Effects of traditional Chinese mind–body exercises on older adults with cognitive impairment: A systematic review and meta-analysis

A meta-analysis of the influence of traditional Chinese exercises on cognitive function in the elderly

Background

This study seeks to assess the impact of traditional Chinese exercises (Tai Chi, Baduanjin, Yijinjing, Wuqinxi, and Liuzijue) on cognitive function in older adults through a systematic review and meta-analysis. It examines their effects on global cognitive performance, as well as specific cognitive domains, providing robust evidence to support the enhancement of cognitive function in the elderly.

Methods

A thorough search was executed across eight key databases, including PubMed, Embase, Cochrane Library, EBSCO, Web of Science, Wanfang Data, the Chinese Science and Technology Journal Database, and China National Knowledge Infrastructure. The quality of the studies that met the inclusion criteria was assessed using the Cochrane Collaboration tool for evaluating risk of bias. Data synthesis was performed using Review Manager 5.4, where pooled intervention outcomes were expressed as mean differences (MD) alongside their 95% confidence intervals (CI). Additional sub-group analysis was conducted to explore potential factors contributing to heterogeneity.

Results

This systematic review and meta-analysis evaluated data from 29 randomized controlled trials, encompassing a total of 2,489 participants. The results demonstrate that traditional Chinese exercises substantially improve language abilities (Category Verbal Fluency: MD = 0.90, 95% CI: 0.38 to 1.41), executive function (TMT B: MD = -13.70, 95% CI: -16.06 to -11.35), short-term memory (MD = 0.85, 95% CI: 0.42 to 1.29), and long-term delayed recall (MD = 1.39, 95% CI: 0.72 to 2.06). Sub-group analysis indicated that baseline cognitive function plays a critical role in determining the effectiveness of the intervention. Patients with cognitive impairment derive significantly greater benefits from traditional Chinese exercise interventions than those with normal cognitive function.

Conclusion

This study found that the traditional Chinese exercises can enhance cognitive function in the elderly, particularly in those with mild cognitive impairment. The effects of traditional Chinese exercises differed across various cognitive domains, indicating that when utilizing traditional Chinese exercise as an intervention, it is crucial to consider the specific cognitive status of the patient to design precisely tailored intervention strategies.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42024535287, identifier [CRD42024535287].

Impact of a multicomponent physical exercise program on intrinsic capacity in community-dwelling older adults

Introduction

In 2015, the World Health Organization introduced intrinsic capacity, a health indicator encompassing five domains aimed at promoting healthy aging. Multicomponent exercise programs are recommended to maintain and optimize intrinsic capacity; however, evidence on their effects in robust older adults is limited. This study aimed to evaluate the effects of a multicomponent exercise program on intrinsic capacity in older adults.

Methods

Older adults (≥60 years) enrolled in a multicomponent training program in Porto Alegre (RS) were evaluated for intrinsic capacity using specific tests for each domain. The total score, ranging from 0 to 10 points, was obtained by summing the scores of the five domains. Participants underwent a 12-week multicomponent exercise intervention and were reassessed.

Results

After the 12-week intervention, the composite intrinsic capacity score significantly increased. Significant improvements were found in the cognitive, vitality and locomotion domains. The practice of Chinese curative gymnastics contributed to a one-point increase in the composite intrinsic capacity score. No association was found between frequency, duration of training, or the number of exercise modalities and the composite intrinsic capacity score.

Conclusion

The multicomponent exercise program positively influenced composite intrinsic capacity, with notable improvements in vitality, cognition, and mobility. Personalization and individualization of training, combined with health education and social integration, were crucial in promoting healthy aging in the studied sample.

Clinical efficacy of Tuina therapy combined with traditional Chinese exercises in the treatment of symptomatic lumbar disc herniation: a multicentre randomised controlled trial protocol

Background

Low back pain and lower extremity sensory and functional abnormalities are common symptoms of lumbar disc herniation (LDH), which can easily cause walking dysfunction and significantly impair the quality of life of patients. Tuina and traditional Chinese exercises (TCEs) are effective in relieving pain and restoring dysfunction, and both are often used in China as a combination of passive therapy and active exercise to ease symptoms in patients with LDH. However, the majority of current clinical trials on the treatment of LDH with Tuina or TCEs are single-centre clinical studies, and the quality of these studies is generally low. Furthermore, clear evidence of clinical efficacy as to whether Tuina combined with TCEs is superior to single TCEs for improving dysfunction and pain in patients with LDH is lacking.

Methods/design

The design is a multicentre, assessor-blinded clinical randomised controlled trial. A total of 166 patients with LDH (aged 18-65 years) were recruited from four centres and randomly assigned at a 1:1 ratio to two groups: the TCE group and the Tuina combined with the TCE group. Each group received three treatments over the course of 1 week for a total of 4 weeks. The primary outcome indicator was the Oswestry Disability Index, whereas the secondary outcome indicators were the Short Form of Quality of Life Scale, the Short-Form McGill Pain Questionnaire Scale, and gait analysis. Assessments were made before the treatment, at the end of the treatment, and at the third and sixth months' follow-ups. Gait analysis was only used for comparison between the two groups before and after treatment, and did not involve follow-up. Adverse events occurring during the trial were faithfully recorded.

Conclusion

The results of this study are expected to provide a more effective research protocol for symptomatic LDH and an evidence-based rationale for the efficacy and safety of Tuina combined with TCEs in the treatment of symptomatic LDH.

Clinical trial registration

https://www.chictr.org.cn/showproj.html?proj=209956, identifier ChiCTR2300077361.

Effects of traditional Chinese exercises or their integration with medical treatments on cognitive impairment: a network meta-analysis based on randomized controlled trials

Objective

This study aims to summarize and critically evaluate the effects of traditional Chinese exercises, both in isolation and in combination with medical treatments, on cognitive impairment.

Methods

A systematic search of academic databases, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP, was conducted to identify the randomized controlled trials (RCTs) that evaluated traditional Chinese exercises and their integration with medical treatments for addressing cognitive impairment. Study quality was assessed using the Cochrane Handbook's Risk of Bias tool. A total of 24 RCTs involving 1,808 participants were included. The primary outcome measures were the Montreal Cognitive Assessment (MOCA) and the Mini-Mental State Examination (MMSE). Subgroup analyses were performed to compare the intervention effects.

Results

The network meta-analysis revealed that acupuncture combined with Tai Chi (Aandtaiji) showed the most significant improvement in MOCA scores, followed by Qigong. Tai Chi soft ball exercise (Taijiball) demonstrated the greatest improvement in MMSE scores.

Conclusion

The combination of traditional Chinese exercises with medical treatment is more effective in improving MOCA scores, while traditional exercises alone yield better results to enhance MMSE scores. The extended practice of Tai Chi and Qigong enhances cognitive function in patients with cognitive impairment.

The effect of Ba Duan Jin exercise intervention on cardiovascular disease: a meta-analysis of randomized controlled trials

Background

There is a growing interest in the use of complementary therapies for the prevention of disease and the maintenance of health. Furthermore, complementary therapies that incorporate exercise are becoming increasingly prevalent among the older adult, and thus may represent a crucial strategy for the primary and secondary prevention of cardiovascular disease (CVD). Exercise therapy, as a means to prevent and treat cardiovascular diseases, has been gradually applied in clinical practice. It has the advantages of reducing mortality, improving clinical symptoms, restoring physical function and improving quality of life. In recent years, traditional Chinese sports such as Ba Duan Jin and Qigong have developed rapidly. Therefore, a comprehensive systematic review is required to examine interventions involving Ba Duan Jin exercise in healthy adults or those at increased risk of CVD in order to determine the effectiveness of Ba Duan Jin exercise for the primary prevention of CVD.

Objective

To investigate the effect of Ba Duan Jin exercise intervention for the primary prevention of cardiovascular diseases.

Methods

Eight databases were systematically searched from inception to July, 2024 for randomized controlled trials (RCTs) to evaluated the impact of Ba Duan Jin exercise intervention on cardiovascular diseases. The search terms were "Cardiovascular diseases" "Ba Duan Jin" and "Randomized controlled." The Cochrane risk assessment tool was used to evaluate the study quality, and the meta-analysis was performed using Rev. Man 5.4 software.

Results

Seventeen completed trials were conducted with 1,755 participants who were randomly assigned and met the inclusion criteria. All 17 studies were conducted in China. The meta-analysis indicates that Ba Duan Jin exercise therapy can provide long-term benefits (20-30 years) by reducing all-cause mortality (RR = 0.55, 95% CI: 0.44-0.68, p < 0.01) and stroke mortality (RR = 0.49, 95% CI: 0.36-0.66, p < 0.01) in hypertensive patients. Subgroup analyses reveal that Ba Duan Jin exercise therapy decreases SBP (MD = -4.05, 95% CI = -6.84 to -1.26, p < 0.01) and DBP (MD = -3.21, 95% CI = -5.22 to -1.20, p < 0.01) levels in patients with essential hypertension, significantly reduces serum TC (MD = -0.78, 95% CI = -1.06 to -0.50, p < 0.01), TG (MD = -0.78, 95% CI = -0.93 to -0.62, p < 0.01), and LDL-C (MD = -0.76, 95% CI = -0.92 to -0.60, p < 0.01) levels in patients with hyperlipidemia, increases HDL-C (MD = 0.32, 95% CI = 0.14-0.51, p < 0.01) levels, and produces beneficial effects on cardiovascular function. Additionally, it can alleviate anxiety (MD = -3.37, 95% CI = -3.84 to -2.89, p < 0.01) and improve sleep quality (MD = -2.68, 95% CI = -3.63to -1.73, p < 0.01).

Conclusion

Ba Duan Jin exercise therapy can improve the physical and mental condition and quality of life of patients with cardiovascular diseases, and it is worthy of further promotion and application in clinical practice.

Systematic review registration

PROSPERO, identifier: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024496934.

Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review

BACKGROUND

Traumatic brain injury (TBI) adversely affects both young and old and is a growing public health concern. The common functional, psychological, and cognitive changes associated with TBI and recent trends in its management, such as recommending sub-threshold aerobic activity, and multi-modal treatment strategies including vestibular rehabilitation, suggest that Tai Chi/Qigong could be beneficial for TBI. Tai Chi and Qigong are aerobic mind-body practices with known benefits for maintaining health and mitigating chronic disease. To date, no systematic review has been published assessing the safety and effectiveness of Tai Chi/Qigong for traumatic injury.

METHODS

The following databases were searched: MEDLINE, CINAHL Cochrane Library, Embase, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. All people with mild, moderate, or severe TBI who were inpatients or outpatients were included. All Types of Tai Chi and Qigong, and all comparators, were included. All measured outcomes were included. A priori, we chose "return to usual activities" as the primary outcome measure as it was patient-oriented. Cochrane-based risk of bias assessments were conducted on all included trials. Quality of evidence was assessed using the grading of recommendation, assessment, development, and evaluation (GRADE) system.

RESULTS

Five trials were assessed; three randomized controlled trials (RCTs) and two non-RCTs; only two trials were conducted in the last 5 years. No trial measured "return to normal activities" or vestibular status as an outcome. Four trials - two RCTs and two non-RCTS - all found Tai Chi improved functional, psychological and/or cognitive outcomes. One RCT had a low risk of bias and a high level of certainty; one had some concerns. One non-RCTs had a moderate risk of bias and the other a serious risk of bias. The one Qigong RCT found improved psychological outcomes. It had a low risk of bias and a moderate level of certainty. Only one trial reported on adverse events and found that none were experienced by either the exercise or control group.

CONCLUSION

Based on the consistent finding of benefit in the four Tai Chi trials, including one RCT that had a high level of certainty, there is a sufficient signal to merit conducting a large, high quality multi-centre trial on Tai Chi for TBI and test it against current trends in TBI management. Based on the one RCT on TBI and Qigong, an additional confirmatory RCT is indicated. Further research is indicated that reflects current management strategies and includes adverse event documentation in both the intervention and control groups. However, these findings suggest that, in addition to Tai Chi's known health promotion and chronic disease mitigation benefits, its use for the treatment of injury, such as TBI, is potentially a new frontier.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO [ CRD42022364385 ].

Effects of mind-body therapies on schizophrenia: A systematic review and network meta-analysis

OBJECTIVE

The objective of this meta-analysis is to evaluate and compare the effectiveness of different mind-body therapies in reducing the symptoms of schizophrenia.

METHODS

A systematic search was performed using databases such as PubMed, Embase, Cochrane Library, Web of Science, and Scopus. Randomized controlled trials that assessed the effects of mind-body therapies on patients with schizophrenia were included. The search covered the period between the inception of each database and November 17th, 2022. The methodological quality of the trials was assessed using the Cochrane risk of bias tool. A network meta-analysis was conducted to compare the effects of various mind-body therapies, including Yoga, Mindfulness, Tai Chi, Baduanjin, and Yijinjing.

RESULTS

The analysis included 22 randomized controlled trials involving a total of 2064 subjects. The network meta-analysis revealed that Yoga and Mindfulness interventions were more effective than other mind-body therapies in reducing the symptoms of schizophrenia. Specifically, Yoga improved PANSS-positive symptom scores (SUCRA: 74.8 %) and PANSS-negative symptom scores (SUCRA: 80.4 %), whereas Mindfulness improved PANSS-positive symptom scores (SUCRA: 85.6 %).

CONCLUSION

The findings of this study indicate that Yoga may be a promising intervention for the treatment of schizophrenia. However, the small sample size and the low quality of the included studies have limited the generalizability of our findings Therefore, this study must be understood with caution, and further investigation is warranted when more relevant studies emerge.