervention on sleep quality in community residing older adults: a systematic review and meta-analysis. Eur Geriatr Med 2024; 15:381-396. [PMID: 38227110 DOI: 10.1007/s41999-023-00923-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/13/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE While clinical research has shown that Tai Chi exercise may improve the sleep quality of older adults, there is a lack of robust evidence-based verification. Therefore, this study conducted a systematic review of published research on the effect of Tai Chi exercise on the sleep quality of community-dwelling older adults, aiming to provide solid evidence-based medicine to enhance their sleep quality. METHODS A systematic search was conducted on PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, VIP, and SinoMed databases from their inception to December 9, 2022. The Cochrane risk of bias assessment tool 2.0 was used to assess the risk of bias in the included studies. RESULTS This systematic review included 12 original articles, involving a total of 1,058 community-dwelling older adults, with 553 in the Tai Chi group and 505 in the control group. The meta-analysis results revealed a significant improvement in the sleep quality of community-dwelling older adults who practiced Tai Chi compared to the control group [WMD = - 1.96 (95% CI: - 3.02 to - 0.90, z = 3.62, P < 0.001)]. Subgroup analysis showed that Tai Chi had significantly beneficial effects regardless of age, country/region, intervention time, and Tai Chi type. CONCLUSIONS Tai Chi exercise can serve as an effective non-medication approach for addressing sleep problems in this demographic. Among the various types of Tai Chi exercises, the 24-form Tai Chi exercise emerges as a preferred option. Moreover, Tai Chi exercise proves to be an excellent choice for older people in their later years, promoting their overall well-being and health.
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Affiliation(s)
- Linyu Lyu
- College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon, Republic of Korea.
| | - Yuelin Li
- College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Xing Fan
- College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Jisu Seo
- College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Oh Eunna
- College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
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Lin J, Ning S, Lyu S, Gao H, Shao X, Tan Z, Zhu X, Chen Y. The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis. Aging Clin Exp Res 2024; 36:65. [PMID: 38472538 PMCID: PMC10933200 DOI: 10.1007/s40520-023-02674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/18/2023] [Indexed: 03/14/2024]
Abstract
OBJECTIVES Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group. In the NMA, the results of incidence of falls were as follows: 24-form > Yang style > Sun style > control > TCEP. The rank probability of BBS was as follows: 24-form > TCEP > Yang style > control. CONCLUSION Among the four types of Tai Chi studied, the 24-form simplified Tai Chi has shown better efficacy than other types.
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Affiliation(s)
- Jiaqi Lin
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shuaiqi Ning
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shaowei Lyu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Hainan Gao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xinxin Shao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Zili Tan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiangyu Zhu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.
| | - Ying Chen
- Department of Encephalopathy, Beijing Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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Wang C, Jiang T, Li H, Cao G, Zhang G. The effects of Tai Chi exercise on sleep quality among the elderly: a study based on polysomnographic monitoring. Front Neurol 2024; 15:1304463. [PMID: 38523606 PMCID: PMC10957755 DOI: 10.3389/fneur.2024.1304463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/31/2024] [Indexed: 03/26/2024] Open
Abstract
Background Sleep disorders contribute to an increased risk of depression, cardiovascular issues, and various other diseases among older individuals. Consequently, enhancing the sleep quality of this demographic population has become a pressing concern. The objective of this study was to investigate the influence of an 8-week Tai Chi exercise intervention in the sleep quality of older adults. Methods Sixty individuals aged 60 years and above, recruited from the community around Southwest University in Beibei District, Chongqing City, were randomly assigned to either a control group (30 participants) or an intervention group (30 participants). The control group adhered to their normal daily routines during the 8-week experimental period, while the intervention group engaged in a 60-min Tai Chi practice three times a week for 8 weeks. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS). Additionally, the Polysomnographic Sleep Quality Monitoring System (PSG) was employed to monitor the sleep process before and after the Tai Chi intervention. Results After the experiment, significant differences were observed in PSQI and IEI scores between the intervention and control groups (p < 0.05). In the experimental group, the pre-post comparisons revealed a significant increase in time spent in bed (p < 0.05), total sleep time (p < 0.05), and non-REM sleep stage 2 (p < 0.05). Conclusion The findings indicate that Tai Chi exercise may improve subjective reported sleep quality. In addition, Tai Chi exercise may alleviate general drowsiness, extend sleep duration, and optimize the sleep process and structure. Consequently, Tai Chi exercise may be a suitable exercise to improve sleep quality in older individuals.
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Affiliation(s)
- Chao Wang
- Institute of Sports Science, College of Physical Education, Southwest University, Chongqing, China
- Youth League Committee of Hotan Normal College, HeTian Normal College, Hetian, China
| | - Tao Jiang
- Physical Education Department, Mianyang High School, Mianyang, China
| | - Hansen Li
- Institute of Sports Science, College of Physical Education, Southwest University, Chongqing, China
| | - Guikang Cao
- Department of Psychology, Southwest University, Chongqing, China
| | - Guodong Zhang
- Institute of Sports Science, College of Physical Education, Southwest University, Chongqing, China
- International College, Krirk University, Bangkok, Thailand
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Wang M, Lyu B. Effect of 24-form simplified Tai Chi on executive inhibitory control of college students: a randomized controlled trial of EEG. Front Psychol 2024; 15:1344989. [PMID: 38515964 PMCID: PMC10955120 DOI: 10.3389/fpsyg.2024.1344989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/27/2024] [Indexed: 03/23/2024] Open
Abstract
Background College students, undergoing crucial cognitive development, face challenges during the COVID-19 pandemic that impact their executive functions. While existing research indicates positive effects of Tai Chi (TC) on college students' cognitive abilities, there is a scarcity of studies investigating its impact on executive functions and frontal brain activity. Objective This study aimed to compare the effects of 24-form simplified TC training on college students' executive functions and frontal brain electrical activity. The hypothesis posited that the TC group would exhibit superior performance compared to the control group during COVID-19 pandemic. Method Seventy college students were randomly assigned to either TC group or control group, engaging in 36 sessions (3 sessions per week, 45 min each) over 12 weeks. Executive inhibitory control was assessed using the Stroop Color and Word Test, and resting brain electrical activity in the frontal area was recorded through Electroencephalography. Result ACC was influenced by group, group-time interaction, and Stroop task-time interaction. RT was affected by time, task condition, task condition-time interaction, and task condition-group interaction. Notably, the TC group showed improved ACC (from 96.54 ± 3.27% to 98.90 ± 1.32%) and decreased RT (from 0.73 ± 0.12 to 0.66 ± 0.07 s), particularly in the inconsistent task. Regarding EEG band power, significant Group and Time interaction effects were found in F3-θ, F3-α, F3-β, F4-θ, and F4-α. Moreover, within the TC group, significant increases in F3-θ band power (from 4.66 ± 3.55 to 7.71 ± 8.44) and F4-θ band power (from 4.41 ± 2.82 to 8.61 ± 9.51) (10-3·μV·Hz) were noted pre-and post-tests. In the control group, significant decreases were observed in F3-α band power (from 5.18 ± 4.61 to 2.79 ± 2.11) and F4-α band power (from 5.57 ± 6.58 to 2.48 ± 1.95) (10-3·μV·Hz). Conclusion The pandemic-induced panic may impact frontal lobe brain activity in college students. TC training not only improves executive inhibitory control but may also enhance localized brain activity, suggesting its potential as a holistic intervention for cognitive and neurological well-being during stressful periods.
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Affiliation(s)
- Min Wang
- Public Sports Department, Institute of Physical Education, Huzhou University, Huzhou, Zhejiang, China
| | - Bei Lyu
- Chinese Graduate School, Panyapiwat Institute of Management, Nonthaburi, Thailand
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Dong J, Wang D, Li H, Ni H. Effects of different Chinese traditional exercises on sleep quality and mental health of adults: systematic review and meta-analysis. Sleep Breath 2024; 28:29-39. [PMID: 37474686 DOI: 10.1007/s11325-023-02881-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/01/2023] [Accepted: 06/27/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To evaluate the effects of traditional Chinese exercises on sleep quality and mental health in adults with different health statuses. METHOD : This review was registered a priori (CRD42023382188) and executed according to PRISMA statement guidelines. We searched the databases CNKI, China Biology Medicine disc (CBM), Wangfang, PubMed, Web of Science, and Embase from the date of database creation to March 2023. Two researchers independently screened the literature, extracted the data, evaluated the methodological quality of the included literature, and then used Revman 5.4 and Stata 17.0 for the corresponding statistical analysis and graphing. RESULTS Thirty-four randomized controlled trials (RCTs) were included, with a total sample of 2563 adults (1276 in the experimental group and 1287 in the control group). The meta-analysis results showed that traditional Chinese exercise significantly improved sleep quality in different groups [WMD = - 1.58, 95% CI = - 2.17, - 1.00, P < 0.00001] and that Badaanjin was better than Taijiquan in improving sleep quality. For mental health, traditional Chinese exercise had good effects on anxiety [WMD = - 1.66, 95% CI = - 2.64, - 0.69, P = 0.0009] and depression [WMD = - 1.67, 95% CI = - 3.23, - 0.11, P = 0.04]. CONCLUSION Traditional Chinese exercises can improve the quality of sleep and mental health in different groups of people and are highly recommended for good health effects.
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Affiliation(s)
- Jin Dong
- Physical Education Institute, Shanxi University, Taiyuan, Shanxi Province, China.
| | - Desheng Wang
- Physical Education Institute, Shanxi University, Taiyuan, Shanxi Province, China
| | - Hang Li
- Information School, The University of Sheffield, Sheffield, UK
| | - HengBo Ni
- Physical Education Institute, Shanxi University, Taiyuan, Shanxi Province, China
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Wang X, Luo H. Effects of traditional Chinese exercise therapy on pain scores, sleep quality, and anxiety-depression symptoms in fibromyalgia patients: a systematic review and meta-analysis. BMC Musculoskelet Disord 2024; 25:99. [PMID: 38281020 PMCID: PMC10821260 DOI: 10.1186/s12891-024-07194-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/10/2024] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVE This study aims to assess the effectiveness of traditional Chinese exercise therapy in alleviating pain, improving sleep quality, and reducing symptoms of anxiety and depression among fibromyalgia patients. METHODS We conducted a comprehensive search across various databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge, VIP database, and Wanfang, to identify randomized controlled trials (RCTs) examining the impact of Traditional Chinese Exercise (TCE) interventions on fibromyalgia. Two independent authors extracted data from the selected studies based on predefined inclusion and exclusion criteria. Meta-analyses were performed using RevMan 5.3. RESULTS The analysis encompassed 15 RCTs, comprising 936 participants. The meta-analysis revealed that TCE significantly surpassed the control group in reducing pain scores for fibromyalgia patients, as evidenced by improvements in FIQ [MD = -3.30, 95% CI (- 5.37, - 0.69), z = 2.53, p = 0.01] and VAS [MD = -1.87, 95% CI (- 2.12, - 1.61), z = 6.98, p < 0.00001]. Additionally, TCE demonstrated notable enhancements in sleep quality (PSQI) [MD = -2.23, 95% CI (- 2.86, - 1.61), z = 6.98, p < 0.0001], as well as in alleviating symptoms of anxiety and depression [MD = - 0.59, 95% CI (- 0.80, - 0.39), z = 5.63, p < 0.0001]. CONCLUSION Traditional Chinese Exercise (TCE) exhibits significant efficacy in ameliorating pain, enhancing sleep quality, and alleviating symptoms of anxiety and depression in fibromyalgia patients.
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Affiliation(s)
- Xinzheng Wang
- Department of Physical Education, Zhejiang Chinese Medical University, Province, Zhejiang, 310053, Hangzhou, China
| | - Hongbin Luo
- Department of Physical Education, Zhejiang Chinese Medical University, Province, Zhejiang, 310053, Hangzhou, China.
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Bong May Ing J, Singh DKA, Tan MP, Adam Bujang M, Tiong IK, Whitney J, Kumar S. Group-based exercise interventions for community-dwelling older people in Southeast Asia: A systematic review. Australas J Ageing 2023; 42:624-637. [PMID: 37465973 DOI: 10.1111/ajag.13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/18/2023] [Accepted: 06/22/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Southeast Asia (SEA) is a rapidly ageing and a diversely populated region that requires strategies to maintain its populations' physical activity and sense of well-being. While the benefits of group exercise programs are known, the characteristics and types of exercises in terms of their effectiveness for physical function and fidelity of the programs have yet to be defined within this population. METHODS Ovid, MEDLINE, Scopus, PEDro (Physiotherapy Evidence Database), EBSCOHOST, Cochrane library and Open Grey databases were searched to identify relevant studies. Methodological quality was assessed using the PEDro Scale and the Newcastle Ottawa Scale (NOS). Meta-analysis was undertaken when the same outcome measures were reported in a minimum of two studies with appropriate data. (PROSPERO: CRD42020177317). RESULTS Eleven studies with 900 participants were included, out of which 395 participants were allocated to group exercise programs and 383 completed the program. Culturally adapted Thai dance programs and multicomponent exercise programs were the most-commonly reported group exercises. The Timed Up and Go test (TUG) and attendance rates were the most-frequently reported outcomes. Meta-analysis demonstrated significant improvement in physical function assessed using the Timed Up and Go test (Random effect model -1.27 s, 95% CI -1.65, -0.88, I2 = 74%). In two studies, adherence (81% and 94%) and dropout rates (4% and 19%) were reported. CONCLUSIONS Group-based exercise programs in Southeast Asia consisting mostly of culturally adapted Thai dance programs and multicomponent exercise programs appear to have positive effects on physical function. However, better descriptions of fidelity, including adherence, are required in future studies.
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Affiliation(s)
- Janet Bong May Ing
- Physiotherapy Programme, Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Physiotherapy Unit, Sarawak Heart Centre, Sarawak Health Department, Ministry of Health, Kuching, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme, Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohammad Adam Bujang
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Malaysia
| | - Ing Khieng Tiong
- Geriatric Unit, Sarawak Heart Centre, Sarawak Health Department, Ministry of Health, Kuching, Malaysia
| | | | - Saravana Kumar
- Allied Health and Human Performance Unit, City East Campus, University of South Australia, Adelaide, South Australia, Australia
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Lee LYK, Chu ECP. Tai Chi as a Body-Mind Exercise for Promotion of Healthy Aging in Nursing Home Residents: Appropriateness, Feasibility, and Effectiveness. Clin Interv Aging 2023; 18:1949-1959. [PMID: 38020454 PMCID: PMC10680471 DOI: 10.2147/cia.s430968] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
The lack of activity, opportunity for providing input and participation in activities, and interaction with other people are the features of institutional living which reinforces dependency among nursing home residents. Residents are usually frustrated with paternalistic-type care. Arranging health-oriented meaningful activities for residents contributes to health promotion and enhancement of healthy aging. Moreover, it contributes to the cultivation of a positive meaning of life which is particularly important as residents reach the late geriatric stages of their lives. With exercise being seen as generally beneficial for health, Tai Chi as a Chinese-based exercise with a body-mind emphasis and unique characteristics becomes a particularly suitable exercise in aiding the residents in this major shift of lifestyle. This paper analyzes the appropriateness, feasibility, and effectiveness of Tai Chi in promoting healthy aging for residents. Theoretical considerations and scientific evaluations lend it appropriate, feasible, and effective in providing physiological and psychosocial health benefits to the residents. This paper recommends the use of Tai Chi to promote healthy aging in nursing home residents. With a rapidly aging population and mounting demand for residential geriatric care worldwide, this paper's timely findings should provide important implications for adopting Tai Chi to advance the quality of care delivered by nursing homes worldwide.
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Affiliation(s)
- Linda Yin-King Lee
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, People’s Republic of China
| | - Eric Chun-Pu Chu
- New York Chiropractic and Physiotherapy Centre, EC Healthcare, Hong Kong, People’s Republic of China
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Liu H, Liu S, Xiong L, Luo B. Effects of traditional Chinese exercise on sleep quality: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2023; 102:e35767. [PMID: 37933009 PMCID: PMC10627671 DOI: 10.1097/md.0000000000035767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/03/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND The efficacy of traditional Chinese exercise (TCE)-based interventions in the improvement of sleep quality is controversial. In this systematic review, we aimed to summarize randomized controlled trials (RCTs) that outline the effects of TCE on sleep quality. METHODS Five databases (Web of Science, Embase, PubMed, Medline, and China National Knowledge Infrastructure) were searched for literature published before July 2022. RCTs examining TCE interventions were included. The treatment effects were estimated using a random-effect meta-analysis model with mean differences (MDs). There were 2 outcome scales for sleep quality; however, because they were extremely contrastive to be analyzed by standard MD, the scales were analyzed separately to ensure the accuracy of the results. This review was registered in the International Prospective Register of Systematic Reviews (identifier CRD42023421314). RESULTS Twenty studies were included for analysis at last. The outcome was calculated using the Verran and Snyder-Halpern Sleep Scale (MD: 344.17, 95% confidence interval: 316.95 to 371.39, P < .00001) and Pittsburgh Sleep Quality Index to measure sleep quality (MD: -2.24, 95% confidence interval: -3.05 to -1.43, P < .00001), both showed improvement effect. In subgroup analysis, for patients with fibromyalgia, normal older adults, and non-Hodgkin lymphoma, chronic fatigue syndrome-like illness, knee osteoarthritis, nasopharyngeal carcinoma, pausimenia, insomnia, TCE could improve sleep quality. However, there was no significant improvement in stroke patients, breast cancer patients, normal college students, and episodic migraine patients. Tai Chi had greater effects in improving sleep quality than Qigong. In addition, the participants practice site, duration, and age did not influence the effects of TCE. CONCLUSION TCE can improve sleep quality in specific populations in specific populations clinical applications. Tai chi should be considered first to improve sleep quality. However, further extensive trials and rigorous study designs should be conducted to strengthen the findings of this study. In addition, considering the large heterogeneity, the findings of our study should be interpreted cautiously.
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Affiliation(s)
- Haoyu Liu
- Capital University of Physical Education and Sports, Haidian, Beijing, China
| | - Siling Liu
- School of Sport and Art, Shenzhen Technology University, Shenzhen, Guangdong province, China
| | - Lu Xiong
- Jiangxi Institute of Applied Science and Technology, Nanchang, Jiangxi province, China
| | - Bingquan Luo
- Capital University of Physical Education and Sports, Haidian, Beijing, China
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Piber D, Olmstead R, Cho JH, Irwin MR. Disturbance of sleep maintenance, but not sleep duration, activates nuclear factor-κB and signal transducer and activator of transcription family proteins in older adults: sex differences. Sleep 2023; 46:zsad130. [PMID: 37140651 PMCID: PMC10566249 DOI: 10.1093/sleep/zsad130] [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: 12/02/2022] [Revised: 03/14/2023] [Indexed: 05/05/2023] Open
Abstract
STUDY OBJECTIVES Disturbances of sleep maintenance and sleep duration are common in older adults and associated with an increased risk for age-related mortality and morbidity. Converging evidence implicates inflammation as an underlying mechanism, especially in females. However, it is unknown what specific aspects of sleep disturbance impact inflammatory mechanisms in older adults. METHODS Using data from community-dwelling older adults who participated in the Sleep Health and Aging Research (SHARE) field study (n = 262, mean age 71.9 ± 8.0 years), we conducted a secondary analysis to examine whether disturbance of sleep maintenance (i.e. greater amount of wake time after sleep onset [WASO]) and sleep duration (i.e. shorter total sleep time [TST]) assessed by sleep diary and actigraphy are associated with greater activation of nuclear factor (NF)-κB and signal transducer and activator of transcription (STAT) family proteins STAT1, STAT3, and STAT5 in peripheral blood monocytic cells. In addition, moderation effects of sex were explored. RESULTS Data were available for sleep diary (n = 82), actigraphy (n = 74), and inflammatory signaling and transcriptional measures (n = 132). As assessed by sleep diary, greater amount of WASO (β = 0.39, p < 0.01), but not TST, was associated with higher levels of NF-κB. Whereas diary-assessed sleep measures were not associated with STAT family proteins, a moderation analysis revealed that greater diary-assessed WASO was associated with higher levels of STAT1 (p < 0.05), STAT3 (p < 0.05), and STAT5 (p < 0.01) in females, but not in males. Actigraphy-assessed sleep measures were not associated either with NF-κB or STAT activation. CONCLUSIONS In older adults, self-reported disturbance of sleep maintenance assessed by sleep diary was uniquely associated with higher levels of NF-κB, along with higher levels of STAT family proteins in females, but not in males. Our data suggest that improvingself-reported sleep maintenance might mitigate age-related increases in inflammatory signaling and transcriptional pathways, possibly more strongly in females, with the potential to reduce mortality risk in older adults.
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Affiliation(s)
- Dominique Piber
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Richard Olmstead
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Joshua H Cho
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Michael R Irwin
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Psychology, College of Arts and Sciences, UCLA, Los Angeles, CA, USA
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Wang S, Lan Y, Liu Z, Xu S, Wu X. Effects of different interventions on insomnia in adults: Systematic review and network meta-analysis. J Psychiatr Res 2023; 165:140-149. [PMID: 37499485 DOI: 10.1016/j.jpsychires.2023.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 05/04/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE Insomnia is a common sleep disorder. There are many clinical-intervention methods for treating this condition, but thus far, the most effective method has not been determined. METHODS We conducted a network meta-analysis by including random evidence of insomnia improvement in people over 18 years old, without other physical diseases. From January 1, 1990 to June 15, 2022, we searched multiple electronic databases for randomized controlled trials of different insomnia-related, clinical-intervention methods. R software was used to analyze 10 indices, in order to evaluate the effect of sleep improvement. Primary outcomes comprised Pittsburgh sleep quality-index (PSQI) scores and insomnia severity-index (ISI) scores. RESULTS Finally, 122 randomized controlled trials were included in our study. For the PSQI scores, we found the sequence of intervention measures by effect to be as follows: electroacupuncture, acupuncture, repetitive transcranial magnetic stimulation (rTMS), essential oils, herbal medicine, traditional Western medicine, Tai Chi and Baduanjin, music, supplements, cognitive behavioral therapy for insomnia (CBT-I), and exercise. The results for ISI were similar to those for PSQI, but with slight differences. CONCLUSION Our research results indicate that various measures have a certain effect on improving sleep, among which the effect of instruments is more prominent. The curative effect of placebo groups was better than that of blank control groups. There is essentially no statistical difference in detailed classification within the same intervention category.
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Affiliation(s)
- Shuwen Wang
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yueyan Lan
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Zixiu Liu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Shuang Xu
- Library of China Medical University, Shenyang, Liaoning Province, China
| | - Xiaomei Wu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China.
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Zhang W, Sun J, Feng X, Zhang H, Zhang Y, Zhao M. Effectiveness of Tai Chi exercise on fear of falling and balance in older adults: A meta-analysis. Geriatr Nurs 2023; 51:194-201. [PMID: 37011491 DOI: 10.1016/j.gerinurse.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/20/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE To assess the effect of Tai Chi exercise on fear of falling (FOF) and balance in older adults. METHOD Chinese and English databases were searched for randomized controlled trials (RCTs) on the effect of Tai Chi on the fear of falling and balance of older adults. The search time limit was from inception until 13 December 2022. RESULTS A total of 13 RCTs were included and the overall quality was moderate. The results showed that Tai Chi exercise could significantly improve fear of falling [SMD = -0.54, 95%CI(-1.09, 0.01), Z =1.94, P = 0.05], dynamic balance [SMD = -2.23, 95%CI(-3.89, -0.75), Z=2.90, P = 0.004] and fall incidence [RR = 0.48, 95%CI(0.35, 0.65), Z =4.67, P <0.001] in older adults. However, its significant benefits in improving the static balance [MD = 4.16, 95%CI(-3.71, 12.04), Z =1.04, P = 0.30] in older adults were not found. The results of the subgroup analysis showed that the short-term effect of Tai Chi in reducing the fear of falling was more significant (P = 0.002). CONCLUSION Tai Chi could alleviate the FOF of older adults, improve balance and reduce fall incidence. However, large-sample, multi-center, high-quality randomized controlled studies are still verified in the future.
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15
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Costa M, Re M. Chronotype and quality of sleep in alpine skiers. Chronobiol Int 2023:1-11. [PMID: 37080773 DOI: 10.1080/07420528.2023.2203236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Alpine skiing is among the most demanding sporting activities in terms of physical effort and mental workload. The aim of the study was to compare sleep quality and chronotype distribution between 84 highly trained alpine skiers and a control sample of 84 non-athletes matched by age and sex ratio. Quality of sleep was assessed by the Pittsburgh Quality of Sleep Index (PSQI), and chronotype was assessed by the Morningness-Eveningness Questionnaire (MEQ). Additional questions assessed sleep management during training or competitions. The results showed a marked skewed chronotype distribution towards morningness in alpine skiers (52.4% morning type, 42.8% intermediate, and 4.8% evening type) in comparison to the control group. The midpoint of sleep was significantly anticipated among alpine skiers. Differently from the previous literature that showed poor sleep quality and quantity in competitive athletes, the quality and quantity of sleep in alpine skiers was within the normal range in all the PSQI subcomponents.
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Affiliation(s)
- Marco Costa
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Matteo Re
- Department of Psychology, University of Bologna, Bologna, Italy
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Yao KR, Luo Q, Tang X, Wang ZH, Li L, Zhao L, Zhou L, Li L, Huang L, Yin XH. Effects of traditional Chinese mind–body exercises on older adults with cognitive impairment: A systematic review and meta-analysis. Front Neurol 2023; 14:1086417. [PMID: 37077563 PMCID: PMC10106716 DOI: 10.3389/fneur.2023.1086417] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/03/2023] [Indexed: 04/05/2023] Open
Abstract
ObjectiveTo determine the effectiveness of traditional Chinese mind–body exercises in improving cognition, memory, and executive function in older adults with cognitive impairment.Data sourcesRelevant English and Chinese language studies published until September 14th, 2022 were retrieved from PubMed, Web of Science, Cochrane Library, Embase, CINAHL, WAN FANG DATA, VIP Information, CNKI, and SinoMed databases.Review methodsRandomized controlled trials assessing traditional Chinese mind–body exercises (Tai Chi, Baduanjin, Qigong, Mind–Body Therapies, and Yijinjing) in older adults with cognitive impairment were included. Two researchers independently identified eligible studies and extracted data. A risk-of-bias assessment was performed using the Cochrane Risk of Bias Tool.ResultsThis study included 15 randomized controlled trials (1,127 participants) from China, Thailand and American. Most studies had a high risk of bias in the blinding of participants and researchers, one study had a high risk of bias in the random sequence generation and two studies had a high risk of bias in the incomplete outcome data. Compared with conventional therapy alone, traditional Chinese mind–body exercises significantly improved global cognitive function (p < 0.00001), and Baduanjin could improve the global cognitive function (p < 0.00001), memory function (p < 0.0001), and executive function (p < 0.0001) outcomes after treatment, and significantly improved some dimensional scores on the auditory verbal learning test after treatment (p = 0.04).ConclusionCompared with conventional therapy, traditional Chinese mind–body exercises (Tai Chi, Baduanjin, and Qigong) significantly improved global cognitive function, and Baduanjin could improve global cognitive function, memory function, and executive function in older adults with cognitive impairment.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#searchadvanced, CRD42022327563.
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Affiliation(s)
- Ke-ru Yao
- School of Nursing, University of South China, Hengyan, China
| | - Qin Luo
- School of Nursing, University of South China, Hengyan, China
| | - Xi Tang
- School of Nursing, University of South China, Hengyan, China
| | - Zhi-han Wang
- School of Nursing, University of South China, Hengyan, China
| | - Lu Li
- School of Nursing, University of South China, Hengyan, China
| | - Lu Zhao
- School of Nursing, University of South China, Hengyan, China
| | - Li Zhou
- Second Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Ling Li
- Second Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Li Huang
- Second Affiliated Hospital of University of South China, Hengyang, Hunan, China
- *Correspondence: Li Huang,
| | - Xin-hong Yin
- School of Nursing, University of South China, Hengyan, China
- Xin-hong Yin,
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Yang M, Yang J, Gong M, Luo R, Lin Q, Wang B. Effects of Tai Chi on Sleep Quality as Well as Depression and Anxiety in Insomnia Patients: A Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3074. [PMID: 36833762 PMCID: PMC9959787 DOI: 10.3390/ijerph20043074] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 02/04/2023] [Indexed: 06/07/2023]
Abstract
To systematically review the effects of Tai chi on sleep quality, depression, and anxiety in patients with insomnia. The electronic databases including PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), WanFang Data, Chinese Biomedical Literature Database (CBM), and VIP Database for Chinese Technical Periodicals (VIP) were retrieved and screened by computer. Randomized controlled trials (RCT) on patients with insomnia who practiced Tai chi were collected, and the RCT risk of bias assessment criteria was used to evaluate the methodological quality of the included studies. The combined effect size was expressed as the weighted mean difference (WMD), with a confidence interval of 95% (CI). Review Manager 5.4 and Stata16.0 were used for heterogeneity analysis and sensitivity analysis. Tai chi reduced the patients' Pittsburgh sleep quality index (PSQI) score (WMD = -1.75, 95% CI: -1.88, -1.62, p < 0.001); Hamilton depression scale (HAMD) score (WMD = -5.08, 95% CI: -5.46, -4.69, p < 0.001), Hamilton anxiety scale (HAMA) score (WMD = -2.18, 95% CI: -2.98, -1.37, p < 0.001), and self-rating anxiety scale (SAS) score (WMD = -7.01, 95% CI: -7.72, -6.29, p < 0.001). Tai chi exercise has a good preventive and ameliorating effect on insomnia, which can relieve patients' depression and anxiety, simultaneously enhancing various functions of the body. However, most of the included studies reported random assignment with some lack of specific descriptions, and the blinding of participants was difficult to achieve due to the nature of exercise, which may cause bias. Therefore, more high-quality, multi-center, and bigger-sample studies need to be included in the future to further verify the results.
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Affiliation(s)
- Min Yang
- School of Physical Education, Yanshan University, Qinhuangdao 066004, China
| | - Jiaqi Yang
- School of Physical Education, Yanshan University, Qinhuangdao 066004, China
| | - Mingjun Gong
- School of Sports Training and Science, Tianjin University of Sport, Tianjin 300211, China
| | - Rui Luo
- School of Sport and Leisure, Sichuan Tourism University, Chengdu 610100, China
| | - Qinqin Lin
- School of Physical Education, Yanshan University, Qinhuangdao 066004, China
| | - Baihui Wang
- School of Physical Education, Yanshan University, Qinhuangdao 066004, China
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Wilfling D, Calo S, Dichter MN, Meyer G, Möhler R, Köpke S. Non-pharmacological interventions for sleep disturbances in people with dementia. Cochrane Database Syst Rev 2023; 1:CD011881. [PMID: 36594432 PMCID: PMC9808594 DOI: 10.1002/14651858.cd011881.pub2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Sleep disturbances occur frequently in people with dementia with a reported prevalence of up to 40%. Common problems are increased number and duration of awakenings and increased percentage of light sleep. Sleep disturbances are associated with a number of problems for people with dementia, their relatives, and carers. In people with dementia, they may lead to worsening of cognitive symptoms, challenging behaviours such as restlessness or wandering, and further harms, such as accidental falls. Sleep disturbances are also associated with significant carer distress and have been reported as a factor contributing to institutionalisation of people with dementia. As pharmacological approaches have shown unsatisfactory results, there is a need to synthesise the research evidence on non-pharmacological strategies to improve sleep in people with dementia. As interventions are often complex, consisting of more than one active component, and implemented in complex contexts, it may not be easy to identify effective intervention components. OBJECTIVES To evaluate the benefits and harms of non-pharmacological interventions on sleep disturbances in people with dementia compared to usual care, no treatment, any other non-pharmacological intervention, or any drug treatment intended to improve sleep, and to describe the components and processes of any complex intervention included. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search was 13 January 2022. SELECTION CRITERIA We included individually or cluster-randomised controlled trials in people with dementia comparing non-pharmacological interventions to improve sleep compared to usual care or to other interventions of any type. Eligible studies had to have a sleep-related primary outcome. We included people with a diagnosis of dementia and sleep problems at baseline irrespective of age, type of dementia, severity of cognitive impairment, or setting. Studies reporting results on a mixed sample (e.g. in a nursing home) were only considered for inclusion if at least 80% of participants had dementia. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were 1. objective sleep-related outcomes (e.g. total nocturnal sleep time, consolidated sleep time at night, sleep efficiency, total wake time at night (or time spent awake after sleep onset), number of nocturnal awakenings, sleep onset latency, daytime/night-time sleep ratio, night-time/total sleep ratio over 24 hours) and 2. ADVERSE EVENTS Our secondary outcomes were 3. subjective sleep-related outcomes, 4. behavioural and psychological symptoms of dementia, 5. quality of life, 6. functional status, 7. institutionalisation, 8. compliance with the intervention, and 9. attrition rates. We used GRADE to assess the certainty of evidence and chose key outcomes to be included in summary of findings tables. MAIN RESULTS We included 19 randomised controlled trials with 1335 participants allocated to treatment or control groups. Fourteen studies were conducted in nursing homes, three included community residents, one included 'inpatients', one included people from a mental health centre, and one included people from district community centres for older people. Fourteen studies were conducted in the US. We also identified nine ongoing studies. All studies applied one or more non-pharmacological intervention aiming to improve physiological sleep in people with dementia and sleep problems. The most frequently examined single intervention was some form of light therapy (six studies), five studies included physical or social activities, three carer interventions, one daytime sleep restriction, one slow-stroke back massage, and one transcranial electrostimulation. Seven studies examined multimodal complex interventions. Risk of bias of included studies was frequently unclear due to incomplete reporting. Therefore, we rated no study at low risk of bias. We are uncertain whether light therapy has any effect on sleep-related outcomes (very low-certainty evidence). Physical activities may slightly increase the total nocturnal sleep time and sleep efficiency, and may reduce the total time awake at night and slightly reduce the number of awakenings at night (low-certainty evidence). Social activities may slightly increase total nocturnal sleep time and sleep efficiency (low-certainty evidence). Carer interventions may modestly increase total nocturnal sleep time, may slightly increase sleep efficiency, and may modestly decrease the total awake time during the night (low-certainty evidence from one study). Multimodal interventions may modestly increase total nocturnal sleep time and may modestly reduce the total wake time at night, but may result in little to no difference in number of awakenings (low-certainty evidence). We are uncertain about the effects of multimodal interventions on sleep efficiency (very low-certainty evidence). We found low-certainty evidence that daytime sleep restrictions, slow-stroke back massage, and transcranial electrostimulation may result in little to no difference in sleep-related outcomes. Only two studies reported information about adverse events, detecting only few such events in the intervention groups. AUTHORS' CONCLUSIONS Despite the inclusion of 19 randomised controlled trials, there is a lack of conclusive evidence concerning non-pharmacological interventions for sleep problems in people with dementia. Although neither single nor multimodal interventions consistently improved sleep with sufficient certainty, we found some positive effects on physical and social activities as well as carer interventions. Future studies should use rigorous methods to develop and evaluate the effectiveness of multimodal interventions using current guidelines on the development and evaluation of complex interventions. At present, no single or multimodal intervention can be clearly identified as suitable for widespread implementation.
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Affiliation(s)
- Denise Wilfling
- Nursing Research Group, Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Stella Calo
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
| | - Martin N Dichter
- Institute of Nursing Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gabriele Meyer
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Ralph Möhler
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
| | - Sascha Köpke
- Institute of Nursing Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Leung LYL, Tam HL, Ho JKM. Effectiveness of Tai Chi on older adults: A systematic review of systematic reviews with re-meta-analysis. Arch Gerontol Geriatr 2022; 103:104796. [PMID: 36058045 DOI: 10.1016/j.archger.2022.104796] [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: 07/03/2022] [Revised: 08/14/2022] [Accepted: 08/24/2022] [Indexed: 11/22/2022]
Abstract
This overview study examined and synthesized the effect of Tai Chi (TC) on the physical conditions, psychological conditions, cognitive abilities, and quality of life (QoL) of older adults. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Using Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register, PubMed, Scopus, and Web of Science, English-language systematic reviews (SRs) published within the latest decade (2010-2020) were included. SRs with meta-analysis were selected if TC was the examined intervention and older adults was the targeted population. A total of 16 SRs covering 89 original studies were included. A number of the pooled results of the included SRs were inconclusive. Taking into consideration of the new meta-analyses of this study, TC significantly improved most outcomes, including the mobility, pain level, physical function, psychological distress, depressive symptoms, anxiety, global cognitive function, mental speed and attention, learning ability, verbal fluency, executive function, and QoL of older adults. TC can be an effective intervention for older adults for improving physical and psychological conditions, cognitive abilities, and QoL. Additional high-quality studies with larger samples investigating the effectiveness of TC in older adults are warranted.
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Affiliation(s)
- Leona Yuen Ling Leung
- The Ronin Institute, Montclair, NJ 07043-2314, USA; Canadian Academy of Independent Scholar, Vancouver, Canada
| | - Hon Lon Tam
- Kiang Wu Nursing College of Macau, Macau; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
| | - Jonathan Ka Ming Ho
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong
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Piber D, Cho JH, Lee O, Lamkin DM, Olmstead R, Irwin MR. Sleep disturbance and activation of cellular and transcriptional mechanisms of inflammation in older adults. Brain Behav Immun 2022; 106:67-75. [PMID: 35953022 DOI: 10.1016/j.bbi.2022.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Sleep disturbance, including poor subjective sleep quality and insomnia disorder, is common in older adults and associated with increases in age-related morbidity risk. Accumulating evidence implicates inflammation as an underlying mechanism. In two complementary studies, we examined whether sleep disturbance is associated with activation of cellular and transcriptional mechanisms of inflammation in older adults. METHODS Study 1 examined whether healthy older adults with poor subjective sleep quality (n = 62), compared to those with good subjective sleep quality (n = 101), differed in monocytic production of interleukin (IL)-6 and/or tumor necrosis factor (TNF)-α following stimulation with lipopolysaccharide. Study 2 examined whether older adults with insomnia disorder (n = 17), compared to those without insomnia disorder (n = 25), differed in the regulation of transcription factors (TFs) related to immune activation (i.e., nuclear factor-κB/Rel family), sympathetic nervous system (SNS) activity (i.e., cAMP-response element-binding protein), hypothalamic-pituitary-adrenal (HPA) axis activity (i.e., glucocorticoid receptor) and anti-viral responses (i.e., interferon-regulatory factor/interferon-stimulated response element) assessed in peripheral blood mononuclear cells. RESULTS In Study 1, older adults with poor subjective sleep quality, compared to those with good subjective sleep quality, showed higher percentages of stimulated monocytes producing IL-6 only (25.4 ± 16.8 % vs 20.4 ± 13.9 %; p < 0.05, ηp2 = 0.03), producing TNF-α only (37.6 ± 13.1 % vs 31.2 ± 14.3 %; p < 0.01, ηp2 = 0.05), and co-producing IL-6/TNF-α simultaneously (17.8 ± 11.7 % vs 13.9 ± 9.6 %; p < 0.05, ηp2 = 0.03). In Study 2, older adults with insomnia disorder, compared to those without insomnia disorder, showed higher TF activity related to immune activation (p's < 0.05) and SNS function (p's < 0.001), along with lower TF activity related to HPA axis function (p's < 0.05). CONCLUSION In older adults, poor subjective sleep quality and insomnia diagnosis are associated with increases in monocytic cytokine production and changes in TF activity related to immune activation, SNS function, and HPA axis function. Activation of markers of cellular and transcriptional inflammation might contribute to the link between sleep disturbance and age-related morbidity risk.
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Affiliation(s)
- Dominique Piber
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA; Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany
| | - Joshua H Cho
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Olivia Lee
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Donald M Lamkin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA
| | - Richard Olmstead
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA; Department of Psychology, College of Arts and Sciences, UCLA, Los Angeles, CA, USA.
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21
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Kruisbrink M, Crutzen R, Kempen GIJM, Delbaere K, Ambergen T, Cheung KL, Kendrick D, Iliffe S, Zijlstra GAR. Disentangling interventions to reduce fear of falling in community-dwelling older people: a systematic review and meta-analysis of intervention components. Disabil Rehabil 2022; 44:6247-6257. [PMID: 34511009 DOI: 10.1080/09638288.2021.1969452] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Fear of falling (FoF) is a common and debilitating problem for older people. Most multicomponent interventions show only moderate effects. Exploring the effective components may help in the optimization of treatments for FoF. MATERIALS AND METHODS In a systematic review of five scientific literature databases, we identified randomized controlled trials with older community-dwelling people that included FoF as an outcome. There was no restriction on types of interventions. Two reviewers extracted information about outcomes and content of interventions. Intervention content was coded with a coding scheme of 68 intervention components. We compared all studies with a component to those without using univariate meta-regressions. RESULTS Sixty-six studies, reporting on 85 interventions, were included in the systematic review. In the meta-regressions (n = 49), few components were associated with intervention effects at the first available follow up after the intervention, but interventions with meditation, holistic exercises (such as Tai Chi or Pilates) or body awareness were significantly more effective than interventions without these components. Interventions with self-monitoring, balance exercises, or tailoring were less effective compared to those without these components. CONCLUSIONS The identified components may be important for the design and optimization of treatments to reduce FoF. Implications for rehabilitationFear of falling (FoF) is a common and debilitating issue among older people and multicomponent interventions usually show only small to moderate effects on FoF.This review and meta-analysis investigated 68 intervention components and their relation to intervention effects on FoF.Interventions with meditation, holistic exercises (such as Tai Chi), or body awareness are more effective than interventions without these components.Clinicians aiming to reduce FoF may recommend selected interventions to older people taking into account the current knowledge of intervention components.
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Affiliation(s)
- Marlot Kruisbrink
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Gertrudis I J M Kempen
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Kim Delbaere
- School of Public Health and Community Medicine, Neuroscience Research Australia, UNSW, Randwick, Australia
| | - Ton Ambergen
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Kei Long Cheung
- Department of Health Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London, UK
| | - Denise Kendrick
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Steve Iliffe
- Research Department of Primary Care & Population Health, University College London, London, UK
| | - G A Rixt Zijlstra
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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22
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Verma K, Singh D, Srivastava A. The Impact of Complementary and Alternative Medicine on Insomnia: A Systematic Review. Cureus 2022; 14:e28425. [PMID: 36176875 PMCID: PMC9509538 DOI: 10.7759/cureus.28425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 11/14/2022] Open
Abstract
Insomnia is characterized by difficulty in maintaining sleep and early morning awakenings. Although pharmacotherapies and psychological interventions remain essential for conventional treatment, motivational factors and interest in using complementary and alternative therapies for insomnia have developed over the last two decades. This review aims to comprehensively explore the effects of complementary and alternative medicine (CAM) on improving sleep quality to guide evidence-based clinical decision-making and inform future research. Several electronic databases such as MEDLINE, PubMed, Scopus, EMBASE, Clinical key, Cochrane, and Research gate were explored to search the relevant articles. For the systematic review, CAM studies were classified under "manual practices," "natural practices," and "mind-body practices." A total of 35 clinical trials were selected for inclusion in the systematic review, comprising adult samples. The systematic review revealed 11 RCTs with manual practice, 12 with mind-body practice, and 12 with natural medicine practice. The methodological quality of the RCTs was measured using the modified Jadad scale, a scientific quality index of ≥ 5/10 (on the augmented Jadad scale). Effect sizes (Cohen’s d) were calculated and reported in all placebo-controlled studies with the available data. Regardless of systematic reviews, and randomized controlled trials on CAM, acupuncture, acupressure, herbal medicine, yoga, and tai chi, for insomnia, most of the RCTs did not agree with the findings. Further RCT for insomnia should be developed by considering the current advanced studies in the field of CAM.
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23
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薛 晨, 李 雨, 钟 冬, 李 涓, 郑 重, 金 荣. [Research progress of effect of Tai Chi on cognitive function in the elderly based on neuroelectrophysiological techniques and brain imaging techniques]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2022; 39:826-832. [PMID: 36008347 PMCID: PMC10957349 DOI: 10.7507/1001-5515.202105003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/14/2022] [Indexed: 06/15/2023]
Abstract
With the increasing prominence of population aging, the cognitive decline of the elderly has gradually become a hotspot of clinical research. As a traditional rehabilitation exercise, Tai Chi has been proved to have a positive effect on improving cognitive function and delaying cognitive decline in the elderly. However, the related brain function mechanism is still unclear. In this paper, we collected studies which observed the changes of Tai Chi on brain regions related to cognitive function in the elderly using magnetic resonance imaging (MRI), electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS). We summarized relevant studies from perspective of structural and functional changes in the brain. The results showed that Tai Chi may delay and improve cognitive decline in the elderly by reshaping the structure and function of brain regions related to cognitive function such as memory, attention and execution. The effect of Tai Chi for cognitive function may be associated with positive regulation of cardiovascular function, emotion and meditation level of the elderly. In addition, the improvement of cognitive function further enhances the balance of the elderly. We also found that practice time, frequency and intensity of Tai Chi could be factors influencing the improvement of cognitive function and brain function in the elderly.
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Affiliation(s)
- 晨 薛
- 成都中医药大学 养生康复学院(成都 610075)Institution of Health and Rehabilitation, Chengdu University of TCM, Chengdu 610075, P. R. China
- 四川大学华西医院 神经生物检测中心(成都 610041)Center for Neurobiological Detection, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
| | - 雨谿 李
- 成都中医药大学 养生康复学院(成都 610075)Institution of Health and Rehabilitation, Chengdu University of TCM, Chengdu 610075, P. R. China
| | - 冬灵 钟
- 成都中医药大学 养生康复学院(成都 610075)Institution of Health and Rehabilitation, Chengdu University of TCM, Chengdu 610075, P. R. China
| | - 涓 李
- 成都中医药大学 养生康复学院(成都 610075)Institution of Health and Rehabilitation, Chengdu University of TCM, Chengdu 610075, P. R. China
| | - 重 郑
- 成都中医药大学 养生康复学院(成都 610075)Institution of Health and Rehabilitation, Chengdu University of TCM, Chengdu 610075, P. R. China
| | - 荣疆 金
- 成都中医药大学 养生康复学院(成都 610075)Institution of Health and Rehabilitation, Chengdu University of TCM, Chengdu 610075, P. R. China
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24
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Yang J, Du Y, Shen H, Ren S, Liu Z, Zheng D, Shi Q, Li Y, Wei GX. Mindfulness-Based Movement Intervention to Improve Sleep Quality: A Meta-Analysis and Moderator Analysis of Randomized Clinical Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10284. [PMID: 36011918 PMCID: PMC9408303 DOI: 10.3390/ijerph191610284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: Given that the most effective dose, optimal type, and most beneficial population for improving sleep with mindfulness-based movement (MBM) remains unknown, we conducted a systematic review and meta-analysis with moderator analysis of randomized controlled trials (RCTs) to assess these effects. (2) Methods: Three electronic databases (PubMed, Web of Science, and EBSCO) were systematically searched for RCTs published through August 2021 for analysis. The risk of bias of the included studies was assessed with Review Manager 5.3, and the meta-analysis was performed in Stata 16.0. (3) Results: A meta-analysis of 61 RCTs with 2697 participants showed that MBM significantly improved sleep quality compared to controls (SMD = −0.794; 95% CI: −0.794 to −0.994, p < 0.001, I2 = 90.7%). Moderator analysis showed that a long-term MBM (SMD = −0.829; 95% CI: 0.945 to 0.712; p < 0.001) had a larger effect size on sleep than a short-term MBM (SMD = −0.714; 95% CI: 0.784 to 0.644; p < 0.001). Practicing at least twice per week (SMD = −0.793; 95% CI: −0.868 to −0.718; p < 0.001) was more effective compared to practicing once per week (SMD = −0.687; 95% CI: −0.804 to −0.570; p < 0.001). Studies with a total intervention time of more than 24 h also revealed better sleep quality improvement (SMD = −0.759; 95% CI: −0.865 to −0.653; p < 0.001). In addition, the healthy population and older adults gained more from MBM than the patients and younger adults. (4) Conclusions: MBM can effectively improve subjective sleep quality, and the optimal intervention dose of MBM can be utilized in future intervention studies to treat or improve sleep disturbance (MBM more than twice a week for more than three months, with a total intervention time of more than 24 h).
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Affiliation(s)
- Jiayi Yang
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing 100875, China
| | - Yan Du
- School of Nursing, Health Science San Antonio, University of Texas, Austin, TX 78712, USA
| | - Haoran Shen
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 101408, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 101408, China
| | - Shujie Ren
- School of Education, Beijing Sport University, Beijing 100084, China
| | - Zhiyuan Liu
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Danni Zheng
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Qingqing Shi
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Youfa Li
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing 100875, China
| | - Gao-Xia Wei
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 101408, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 101408, China
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25
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Intervenções para prevenção de quedas em idosos na Atenção Primária: revisão sistemática. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ar022566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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26
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Liao T, Ke XW, Wang YT. Wheelchair Tai Chi Ball Exercise for Improving Neuromuscular Functions of Older Adults With Disability. Front Aging Neurosci 2022; 14:935986. [PMID: 35928991 PMCID: PMC9344890 DOI: 10.3389/fnagi.2022.935986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022] Open
Abstract
The purposes of this perspective article were to summarize Wheelchair or Seated Tai Chi studies related to neuromuscular functions of older adults with disability; to describe the development of Wheelchair Tai Chi Ball (WTCB) exercise — a concept to combine mind-body exercise with strength training; and to propose a new Telehealth WTCB exercise for improving neuromuscular functions of old adults with spinal cord injury (SCI) and disability. With reference to neuromuscular functions, WTC intervention may have positive effects on simple reaction time, range of motion at the shoulder and trunk, static and dynamic sitting balance, handgrip strength, vagal activity, and sympathetic activity among older adults with disability. The developed WTCB intervention is a feasible and safe exercise which combines the mind-body exercise and strength conditioning into one exercise which possesses aerobic, stretching and strength trainings and may facilitate neuromuscular functions of older adults with disability. The proposed Telehealth WTCB 12 forms (TWTCB12) exercise with a “Moving Shadow” method in the telehealth may enable the learner to superimpose learner’s image on an expert’s demonstrating model to enhance the learning and practice effects. Since wheelchair users will learn and practice TWTCB12 movements in a seated position or sitting on a wheelchair the “Moving shadow” method on Zoom would provide an ideal telehealth learning and practice environment for the wheelchair users to learn and practice TWTCB12 exercise from home more feasible and user friendly.
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Affiliation(s)
- Ting Liao
- Aquatic Therapy and Fitness Research Center, Wuhan Sports University, Wuhan, China
| | - Xiong-Wen Ke
- Department of Marital Art, Wuhan Sports University, Wuhan, China
- Department of Medical Sciences, Health and Management, Rochester Institute of Technology, Rochester, NY, United States
| | - Yong Tai Wang
- Department of Medical Sciences, Health and Management, Rochester Institute of Technology, Rochester, NY, United States
- *Correspondence: Yong Tai Wang,
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27
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Baklouti S, Aloui A, Baklouti H, Souissi N, Jarraya M. Effects of Hatha yoga on cognitive functions in the elderly: a cross-sectional study. Libyan J Med 2022; 17:2080799. [PMID: 35657065 PMCID: PMC9176371 DOI: 10.1080/19932820.2022.2080799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
This study aimed to investigate the effects of Hatha yoga practice on cognitive functions in the elderly. Thirty healthy older men participated in this study. They belonged to 2 groups. The first group included 15 Hatha yoga practitioners for at least 2 years. The control group involved 15 male older adults who shared the same characteristics (age, years of formal education, and level of physical activity) as the Hatha yoga group but were naive to yoga, meditation, or any mind-body intervention. Neuropsychological tests were applied to measure selective attention, sustained attention, episodic memory, and processing speed. The following tests were administered: The French adaptation of the Victoria Stroop test, the Zazzo's Cancellation Task, the Five Word Test, and a battery of computerized tests to evaluate reaction time. Long-term Hatha yoga practice showed promising results related to executive functions and reaction time, but no significant difference was found between the two groups in episodic memory and sustained attention although a trend of improvement was observed in favor of Hatha yoga practitioners. In conclusion, long-term Hatha yoga practitioners have better cognitive abilities compared to the control group in certain aspects of cognitive functions. Further physiological and psychological variables need to be examined in order to highlight the correlation between yoga intervention and cognitive performance.
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Affiliation(s)
- Souad Baklouti
- Physical Activity, Sport and Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia
| | - Asma Aloui
- Physical Activity, Sport and Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia.,High Institute of Sport and Physical Education, University of Gafsa, Gafsa, Tunisia
| | - Hana Baklouti
- Physical Activity, Sport and Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia
| | - Nizar Souissi
- Physical Activity, Sport and Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia
| | - Mohamed Jarraya
- High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
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28
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Effects of Exercise on Sleep in Older Adults: An Overview of Systematic Reviews and Meta-Analyses. J Aging Phys Act 2022; 30:1101-1117. [PMID: 35385825 DOI: 10.1123/japa.2021-0444] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/31/2022] [Accepted: 03/01/2022] [Indexed: 11/18/2022]
Abstract
We aimed to systematically analyze reviews of randomized clinical trials that investigate the overall effect of exercise and of different types of exercise on sleep in older adults. Meta-analysis was performed to obtain the standardized mean difference of the effect of the different types of exercise. Twenty systematic reviews published between 2012 and 2020 met the inclusion criteria of this overview. Moderate significant effects of exercise were observed on overall sleep quality and its subjective components (quality, duration, latency, habitual efficiency, medication use, and daytime dysfunction). Among the types of exercise, sensitivity analysis revealed significant effects of Pilates, Tai Chi, and Baduanjin Qigong on sleep quality. Exercise has a positive effect on sleep quality in older people. Our findings are extremely important, especially for decision makers in the health area, permitting the planning of actions and evidence-based decision making. PROSPERO registration number: CRD42020222469.
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29
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Sella E, Toffalini E, Canini L, Borella E. Non-pharmacological interventions targeting sleep quality in older adults: a systematic review and meta-analysis. Aging Ment Health 2022; 27:847-861. [PMID: 35352595 DOI: 10.1080/13607863.2022.2056879] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives: This review aimed to examine the available evidence about non-pharmacological interventions (NPIs) aimed at improving sleep quality in older adults without insomnia or dementia.Methods: Studies on NPIs targeting older adults' sleep were searched in the PsycInfo, PubMed and Scopus databases, with no restriction on publication year up to September 2021. Studies on NPIs for older adults with no diagnosed sleep disorders were included, while those on pharmacological therapies and/or concerning pathological samples were excluded. The risk of bias was assessed using tools based on Joanna Briggs' criteria. The data extracted were meta-analyzed using random effects models for subgroups of NPIs.Results: Of the 1,893 records identified, 31 studies on NPIs (N = 2,224; range of mean ages: 60-78 years) were analyzed. All NPIs improved self-reported sleep quality, albeit to a different extent (physical activity: d=.97 - 95% CI=.62, 1.32-; psychological/psychoeducational, or NPIs that combined more than one sleep-targeting activity: d range: .21 to .97). Only the NPIs based on physical activity improved objectively-measured sleep, d=.31 (.04, .57). The methodological quality of most studies was limited.Conclusion: The most often used NPIs targeting sleep rely on physical activity and sensory stimulation with promising results on sleep quality for the former. More data are needed on psychological/psychoeducational NPIs and combined interventions in order to test their effectiveness. The methodological weaknesses of the available studies suggest they their findings should be interpreted with caution.
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Affiliation(s)
- Enrico Sella
- Department of General Psychology, University of Padova, Padova, Italy
| | - Enrico Toffalini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Luca Canini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Erika Borella
- Department of General Psychology, University of Padova, Padova, Italy
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30
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Rosa JPP, Gentil P, Knechtle B, Vancini RL, Campos MH, Vieira CA, Andrade MS, de Lira CAB. Technology and Sleep Quality: Friend or Foe? Let the Exergames Come into Play! Int J Sports Med 2022; 43:768-772. [PMID: 35315004 DOI: 10.1055/a-1756-5005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Low sleep quality is associated with many health problems. Although physical exercise is a nonpharmacological tool that positively impacts sleep quality, there are many barriers (lack of energy, lack of motivation, lack of skills, lack of resources, and fear of injury) for people to adopt an active lifestyle. Exergames are an alternative way of physical exercise that are funnier and more attractive than traditional forms of physical exercise and, therefore, has the potential to increase adherence to a physical exercise program. Given that previous studies showed that exergames presents similar physiological and psychological outcomes to traditional forms of exercise, we aimed to discuss in this narrative review potentials applications, limitations and perspectives of using exergames to improve sleep quality.
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Affiliation(s)
- João Paulo Pereira Rosa
- Faculdade Educação Física e Dança, Universidade Federal de Goias - Campus Samambaia, Goiania, Brazil
| | - Paulo Gentil
- Faculdade Educação Física e Dança, Universidade Federal de Goias - Campus Samambaia, Goiania, Brazil
| | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland.,Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Rodrigo Luiz Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Mário Hebling Campos
- Faculdade Educação Física e Dança, Universidade Federal de Goias - Campus Samambaia, Goiania, Brazil
| | - Carlos Alexendre Vieira
- Faculdade Educação Física e Dança, Universidade Federal de Goias - Campus Samambaia, Goiania, Brazil
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31
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Comparing the Effectiveness of Multicomponent Sleep-Promoting Interventions on the Sleep Quality of Menopausal Women: A Quasi-Experimental Study. Healthcare (Basel) 2022; 10:healthcare10030559. [PMID: 35327037 PMCID: PMC8954696 DOI: 10.3390/healthcare10030559] [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: 02/06/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 01/27/2023] Open
Abstract
Sleep disturbance is considered one of the hallmarks of the common symptoms experienced by women during and after menopause. This study aimed to compare the effectiveness of two different multiple-component, sleep-promoting interventions on the sleep quality of menopausal women. A quasi-experimental study and repeated measured design, with a four-week sleep-promoting intervention, was conducted. A total of 123 eligible participants were recruited from a health center in northern Taiwan and divided into the progressive muscle relaxation plus sleep hygiene (PMRS), the meditative movement relaxation plus sleep hygiene (MMRS), or control group at a 1:1:1 ratio. The Chinese version of Pittsburgh sleep quality index and actigraphy were used to assess the sleep disturbances of menopausal women. The subjective sleep data was collected before, immediately after the intervention, 8 weeks, and 12 weeks after the intervention. The results showed that the global score of subjective sleep quality and its components were significantly improved after both interventions. Additionally, the MMRS was superior to the PMRS for subjective sleep quality. Moreover, the objective sleep indices indicated that sleep latency was reduced after both the interventions. These findings can serve as a reference for nurses when caring for menopausal women with sleep disturbance.
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32
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Han D, Cheng J, Qu J, Wen X, Liu X, Chen Y, Wen Y, Liu Z, Liu H, Huang Y. Effectiveness of Taijiquan in treating insomnia: A systematic review and meta-analysis of randomized controlled studies. Front Psychiatry 2022; 13:892453. [PMID: 36238941 PMCID: PMC9551091 DOI: 10.3389/fpsyt.2022.892453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sleep efficiency of <80% based on actigraphy was defined as insomnia as self-reported difficulty falling asleep or waking up at night three to four times per week. It is known that adequate sleep is very important for human wellbeing, affecting people's work and life, insomnia will seriously damage our daily life. There is no recognized non-drug treatment. Studies have found that Taijiquan has a positive effect on insomnia patients. This systematic review and meta-analysis will evaluate the effect of Taijiquan on insomnia. METHODS To find all randomized controlled trials exploring the effects of Taijiquan on insomnia patients in Chinese and English, eight databases (Pubmed, Embase, Cochrane library, Web of Science, CNKI, CBM, VIP, and Wanfang Data) were searched. The retrieval time is from database construction to October 2021. Searches were conducted in both English and Chinese language. A meta-analysis by mean difference (MD) and 95% confidence interval (CI) was performed with RevMan 5.3. The risk of bias for each study was accounted for according to the Cochrane Handbook. Our primary outcome was Pittsburg Sleep Quality Index. We explored sources of heterogeneity by comparing effect sizes across different types of etiology, country, control group, and intervention type. The protocol was pre-registered with PROSPERO, CRD42021284511. RESULTS Twenty-one RCTs published between 2004 and 2021 with 2,022 participants were included in this study. Twenty-one randomized controlled studies showed that Tai Chi significantly improved PSQI scores in patients with cancer, muscle fibrosis, and sub-health insomnia [MD = -1.16, 95% CI (-1.62, -0.71), P < 0.01]; There is insufficient evidence of improvement in patients with cerebrovascular disease [MD = -0.54, 95% CI (-1.58, 0.51), P = 0.31]; 8-form, 10-form or 24-form Yang's Taijiquan had the same effect in improving PSQI [MD = -1.33, 95% CI (-1.85, -0.81), P < 0.01]. When there is no treatment, exercise, exercise and health education as the control, taijiquan has a significant effect on insomnia treatment, and there is no difference in efficacy compared with cognitive behavioral therapy and health education (usual care) alone. CONCLUSIONS The results of the study showed that Taijiquan significantly improved sleep quality in healthy adults and patients with chronic diseases, which suggests that Taijiquan may be considered as an alternative behavioral therapy in the treatment of insomnia. In the future, more high-quality, well-controlled randomized trials are needed to better inform clinical decisions.
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Affiliation(s)
- Dongmiao Han
- School of Rehabilitation, Gannan Medical University, Ganzhou, China
| | - Jinling Cheng
- School of Rehabilitation, Gannan Medical University, Ganzhou, China
| | - Jiayang Qu
- School of Rehabilitation, Gannan Medical University, Ganzhou, China
| | - Xin Wen
- School of Rehabilitation, Gannan Medical University, Ganzhou, China.,Department of Rehabilitation Medicine, YueBei People's Hospital, Shaoguan, China
| | - Xuejin Liu
- School of Rehabilitation, Gannan Medical University, Ganzhou, China.,Department of Rehabilitation Medicine, YueBei People's Hospital, Shaoguan, China
| | - Yanfeng Chen
- School of Rehabilitation, Gannan Medical University, Ganzhou, China
| | - Youliang Wen
- School of Rehabilitation, Gannan Medical University, Ganzhou, China
| | - Zicai Liu
- School of Rehabilitation, Gannan Medical University, Ganzhou, China.,Department of Rehabilitation Medicine, YueBei People's Hospital, Shaoguan, China
| | - Huiyu Liu
- Department of Rehabilitation Medicine, YueBei People's Hospital, Shaoguan, China
| | - Ying Huang
- School of Rehabilitation, Gannan Medical University, Ganzhou, China
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33
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Wu YHT, He WB, Gao YY, Han XM. Effects of traditional Chinese exercises and general aerobic exercises on older adults with sleep disorders: A systematic review and meta-analysis. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2021; 19:493-502. [PMID: 34649821 DOI: 10.1016/j.joim.2021.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 12/18/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sleep disorders are common in older adults and have a negative influence on their physical and mental health. General aerobic exercises (GAEs) have long been used in the treatment of sleep disorders as a non-pharmacological measure. However, there is no consensus on the efficacy of traditional Chinese exercises (TCEs) for treating sleep disorders in older adults and the difference between TCEs and GAEs. OBJECTIVE This study assessed the effects of TCEs and GAEs on the sleep quality of older adults and the differences between these two interventions. SEARCH STRATEGY PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, China Science Journal Database and Wanfang Data were searched from their inception to August 2020. INCLUSION CRITERIA Randomized controlled trials (RCTs) that evaluated the effects of TCEs and GAEs on older adults with sleep disorders were included. DATA EXTRACTION AND ANALYSIS Data were extracted by two researchers working independently. The risk bias of included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and the quality of evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. The Pittsburgh Sleep Quality Index (PSQI) was used to estimate sleep quality. Meta-analyses were performed to assess the total PSQI score of the exercise intervention as the primary outcome, and the scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication and daytime dysfunction were assessed as secondary outcomes. Subgroup, sensitivity, and meta-regression analyses were conducted to assess the contribution of covariables to heterogeneity. RESULTS A total of 22 RCTs (including 1747 participants) were included in the meta-analysis. The results indicated that TCEs (weighted mean difference [WMD] = -2.14, 95% confidence interval [CI] [-2.82, -1.46], P < 0.001; heterogeneity: P < 0.001, I2 = 82%; 15 studies, n = 1063) and GAEs (WMD = -2.88, 95% CI [-5.22, -0.55], P < 0.001; heterogeneity: P < 0.001, I2 = 98%; 5 studies, n = 500) significantly improved total sleep quality, having favorable effects on subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication and daytime dysfunction. Subgroup analysis showed that TCEs demonstrated superiority after 12 weeks (WMD = -2.77, 95% CI [-4.26, -1.28], P < 0.001; heterogeneity: P < 0.001, I2 = 85%; 5 studies, n = 420) and Qigong had a greater intervention effect for improving the sleep quality of older adults than Tai Chi (WMD = -3.37, 95% CI [-4.38, -2.35], P < 0.001; heterogeneity: P = 0.04, I2 = 63%; 4 studies, n = 321). Meta-regression revealed that the year of publication, sample size, mean age of participants, and percentage of females in the primary studies did not account for the overall heterogeneity. CONCLUSION Current evidence shows that both TCEs and GAEs, as complementary and non-pharmacological approaches, help to improve the sleep quality in older adults with potentially clinical implications; however, there was not enough evidence to conclude the difference between them. More rigorous and high-quality RCTs are needed to arrive at reliable conclusions.
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Affiliation(s)
- Yang-Hao-Tian Wu
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Wen-Bo He
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Yin-Yan Gao
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Xue-Mei Han
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu Province, China.
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Caristia S, Campani D, Cannici C, Frontera E, Giarda G, Pisterzi S, Terranova L, Payedimarri AB, Faggiano F, Dal Molin A. Physical exercise and fall prevention: A systematic review and meta-analysis of experimental studies included in Cochrane reviews. Geriatr Nurs 2021; 42:1275-1286. [PMID: 34555570 DOI: 10.1016/j.gerinurse.2021.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 01/04/2023]
Abstract
The aim of this systematic review (SR) and meta-analysis was to assess what type of exercise is associated with fall risk reduction among apparently healthy adults aged 50 and older. We conducted a SR by searching for randomized controlled trials (RCTs) included in Cochrane SRs published until October 2019. Five SRs that compared exercise versus any type of control included 32 RCTs. The outcomes examined were falls, fallers, fractures, and fear of falling. A random effects-based meta-analysis by type of exercise was performed. Almost all the interventions were effective for fall rate reduction, with a major effect for three-dimensional exercise, strength/resistance exercises, and mixed exercises. The number of fallers was reduced by three-dimensional exercise and mixed exercises. Fall-related fractures were generally reduced by all types of exercises considered all together, but none singly resulted in statistically effective fracture prevention. Fear of falling was slightly decreased with endurance exercises.
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Affiliation(s)
- Silvia Caristia
- Department of Translational Medicine, Università del Piemonte Orientale, Via G. Solaroli 17, Novara 28100, Italy
| | - Daiana Campani
- Department of Translational Medicine, Università del Piemonte Orientale, Via G. Solaroli 17, Novara 28100, Italy.
| | - Chiara Cannici
- Hematology Department, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Via Venezia, 16, Alessandria 15121, Italy
| | - Edoardo Frontera
- S. Andrea Hospital, Local Health Unit of Vercelli, Corso M. Abbiate 21, Vercelli 13100, Italy
| | - Giulia Giarda
- D.E.A. of Local Health Unit of Torino, Corso Galileo Ferraris 3, Chivasso 10034, Italy
| | - Sara Pisterzi
- Hospital of Local Health Unit of Biella, Via dei Ponderanesi 2, Ponderano 13875, Italy
| | - Luisa Terranova
- Hospital of Local Health Unit of Biella, Via dei Ponderanesi 2, Ponderano 13875, Italy
| | - Anil Babu Payedimarri
- Department of Translational Medicine, Università del Piemonte Orientale, Via G. Solaroli 17, Novara 28100, Italy
| | - Fabrizio Faggiano
- Department of Translational Medicine, Università del Piemonte Orientale, Via G. Solaroli 17, Novara 28100, Italy
| | - Alberto Dal Molin
- Department of Translational Medicine, Università del Piemonte Orientale, Via G. Solaroli 17, Novara 28100, Italy; Health Professions' Direction, Maggiore della Carità Hospital, Corso Mazzini 18, Novara 28100, Italy
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Kruisbrink M, Delbaere K, Kempen GIJM, Crutzen R, Ambergen T, Cheung KL, Kendrick D, Iliffe S, Zijlstra GAR. Intervention Characteristics Associated With a Reduction in Fear of Falling Among Community-Dwelling Older People: A Systematic Review and Meta-analysis of Randomized Controlled Trials. THE GERONTOLOGIST 2021; 61:e269-e282. [PMID: 32267498 PMCID: PMC8361503 DOI: 10.1093/geront/gnaa021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Fear of falling (FoF) is associated with decreased physical functioning and an increased fall risk. Interventions generally demonstrate moderate effects and optimized interventions are needed. Intervention characteristics, such as setting or delivery method may vary. We investigated which overarching intervention characteristics are associated with a reduction in FoF in community-dwelling older people. RESEARCH DESIGN AND METHODS A systematic review and meta-analysis of randomized controlled trials (RCTs) in community-dwelling older people without specific diseases was performed. Associations between intervention characteristics and standardized mean differences (SMD) were determined by univariate meta-regression. Sensitivity analyses were performed. RESULTS Data on 62 RCTs were extracted, 50 intervention groups were included in the meta-analysis. Most intervention characteristics and intervention types were not associated with the intervention effect. Supervision by a tai chi instructor (SMD: -1.047, 95% confidence interval [CI]: -1.598; -0.496) and delivery in a community setting (SMD: -0.528, 95% CI: -0.894; -0.161) were-compared to interventions without these characteristics-associated with a greater reduction in FoF. Holistic exercise, such as Pilates or yoga (SMD: -0.823, 95% CI: -1.255; -0.392), was also associated with a greater reduction in FoF. Delivery at home (SMD: 0.384, 95% CI: 0.002; 0.766) or with written materials (SMD: 0.452, 95% CI: 0.088; 0.815) and tailoring were less effective in reducing FoF (SMD: 0.687, 95% CI: 0.364; 1.011). DISCUSSION AND IMPLICATIONS Holistic exercise, delivery with written materials, the setting and tailoring potentially represent characteristics to take into account when designing and improving interventions for FoF in community-dwelling older people. PROSPERO international prospective register of systematic reviews, registration ID CRD42018080483.
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Affiliation(s)
- Marlot Kruisbrink
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, the Netherlands.,Neuroscience Research Australia, School of Public Health and Community Medicine, UNSW, Randwick, New South Wales, Australia
| | - Kim Delbaere
- Neuroscience Research Australia, School of Public Health and Community Medicine, UNSW, Randwick, New South Wales, Australia.,Care and Public Health Research Institute, Department of Methodology and Statistics, Maastricht University, Maastricht, the Netherlands
| | - Gertrudis I J M Kempen
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, the Netherlands.,Neuroscience Research Australia, School of Public Health and Community Medicine, UNSW, Randwick, New South Wales, Australia
| | - Rik Crutzen
- Maastricht University, Care and Public Health Research Institute, Department of Health Promotion, Maastricht, the Netherlands
| | - Ton Ambergen
- Care and Public Health Research Institute, Department of Methodology and Statistics, Maastricht University, Maastricht, the Netherlands
| | - Kei-Long Cheung
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University, London, United Kingdom
| | - Denise Kendrick
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Steve Iliffe
- Research Department of Primary Care & Population Health, University College London, London, United Kingdom
| | - G A Rixt Zijlstra
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, the Netherlands.,Neuroscience Research Australia, School of Public Health and Community Medicine, UNSW, Randwick, New South Wales, Australia
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Liu F, Chen X, Nie P, Lin S, Guo J, Chen J, Yu L. Can Tai Chi Improve Cognitive Function? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Altern Complement Med 2021; 27:1070-1083. [PMID: 34314596 DOI: 10.1089/acm.2021.0084] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Tai Chi (TC) is a traditional Chinese martial art with demonstrated beneficial effects on physical and mental health. In this study, the authors performed a systematic review to assess the efficiency of TC in different populations' cognitive function improvement. Design: The present systematic review utilized the Chinese National Knowledge Infrastructure (1915-), Wanfang (1998-), VIP (1989-), Chinese Biomedicine databases (1978-), PubMed (1950-), Web of Science (1900-), Cochrane Library (1948-), Embase (1974-), EBSCOhost (1922-), and OVID (1996-) databases to search and identify relevant articles published in English and Chinese from the beginning of coverage through October 17, 2020. Randomized controlled trials (RCTs) published from the beginning of coverage through October 17, 2020 in English and Chinese were retrieved from many indexing databases. Selected studies were graded according to the Cochrane Handbook for Systematic Reviews of Intervention 5.1.0. The outcome measures of cognitive function due to traditional TC intervention were obtained. Meta-analysis was conducted by using RevMan 5.4 software. We follow the PRISMA 2020 guidelines. Results: Thirty-three RCTs, with a total of 1808 participants, were included. The study showed that TC could progress global cognition when assessed in middle-aged as well as elderly patients suffering from cognitive and executive function impairment. The findings are as follows: Montreal Cognitive Assessment Scale: mean difference (MD) = 3.23, 95% CI = 1.88-4.58, p < 0.00001, Mini-Mental State Exam: MD = 3.69, 95% CI = 0.31-7.08, p = 0.03, Trail Making Test-Part B: MD = -13.69, 95% CI = -21.64 to -5.74, p = 0.0007. The memory function of older adults assessed by the Wechsler Memory Scale was as follows: MD = 23.32, 95% CI = 17.93-28.71, p < 0.00001. The executive function of college students evaluated by E-prime software through the Flanker test was as follows: MD = -16.32, 95% CI = -22.71 to -9.94, p < 0.00001. Conclusion: The TC might have a positive effect on the improvement of cognitive function in middle-aged and elderly people with cognitive impairment as well as older adults and college students.
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Affiliation(s)
- Fang Liu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xinming Chen
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Pingying Nie
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shaohong Lin
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiaying Guo
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Junying Chen
- Department of Orthopedics, Fujian Provincial Hospital, Fuzhou, China
| | - Liqiang Yu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Li S, Li Z, Wu Q, Liu C, Zhou Y, Chen L, Lan W, Li Y, Han S, Chen Z. Effect of exercise intervention on primary insomnia: a meta-analysis. J Sports Med Phys Fitness 2021; 61:857-866. [PMID: 34110122 DOI: 10.23736/s0022-4707.21.11443-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Exercise can have a positive effect on body functioning and immunity. This study systematically evaluated the effect of exercise intervention on patients diagnosed with primary insomnia. Based on the meta-analysis, we developed exercise recommendations to help improving sleep quality in these patients. EVIDENCE ACQUISITION Using a combination of manual and electronic retrieval strategies, we examined the CNKI, VIP, Wanfang, Web of Science, SpringerLink, EBSCO, PubMed, Cochrane Library, and Embase databases; and identified randomized controlled trials that addressed the effects of exercise intervention on primary insomnia and were published before October 2019. Risk of bias was assessed based on the Cochrane Handbook 5.1.0, and meta-analysis was conducted using STATA 13.0 (StataCorp LLC; College Station, TX, USA). EVIDENCE SYNTHESIS Data were included for 1269 patients who received exercise interventions and 1203 patients who received drug therapy or no intervention (controls) in 23 trials of high quality. Meta-analysis showed that exercise intervention had a significant effect on the treatment of primary insomnia (SMD: -1.64, 95% CI: -2.08 to -1.19, P<0.001). Subgroup analysis showed significant effect sizes for older patients (>60 years) (SMD: -1.69, 95% CI: -2.40 to -0.97, P<0.001), aerobic exercise (SMD: -2.21, 95% CI: -2.89 to -1.53, P<0.001), interventions lasting 8-12 weeks (SMD: -2.58, 95% CI: -3.61 to -1.54, P<0.001), interventions lasting ≤60 min (SMD: -2.29, 95% CI: -3.66 to -0.92, P=0.001), Asian patients (SMD: -1.86, 95% CI: -2.42 to -1.31, P<0.001), and interventions ≤4 times/week (SMD: -1.70, 95% CI: -2.29 to -1.11, P<0.001). Both bias and sensitivity analyses suggested that our meta-analysis gave robust results. CONCLUSIONS Our results indicate that exercise intervention has a significant positive influence on primary insomnia, especially for older patients. We recommend that an exercise regimen of 60 min 4-5 times a week for 8-12 weeks can improve sleep quality and treat the symptoms of primary insomnia. Future studies should focus on verifying and extending our results by increasing sample size and improving the quality of studies included.
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Affiliation(s)
- Shanshan Li
- Institute of Sport Science, Sichuan University, Chengdu, China
| | - Zhichao Li
- Institute of Sport Science, Sichuan University, Chengdu, China
| | - Qianjin Wu
- Institute of Sport Science, Sichuan University, Chengdu, China
| | - Chenyu Liu
- University for the Creative Arts, Farnham, UK
| | - Yan Zhou
- Institute of Sport Science, Sichuan University, Chengdu, China
| | - Lan Chen
- Institute of Sport Science, Sichuan University, Chengdu, China
| | - Wencen Lan
- Institute of Sport Science, Sichuan University, Chengdu, China
| | - Yan Li
- Institute of Sport Science, Sichuan University, Chengdu, China
| | - Song Han
- Institute of Sport Science, Sichuan University, Chengdu, China
| | - Zichao Chen
- Institute of Sport Science, Sichuan University, Chengdu, China -
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Amiri S, Hasani J, Satkin M. Effect of exercise training on improving sleep disturbances: a systematic review and meta-analysis of randomized control trials. Sleep Med 2021; 84:205-218. [PMID: 34166987 DOI: 10.1016/j.sleep.2021.05.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/11/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Exercise training has beneficial effects on various aspects of health. This study aimed to investigate the effect of exercise training on the improvement of sleep disturbances using systematic review and meta-analysis of randomized control trials. METHOD Four indexes of scientific information including PubMed, Web of Science, Scopus, and the Cochrane library were selected and all manuscripts of these sources were searched in English until January 2021. The studies were screened and finally, the studies were entered into meta-analysis and the Standardized Mean Difference (SMD) was calculated, and the analyzes were performed based on the random effects method. Publication bias and heterogeneity were examined in all analyzes. RESULT A total of 32 studies were included in the meta-analysis. Meta-analysis showed that exercise training is effective in improving sleep quality (SMD = -0.85 and confidence interval (CI) was -1.16-0.54; P < 0.001). Exercise training improving insomnia (SMD = -0.87 and CI was -1.68-0.06; P = 0.036). Exercise training improves sleepiness (SMD = -0.38 and CI was -0.68-0.07; P = 0.016), obstructive sleep apnea (SMD = -0.40 and CI was -0.67-0.14; P = 0.003) and restless legs syndrome (SMD = -1.02 and CI was -1.56-0.49; P < 0.001). DISCUSSION Exercise training has beneficial effects on a variety of sleep disturbances and therefore it can be said that providing the necessary conditions for exercise training can play a major role in promoting health, especially since this type of intervention is a non-pharmacological intervention.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran; Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Jafar Hasani
- Department of Psychology, Kharazmi University, Tehran, Iran
| | - Mojtaba Satkin
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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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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Yang SY, Lee HC, Huang CM, Chen JJ. Efficacy of Tai Chi-Style Multi-Component Exercise on Frontal-Related Cognition and Physical Health in Elderly With Amnestic Mild Cognitive Impairment. FRONTIERS IN AGING 2021; 2:636390. [PMID: 35822039 PMCID: PMC9261301 DOI: 10.3389/fragi.2021.636390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/17/2021] [Indexed: 02/06/2023]
Abstract
Early prevention from accelerated neurocognitive declines with advanced aging and the delay of the onset of dementia have became paramount for the achievement of active aging. The present study examined whether the proposed non-pharmaceutical, multi-component exercise training which combined Tai-Chi exercise, Aerobic fitness, and thera-band therapy protects against age-related neurocognitive and physical deterioration in the older participants with amnestic mild cognitive impairment (aMCI). Participants with aMCI in the quasi-experimental design were assigned to the multi-component exercise group or care control group. Evaluations of neuropsychological function and functional fitness were performed before and after 12-weeks intervention, and after 24-weeks follow-up. Our results showed that the multi-component intervention significantly improved various domains of neurocognitive function, particularly in memory- and frontal-related cognition, and better performance on functional fitness, including muscle strength, cardiopulmonary endurance, and agility. Furthermore, such beneficial effects were preserved after 24 weeks. The findings provide supportive evidence that non-pharmaceutically multi-component intervention with Tai-Chi style practice as a core exercise may protect against age-related neurocognitive and physical deficits and lay the path on developing age-friendly intervention programs to delay, or even reverse, the progression of MCI to dementia.
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Affiliation(s)
- Shao-Yun Yang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sports and Health Science Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsuei-Chen Lee
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sports and Health Science Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-devices (IDSB), National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- *Correspondence: Chih-Mao Huang, ; Jin-Jong Chen,
| | - Jin-Jong Chen
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sports and Health Science Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Innovation Center of Artificial Intelligence for Precision Exercise and Health Promotion, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- *Correspondence: Chih-Mao Huang, ; Jin-Jong Chen,
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Chen ML, Wotiz SB, Banks SM, Connors SA, Shi Y. Dose-Response Association of Tai Chi and Cognition among Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3179. [PMID: 33808633 PMCID: PMC8003349 DOI: 10.3390/ijerph18063179] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/16/2021] [Accepted: 03/15/2021] [Indexed: 12/16/2022]
Abstract
Previous studies indicated that Tai Chi might be an effective way to improve or prevent cognitive impairments in older populations. However, existing research does not provide clear recommendations about the optimal dose of Tai Chi practice, which is the most effective in improving cognitive function in older adults. The purpose of this systematic review and meta-analysis was to investigate the dose-response relationship between Tai Chi and cognition in community-dwelling older adults. A total of 16 studies with 1121 subjects were included in this study. Meta-regression analyses of Tai Chi duration (Tai Chi session duration, Tai Chi practice duration per week, study duration, and Tai Chi practice duration for the entire study) on the study effect size (ES) were performed to examine the dose-response association of Tai Chi and cognition. The results showed that there was a positive effect of Tai Chi on cognitive function, but there were no statistically significant dose duration effects on cognition. The findings suggest that Tai Chi has beneficial effects on cognitive function, but a longer duration was not associated with larger effects. In order to establish evidence-based clinical interventions using Tai Chi, future research should clearly demonstrate intervention protocol, particularly the style and intensity of Tai Chi.
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Affiliation(s)
- Mei-Lan Chen
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA 30303, USA; (S.B.W.); (S.M.B.); (S.A.C.)
- Gerontology Institute, Georgia State University, Atlanta, GA 30303, USA
| | - Stephanie B. Wotiz
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA 30303, USA; (S.B.W.); (S.M.B.); (S.A.C.)
| | - Starr M. Banks
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA 30303, USA; (S.B.W.); (S.M.B.); (S.A.C.)
| | - Sabine A. Connors
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA 30303, USA; (S.B.W.); (S.M.B.); (S.A.C.)
| | - Yuyin Shi
- Department of Mathematics, University of Maryland, College Park, MD 20742, USA;
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Chen FT, Etnier JL, Chan KH, Chiu PK, Hung TM, Chang YK. Effects of Exercise Training Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis. Sports Med 2021; 50:1451-1467. [PMID: 32447717 PMCID: PMC7376513 DOI: 10.1007/s40279-020-01292-x] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background Chronic exercise training has been shown be to positively associated with executive function (EF) in older adults. However, whether the exercise training effect on EF is affected by moderators including the specific sub-domain of EF, exercise prescription variables, and sample characteristics remains unknown. Objectives This systematic and meta-analytic review of randomized controlled trials (RCTs) investigated the effects of exercise training on EF in older adults and explored potential moderators underlying the effects of exercise training on EF. Methods In accordance with the PRISMA guidelines, the electronic databases MEDLINE (PubMed) and EMBASE (Scopus) were searched from January 2003 to November 2019. All studies identified for inclusion were peer-reviewed and published in English. To be included, studies had to report findings from older (> 55 years old), cognitively normal adults or adults with mild cognitive impairment (MCI) randomized to an exercise training or a control group. The risk of bias in each study was appraised using the Cochrane risk-of-bias tool. Fixed-effects models were used to compare the effects of exercise training and control conditions on EF assessed at baseline and post-intervention. In addition, subgroup analyses were performed for three moderators (i.e., the specific sub-domain of EF, exercise prescription variables, and sample characteristics). Results Thirty-three RCTs were included. Overall, exercise training was associated with a significant small improvement in EF [Q(106) = 260.09, Hedges’ g = 0.21; p < 0.01]. The EF sub-domain moderator was not significant [Q(2) = 4.33, p > 0.05], showing that the EF improvement in response to exercise is evident for measures of inhibition, updating, and shifting. Regarding exercise prescription variables, results were significantly moderated by frequency of exercise training [Q(1) = 10.86, p < 0.05], revealing that effect sizes (ESs) were larger for moderate frequency (g = 0.31) as compared to low frequency exercise (g = 0.15). The results also showed type of exercise training moderated the ESs [Q(4) = 26.18, p < 0.05], revealing that ESs were largest for other forms of exercise (g = 0.44), followed by Tai Chi and yoga (g = 0.38), resistance exercise (g = 0.22), aerobic exercise (g = 0.14), and combined exercise (g = 0.10). In addition, The results showed moderated length of training the ESs [Q(2) = 16.64, p < 0.05], revealing that ESs were largest for short length (g = 0.32), followed by mid length (g = 0.26) and long length (g = 0.09). No significant difference in effects was observed as a function of exercise intensity [Q(1) = 2.87 p > 0.05] and session time [Q(2) = 0.21, p > 0.05]. Regarding sample characteristics, the results were significantly moderated by age [Q(2) = 20.64, p < 0.05], with significant benefits for young-old (55–65 years old) (g = 0.30) and mid-old (66–75 years old) (g = 0.25), but no effect on EF for old-old (more than 75 years old). The results were also significantly moderated by physical fitness levels [Q(1) = 10.80, p < 0.05], revealing that ESs were larger for sedentary participants (g = 0.33) as compared to physically fit participants (g = 0.16). In addition, results were also significantly moderated by cognitive status [Q(1) = 11.44, p < 0.05], revealing that ESs were larger for participants with cognitively normal (g = 0.26) as compared to those with mild cognitive impairment (g = 0.08). No significant differences in effects were observed as a function of sex [Q(2) = 5.38, p > 0.05]. Conclusions Exercise training showed a small beneficial effect on EF in older adults and the magnitude of the effect was different across some moderators.
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Affiliation(s)
- Feng-Tzu Chen
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan, ROC
| | - Jennifer L Etnier
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Kuei-Hui Chan
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan, ROC
| | - Ping-Kun Chiu
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan, ROC
| | - Tsung-Ming Hung
- Department of Physical Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei, Taiwan, ROC.,Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan, ROC
| | - Yu-Kai Chang
- Department of Physical Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei, Taiwan, ROC. .,Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan, ROC.
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Effects of Tai Chi Chuan on Cognitive Function in Older Adults with Cognitive Impairment: A Systematic and Meta-Analytic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:6683302. [PMID: 33424991 PMCID: PMC7781704 DOI: 10.1155/2020/6683302] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/03/2020] [Accepted: 12/18/2020] [Indexed: 11/18/2022]
Abstract
This systematic and meta-analytic review aimed to investigate the effects of Tai Chi Chuan (TCC) on the cognitive function of the elderly with cognitive impairment and to analyze the moderators of these effects. We searched eight electronic databases for randomized controlled trials on the effects of TCC on cognitive function, published up to June 14, 2020. The PEDro scale was used to evaluate the methodological quality of the included literature. Stata14.0 software was used for meta-analysis, subgroup analysis, and publication bias testing. A total of 19 studies and 1,970 samples were included. The methodological quality of the included literature was fair to good, and there was no publication bias. Overall, the research shows that the effect of TCC on the elderly with cognitive impairment is statistically significant (SMD = 0.31, p < 0.0001). Five of the cognitive function subdomains were significant moderators [Q (5) = 15.66, p=0.008], and the effect size (ES) was the largest for global cognitive function (SMD = 0.41), followed by executive function (SMD = 0.33), memory (SMD = 0.31), and verbal fluency (SMD = 0.27). Regarding the exercise prescription variables, results were significantly moderated by the length of exercise training [Q (2) = 6.00, p=0.05], with ESs largest for moderate length (SMD = 0.41), followed by short length (SMD = 0.40) and long length (SMD = 0.29). However, the results were not moderated by session time or frequency. TCC can improve multiple cognitive functions of the elderly with cognitive impairment. The intervention effects are moderated by exercise length, but not by exercise session time and frequency.
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Are Reallocations between Sedentary Behaviour and Physical Activity Associated with Better Sleep in Adults Aged 55+ Years? An Isotemporal Substitution Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249579. [PMID: 33371373 PMCID: PMC7767359 DOI: 10.3390/ijerph17249579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 11/28/2022]
Abstract
Physical activity has been proposed as an effective alternative treatment option for the increasing occurrence of sleep problems in older adults. Although higher physical activity levels are associated with better sleep, the association between specific physical activity intensities and sedentary behaviour (SB) with sleep remains unclear. This study examines the associations of statistically modelled time reallocations between sedentary time and different physical activity intensities with sleep outcomes using isotemporal substitution analysis. Device-measured physical activity data and both objective and subjective sleep data were collected from 439 adults aged 55+ years. Replacing 30 min of SB with moderate to vigorous intensity physical activity (MVPA) was significantly associated with an increased number of awakenings. Moreover, a reallocation of 30 min between light physical activity (LPA) and MVPA was significantly associated with increased sleep efficiency. Furthermore, reallocating 30 min of SB to LPA showed a significant association with decreased sleep efficiency. There were no significant associations of time reallocations for wake time after sleep onset, length of awakenings, and sleep quality. These results improve our understanding of the interrelationships between different intensities of movement behaviours and several aspects of sleep in older adults.
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Huang N, Li W, Rong X, Champ M, Wei L, Li M, Mu H, Hu Y, Ma Z, Lyu J. Effects of a Modified Tai Chi Program on Older People with Mild Dementia: A Randomized Controlled Trial. J Alzheimers Dis 2020; 72:947-956. [PMID: 31743998 DOI: 10.3233/jad-190487] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Tai Chi exercise is a non-pharmacological therapy that has received increased attention in recent years. A Tai Chi program has been specifically modified for older people with cognitive impairments by the research team. OBJECTIVE We aim to assess the effects of this Tai Chi program on mild dementia. METHODS Eighty older people with mild dementia were recruited and randomly assigned to a Tai Chi group or a control group. The Tai Chi group practiced the Tai Chi program three times a week for 10 months, while the control group continued receiving routine treatments. All participants were assessed for cognitive function, behavior/mood, and activities of daily living at baseline, 5 months, and 10 months. RESULTS The Tai Chi group performed better than the control group. Repeated measures ANOVA revealed a significant group×time interaction in the Montreal Cognitive Assessment (MoCA). Further analysis of sub-items of the MoCA showed a significant time effect in naming and abstraction. It was statistically significant in both main effect of time and group×time interaction in the Neuropsychiatric Inventory (NPI) and Geriatric Depression Scale (GDS). Paired sample t test showed the Tai Chi group scored lower at 5 and 10 months in the NPI and at 10 months in the GDS compared with baseline. The Tai Chi group scored lower than the control group at 10 months in the NPI and GDS. CONCLUSION The results suggest this Tai Chi program may help improve cognitive function and mental well-being for older adults with mild dementia.
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Affiliation(s)
- Nayan Huang
- Center for Cognitive Disorders, Beijing Geriatric Hospital, Beijing, China.,Center for Brain Disorders Research, Capital Medical University; Beijing Institute of Brain Disorders, Beijing, China
| | - Wenjie Li
- Center for Cognitive Disorders, Beijing Geriatric Hospital, Beijing, China
| | - Xiangjiang Rong
- School of Kinesiology and Health, Capital University of Physical Education and Sport, Beijing, China
| | - Mei Champ
- Department of Nursing and Midwifery, University of the West of England, Bristol, UK
| | - Lian Wei
- Graduate School, Capital University of Physical Education and Sport, Beijing, China
| | - Mo Li
- Center for Cognitive Disorders, Beijing Geriatric Hospital, Beijing, China
| | - Haiyan Mu
- Center for Cognitive Disorders, Beijing Geriatric Hospital, Beijing, China
| | - Yueqing Hu
- Center for Cognitive Disorders, Beijing Geriatric Hospital, Beijing, China
| | - Zongjuan Ma
- Center for Cognitive Disorders, Beijing Geriatric Hospital, Beijing, China
| | - Jihui Lyu
- Center for Cognitive Disorders, Beijing Geriatric Hospital, Beijing, China.,Center for Brain Disorders Research, Capital Medical University; Beijing Institute of Brain Disorders, Beijing, China
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Converse AK, Barrett BP, Chewning BA, Wayne PM. Tai Chi training for attention deficit hyperactivity disorder: A feasibility trial in college students. Complement Ther Med 2020; 53:102538. [PMID: 33066865 DOI: 10.1016/j.ctim.2020.102538] [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] [Received: 05/12/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Many young adults are affected by attention deficit hyperactivity disorder (ADHD) and often desire non-pharmacological treatment options. Mind-body techniques might serve as complementary therapies to first-line stimulant medications, but studies are limited. Tai Chi is an increasingly popular practice that integrates movement with cognitive skills relevant to ADHD. We performed a feasibility trial of Tai Chi training in undergraduates to inform the design of a fully powered randomized controlled trial (RCT). METHOD Undergraduates with ADHD were recruited, screened, enrolled, and assessed at baseline. They were assigned to three parallel seven-week intervention arms, Tai Chi, Active Control (cardio-aerobic fitness), and Inactive Control (no contact), with follow-up assessments. Feasibility of a larger clinical trial was evaluated, especially with respect to enrollment and retention. Additionally, potential clinical outcome measures were examined for practicality and reliability. RESULTS 21 participants were assessed at baseline and 19 at follow-up (90 % retention). The primary clinical outcome measure, self-reported inattention symptoms (Conners' CAARS-S:L DSM-IV Inattentive Symptoms subscale), exhibited good test-retest reliability in controls (r = 0.87, n = 10) and correlated with reduced mindfulness (FFMQ acting with awareness subscale) at baseline (r = -0.74, n = 20). Class attendance and self-reported daily practice time were variable. Randomization to group classes was hindered by the college students' restricted schedules. CONCLUSION The high retention rate and good data quality suggest that an RCT of Tai Chi for ADHD is feasible. Further measures are identified to improve enrollment rates, adherence, and randomization procedures. Future work might extend to other young adult populations and high school students.
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Affiliation(s)
| | - Bruce P Barrett
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, United States
| | - Betty A Chewning
- School of Pharmacy, University of Wisconsin-Madison, United States
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, United States
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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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Li H, Chen J, Xu G, Duan Y, Huang D, Tang C, Liu J. The Effect of Tai Chi for Improving Sleep Quality: A Systematic Review and Meta-analysis. J Affect Disord 2020; 274:1102-1112. [PMID: 32663938 DOI: 10.1016/j.jad.2020.05.076] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 03/31/2020] [Accepted: 05/14/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sleep quality is a major concern around the world, yet currently there are no recognized non-pharmacological treatments. A systematic review and meta-analysis investigated Tai Chi's effect on patients with sleep complaints, both those with insomnia and those with other conditions. METHODS 4 English language databases (MEDLINE, EMBASE, PsycINFO, and CENTRAL) and 4 Chinese databases (CNKI, CBM, VIP, and Wanfang Data) were searched from database inception through June 23, 2019. Searches were conducted in both English and Chinese language. Meta-analysis by mean difference (MD) and 95% confidence interval (CI) was performed with RevMan 5.3. Risk of bias for each study was accounted for according to the Cochrane Handbook. RESULTS Twenty randomized controlled studies from five countries covering 1,703 patients were included and divided into two control groups. Tai Chi had a significant effect on the Pittsburgh Sleep Quality Index (PSQI) compared with non-treatment and active treatment groups. Moreover, the articles were divided into groups according to Tai Chi styles. Both 24-form Yang-style Tai Chi and 8-form Yang-style Tai Chi had significant effects on PSQI. LIMITATIONS One limitation of our work was that there were some forms of insomnia for which conclusions could not be drawn. Also, no relationship between efficacy and any of the factors could be elucidated. CONCLUSIONS Compared with non-therapeutic and other active treatments, Tai Chi has a positive effect on improving sleep quality. In-depth analysis showed that 24-form and 8-form Yang style Tai Chi have significant positive effects on sleep quality, as assessed by PSQI.
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Affiliation(s)
- Huanjie Li
- Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Chinese Medicine, Address: No.6 Qinren Road, Chancheng District, Foshan, 528000, China.
| | - Juexuan Chen
- American Academy of Acupuncture and Oriental Medicine, Address:1925 West County Road B2, Roseville, Minnesota, United States; Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Address: No.232 Waihuandong Road, Panyu District, Guangzhou, 510006, China.
| | - Guangzhen Xu
- Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Chinese Medicine, Address: No.6 Qinren Road, Chancheng District, Foshan, 528000, China.
| | - Yuting Duan
- Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Address: 3/F, Jockey Club School of Chinese Medicine Building, 7 Baptist University Road, Kowloon Tong, Hong Kong SAR, China; Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Address: No.232 Waihuandong Road, Panyu District, Guangzhou, 510006, China.
| | - Danxuan Huang
- Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Chinese Medicine, Address: No.6 Qinren Road, Chancheng District, Foshan, 528000, China.
| | - Chunzhi Tang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Address: No.232 Waihuandong Road, Panyu District, Guangzhou, 510006, China.
| | - Jihong Liu
- Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Chinese Medicine, Address: No.6 Qinren Road, Chancheng District, Foshan, 528000, China.
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Tai Chi Chuan for Subjective Sleep Quality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:4710527. [PMID: 32849900 PMCID: PMC7439202 DOI: 10.1155/2020/4710527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/10/2020] [Accepted: 06/09/2020] [Indexed: 01/09/2023]
Abstract
Background This review aims to investigate the efficacy of Tai Chi Chuan on subjective sleep quality among adults. Methods We systematically searched PubMed, Embase, Cochrane Library, Scopus, CNKI (China National Knowledge Infrastructure), and the Wanfang Database from their inception to August 2019 and identified 25 eligible studies that were published in both English and Chinese. Results 24 out of 25 studies were identified to be high-quality studies according to the PEDro scale. The pooled results confirmed that Tai Chi Chuan elicited moderate improvements in subjective sleep quality (SMD = −0.512, 95% CI [−0.767, −0.257], P < 0.001). Notably, Tai Chi Chuan yielded more significant effects on sleep quality among the healthy population (SMD = −0.684, 95% CI [−1.056, −0.311], P < 0.001) than the clinical population (SMD = −0.395, 95% CI [−0.742, −0.047], P=0.026) and more benefits among the Asian population (SMD = −0.977, 95% CI [−1.446, −0.508], P < 0.001) than the American population (SMD = −0.259, 95% CI [−0.624, 0.105], P=0.164). After controlling the methodological quality of studies, it has been noted that Asians could achieve the most significant sleep-promoting benefit when Tai Chi Chuan was practiced between 60 and 90 min per session. Conclusions Available data implied that subjective sleep quality was improved via Tai Chi training, but more thorough studies must be executed to ascertain our findings and optimize Tai Chi practices accordingly toward various populations.
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50
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Wang YT, Goh CH, Liao T, Dong XN, Duke G, Alfred D, Yang Y, Xu J, Yu S. Effects of wheelchair Tai Chi ball exercise on physical and mental health and functional abilities among elderly with physical disability. Res Sports Med 2020; 29:289-302. [PMID: 32546105 DOI: 10.1080/15438627.2020.1777553] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to examine the effect of a 12-week Wheelchair Tai Chi Ball (WTCB) intervention, a combination of mind-body exercise with strength training, on physical and mental health and functional abilities among elderly with disability. Twenty-six elderly persons participated in the study, nine WTCB group participants and ten control group participants completed the study. The WTCB group practised WTCB12 twice/week for one hour each time. The control group did their daily routine without WTCB intervention. The outcomes measures were: Pain Self-Efficacy Questionnaire (PSEQ), SF-36v2 for physical and mental health, heart rate, blood pressure, range of motion and muscle strength of the dominant arm at the shoulder, elbow and wrist joints. The Mixed Model ANOVA was employed to examine the differences between and within the two groups using pre-test and post-test scores. The results demonstrated the WTCB group had significant improvements on PSEQ, general physical health and had positive effects on maintaining muscle strength at the shoulder, elbow and wrist joints as compared to the control group. The WTCB12 exercise had positive effects on self-efficacy for pain management, general physical health, and maintain upper extremity muscle strength and is a feasible exercise for elderly with disability.
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Affiliation(s)
- Yong Tai Wang
- School of Nursing, University of Texas at Tyler, Tyler, United States
| | - Chung-Hyun Goh
- Department of Mechanical Engineering, University of Texas at Tyler, Tyler, United States
| | - Ting Liao
- Wuhan Sports University, Wuhan, China
| | - Xuanliang Neil Dong
- Department of Health and Kinesiology, University of Texas at Tyler, Tyler, United States
| | - Gloria Duke
- School of Nursing, University of Texas at Tyler, Tyler, United States
| | - Danita Alfred
- School of Nursing, University of Texas at Tyler, Tyler, United States
| | - Yi Yang
- Wuhan Sports University, Wuhan, China
| | - Jingle Xu
- School of Nursing, University of Texas at Tyler, Tyler, United States
| | - Shiqi Yu
- Department of Health and Kinesiology, University of Texas at Tyler, Tyler, United States
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