Adapting Tai Chi for Upper Limb Rehabilitation Post Stroke: A Feasibility Study

A scoping review of mind-body therapies for people with persistent pain after stroke

PURPOSE

Persistent pain post-stroke is common; however, non-medical management options remain under-researched. This scoping review sought to identify and summarise existing literature regarding mind-body therapies for people with persistent pain post-stroke, examine pain and pain-related biopsychosocial outcomes, and identify areas for future research.

MATERIALS AND METHODS

This review followed PRISMA and JBI guidelines; the protocol was registered on Open Science Framework. Five electronic databases (PubMed, EMBASE, CINAHL, PsycINFO, Web of Science) were searched from 1992 until 19th August 2024. Primary studies of any design evaluating mind-body therapies in adults with persistent pain post-stroke, published in English in peer-reviewed journals, were eligible. Findings were narratively summarised by study, sample, and mind-body therapy characteristics.

RESULTS

Twenty-one studies comprising 458 adults with various post-stroke pain presentations were included. Only 10 studies specifically targeted stroke pain; the remainder primarily incorporated pre-post measures of pain in a heterogenous stroke sample (with and without pain). Studies varied in their levels of evidence, sample characteristics, mind-body therapies, and biopsychosocial outcome measurement. Nonetheless, improvements in pain and pain-related biopsychosocial outcomes were consistently reported.

CONCLUSION

Limited, lower-quality research suggests improved pain and biopsychosocial outcomes. However, further rigorous research exploring feasibility, safety, efficacy, optimal dosage, format, and setting is recommended.

Hand-to-hand combat in the 21st century-INNOAGON warrior or modern gladiator?-a prospective study

Introduction

In being an important lifestyle factor, the physical activity influences people's health status, including life expectancy. Specific forms of physical activity are exercises related to hand-to-hand combat in the broadest sense, often overlapping and containing similar elements associated with combat sports (for Western culture) and martial arts (for Far Eastern culture). There are many types of forms of practising hand-to-hand combat exercises, which can be seen as opposing or in some ways complementary, e.g.: "traditional"-e.g., karate or kung fu, practised for hundreds or even thousands of years, usually adhering to moral codes of conduct, and drawing ideas from philosophy, religion vs. "modern"-e.g., American pro wrestling or mixed martial arts-MMA, suggesting a combination of various traditional forms of martial arts. In terms of shaping a healthy lifestyle with mental health elements based on the implementation of hand-to-hand combat exercises, an analysis of these fundamental insights into physical activity is warranted. This study aims to investigate the development direction of the hand-to-hand exercises in Western culture, opposing the "traditional" and "modern" forms.

Discussion

In this study, INNOAGON theory responds to the overuse of the term "science of martial arts". It is currently being used to promote extreme aggression and violence as an acceptable means of achieving success, and this model is expressively permeating other spheres of social interaction. In INNOAGON's understanding, hand-to-hand combat should be associated with the ancient thought of "doing good" (ancient Greece) or "wisdom" (Far Eastern cultures) including aesthetic and philosophical aspects. This links to numerous psychosocial benefits, self-esteem, discipline, body-mind coordination including breath control and relaxation, respect for others. The modern form of hand-to-hand combat, framed in these discussions as MMA or American pro wrestling, historically refers to the gladiatorial fights held during the Roman Games. The holding of fights in so-called "cages" refers to the arena in which Roman slave fights were held, and the athletes performing there are often referred to as modern-day "gladiators".

Conclusion

Proper education, including education in the area of physical culture, leading to the development of a society turned towards values broader than just fun or self-satisfaction should be the basis for the development of the next generations. It actually remains to decide which path of social change we will choose: in the case of INNOAGON a positive one, and in the case of modern gladiator a destructive one. Only a proper education combined with a broad programme of social role modelling, social facilitation-the foundations of which are laid by INNOAGON-including promotion on the Internet and social media can provide the right counterbalance to the pathology increasingly penetrating our lives, leading to the promotion of aggression and threats to physical and mental health.

Bibliometric Evaluation of Global Tai Chi Research from 1980-2020

While studies on the health benefits of Tai Chi have sprung up over the past four decades, few have engaged in collecting global data, estimating the developing trends, and conducting reviews from the perspective of visualization and bibliometric analysis. This study aimed to provide a summary of the global scientific outputs on Tai Chi research from 1980 to 2020, explore the frontiers, identify cooperation networks, track research trends and highlight emerging hotspots. Relevant publications were downloaded from the Web of Science Core Collection (WoSCC) database between 1980 and 2020. Bibliometric visualization and comparative analysis of authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords were systematically conducted using CiteSpace software. A total of 1078 publications satisfied the search criteria, and the trend of annual related publications was generally in an upward trend, although with some fluctuations. China (503) and Harvard University (74) were the most prolific country and institution, respectively. Most of the related researches were published in the journals with a focus on sport sciences, alternative medicine, geriatrics gerontology, and rehabilitation. Our results indicated that the current concerns and difficulties of Tai Chi research are "Intervention method", "Targeted therapy", "Applicable population", "Risk factors", and "Research quality". The frontiers and promising domains of Tai Chi exercise in the health science field are preventions and rehabilitations of "Fall risk", "Cardiorespiratory related disease", "Stroke", "Parkinson's disease", and "Depression", which should receive more attention in the future.

The Influences of Tai Chi on Balance Function and Exercise Capacity among Stroke Patients: A Meta-Analysis

Objective

This study aims to explore the influences of Tai Chi on the balance function and exercise capacity among stroke patients.

Methods

Databases including PubMed, Embase, WOS (Web of Science), the Cochrane Library, CNKI (China National Knowledge Infrastructure), Wanfang Data, VIP (VIP database), and CBM (China Biology Medicine disc) were retrieved to gather the figures of randomized controlled trials on the balance function and exercise capacity among stroke patients. Then relevant data were input and analyzed in Review Manager 5.3.

Results

Nineteen papers were included and analyzed in this study. According to the combined effect size, the balance function of stroke patients improved significantly: the Berg Balance Function Scale score [MD = 7.67, 95% CI (3.44, 11.90)]; standing and walking test scores [MD = 3.42, 95% CI (4.22, −2.63)]; gravity swing area [MD = 0.79, 95% CI (1.48, 0.10)]; and gravity swing speed [MD = −5.43, 95% CI (−7.79, 3.08)]. In addition, the exercise capacity improved significantly as well: the FMA (Fugl-Meyer Assessment Scale) scale score [MD = 4.15, 95% CI (1.68, 6.63)]. There are no significant influences or changes of other related results.

Conclusions

Stroke patients are able to improve their balance functions and exercise capacities prominently when they do Tai Chi exercise once or twice a week and ≥5 times/week and >30 ≤ 60 min/time.

Effects of Tai Chi therapy on body mass index and physical index of intellectual disability

AIM

Continuous program development and application are necessary in order to manage the health and address the problems of secondary metabolic disorders for people with intellectual disabilities. This study examines the effects of Tai Chi therapy on body mass index (BMI) and physical index among people with intellectual disabilities.

METHODS

A quasi-experimental study using a pretest-post-test control group, non-synchronized design was employed. Samples were in total 104 people with intellectual disabilities (experimental: n = 67, control: n = 37) in two facilities in South Korea. They were randomly allocated using a coin toss into the two groups. Tai Chi therapy as an experimental intervention was the Sun style Tai Chi exercise, which consists of the warm-up (5 min), main exercise (45 min), and finishing (meditation, 10 min). Tai Chi therapy was conducted twice a week for a total of 40 sessions for 5 months (1 hour each) by one professional instructor. Measures were general characteristics of study participants, BMI as degree of obesity, and physical index. Data were analyzed using the SPSS 21.0 program (descriptive statistics, χ² test, independent t test). A P value of less than .05 was considered statistically significant.

RESULTS

There were statistically significant differences on fasting blood glucose (t = 4.351, P < .001) and high-density lipoprotein (t = -2.052, P = .043) in the physical index between the two groups.

CONCLUSIONS

Tai Chi therapy was an effective intervention for decreasing fasting blood glucose and for increasing high-density lipoprotein in those with intellectual disabilities. Tai Chi therapy can be implied as a nursing intervention for intellectual disabilities in nursing practice.

Mind-body interactive qigong improves physical and mental aspects of quality of life in inpatients with stroke: A randomized control study

BACKGROUND

Stroke, a medical condition that causes physical disability and mental health problems, impacts negatively on quality of life. Post-stroke rehabilitation is critical to restoring quality of life in these patients.

OBJECTIVES

This study was designed to evaluate the effect of a mind-body interactive qigong intervention on the physical and mental aspects of quality of life, considering bio-physiological and mental covariates in subacute stroke inpatients.

METHODS

A randomized controlled trial with repeated measures design was used. A total of 68 participants were recruited from the medical and rehabilitation wards at a teaching hospital in northern Taiwan and then randomly assigned either to the Chan-Chuang qigong group, which received standard care plus a 10-day mind-body interactive exercise program, or to the control group, which received standard care only. Data were collected using the National Institutes of Health Stroke Scale, Hospital Anxiety and Depression Scale, Short Form-12, stroke-related neurologic deficit, muscular strength, heart rate variability and fatigue at three time points: pre-intervention, halfway through the intervention (day 5) and on the final day of the intervention (day 10).

RESULTS

The results of the mixed-effect model analysis showed that the qigong group had a significantly higher quality of life score at day 10 (p<0.05) than the control group. Among the covariates, neurologic deficit (p=0.04), muscle strength (p=0.04), low frequency to high frequency ratio (p=0.02) and anxiety (p=0.04) were significantly associated with changes in quality of life. Conversely, heart rate, heart rate variability (standard deviation of normal-to-normal intervals, low frequency and high frequency), fatigue and depression were not significantly associated with change in quality of life (p >0.05).

CONCLUSIONS

This study supports the potential benefits of a 10-day mind-body interactive exercise (Chan-Chuang qigong) program for subacute stroke inpatients and provides information that may be useful in planning adjunctive rehabilitative care for stroke inpatients.