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Loewenthal J, Berning MJ, Wayne PM, Eckstrom E, Orkaby AR. Holistic frailty prevention: The promise of movement-based mind-body therapies. Aging Cell 2024; 23:e13986. [PMID: 37698149 PMCID: PMC10776124 DOI: 10.1111/acel.13986] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023] Open
Abstract
Aging is characterized by fundamental cellular and molecular hallmarks that result in physiologic decline of most body systems. This may culminate in frailty, a state of decreased reserve. Because frailty is a state of multisystem dysregulation, multimodal interventions may be necessary to mitigate and prevent progression rather than interventions targeting a single system. Movement-based mind-body therapies, such as tai chi and yoga, are promising multimodal strategies for frailty prevention and treatment given their inherent multicomponent nature. In this review, we summarize the links between hallmarks of aging and frailty and how tai chi and yoga may impact these hallmarks. We review trial evidence for the impact of tai chi and yoga on frailty in older populations and discuss opportunities for future research.
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Affiliation(s)
- Julia Loewenthal
- Division of Aging, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | | | - Peter M. Wayne
- Division of Preventive MedicineBrigham and Women's HospitalBostonMassachusettsUSA
- Osher Center for Integrative Medicine, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Elizabeth Eckstrom
- Division of General Internal Medicine & GeriatricsOregon Health & Science UniversityPortlandOregonUSA
| | - Ariela R. Orkaby
- Division of Aging, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- New England Geriatric Research, Education, and Clinical Center (GRECC)VA Boston Healthcare SystemBostonMassachusettsUSA
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Ramachandran HJ, Seah ACW, Teo JYC, Yeo TJ, Wang W. East meets West: making the case for traditional Chinese exercises in the management of heart disease. Eur J Cardiovasc Nurs 2023; 22:e47-e48. [PMID: 36595034 DOI: 10.1093/eurjcn/zvad006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/31/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD, 11,10 Medical Drive, 117597Singapore
| | - Alvin Chuen Wei Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD, 11,10 Medical Drive, 117597Singapore
| | - Jun Yi Claire Teo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD, 11,10 Medical Drive, 117597Singapore
| | - Tee Joo Yeo
- Cardiac Rehabilitation, Department of Cardiology, National University Heart Centre, 5 Lower Kent Ridge Rd, 119074 Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD, 11,10 Medical Drive, 117597Singapore
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Zheng P, Zhang L, Shi F, Man K, Aguiar EJ. Health and Fitness Comparisons Among Middle-Aged and Older Adults with Long-Term Participation in Four Different Sports. Int J Exerc Sci 2022; 15:1028-1039. [PMID: 36159338 PMCID: PMC9458280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Physical activity is known to confer numerous health benefits. However, few studies have assessed the prolonged impact of participation in different sports on health and fitness. The purpose of this cross-sectional study was to compare the impact of long-term participation (i.e., ≥9 years) in four different sports, including two traditional Chinese (Tai Chi; diabolo) and two modern sports (aerobics; track and field [TF]) on health and fitness measures among middle-aged and older adults. Participants (n=252, 56.6±8.5y, 66% female) completed the following measures: height, weight, BMI, waist circumference, waist-hip ratio (WHR), body fat%, resting blood pressure (BP) and heart rate, vital capacity, grip strength, reaction time, flexibility, balance. Compared to Tai Chi, aerobics was associated with lower systolic BP and fat%, and greater vital capacity, while TF was associated with lower systolic BP, shorter reaction time, greater vital capacity and better balance (p-values<0.05). Diabolo was associated with lower WHR compared to aerobics and Tai Chi, and greater vital capacity than Tai Chi (p-values<0.05). No significant differences were observed across sports in other measures. Long-term participation in four sports might have different effects on BP, vital capacity, balance, reaction time, body fat, and central adiposity. Individuals who prefer to choose traditional sports (Tai Chi, diabolo) may anticipate similar long-term effects on resting heart rate, BMI, muscle mass, and grip strength compared to those who perform modern sports (aerobics, TF). Information presented in this study may be valuable when designing population, group and individually-tailored PA recommendations in culturally diverse individuals.
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Affiliation(s)
- Peixuan Zheng
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL, USA
| | - Lei Zhang
- Department of Sports Science, Jeonbuk National University, Jeonju-si, SOUTH KOREA
- College of Physical Education (main campus), Zhengzhou University, Zhengzhou, CHINA
| | - Feng Shi
- Physical Education College of Zhengzhou University, Zhengzhou, CHINA
| | - Kaiwen Man
- Department of Educational Studies in Psychology, Research Methodology and Counseling, The University of Alabama, Tuscaloosa, AL, USA
| | - Elroy J Aguiar
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL, USA
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Lyu S, Wang H, Zhang J, Wei Q, Cui M, Li Y, Chen Z, Peng F. Effects of tai chi cardiac rehabilitation program on anxiety and depression in patients with coronary heart disease: A randomized controlled clinical trial. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Taylor-Piliae R, Dolan H, Yako A. Stroke Survivors' Personal Efficacy Beliefs and Outcome Expectations of Tai Chi Exercise: A Qualitative Descriptive Study. Int J Environ Res Public Health 2021; 18:13001. [PMID: 34948610 DOI: 10.3390/ijerph182413001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
Prior qualitative research conducted among stroke survivors to explore the potential benefits and challenges of participating in tai chi exercise during stroke recovery is limited to those without depression. A qualitative descriptive approach was used. Social Cognitive Theory and Complex Systems Biology provided the theoretical framework, with focus group interview data collected from stroke survivors after participation in a tai chi intervention. Due to COVID-19, the focus group interview was conducted via online video conferencing. Content analysis of the de-identified transcript was conducted with a-priori codes based on the theoretical framework and inductive codes that were added during the analysis process. Lincoln and Guba's criteria were followed to ensure trustworthiness of the data. Community-dwelling stroke survivors (n = 7) participating in the focus group interviews were on average 68 years old, mainly retired (71%, n = 5), married women (57%, n = 4) with >13 years education (86%, n = 6). The three major themes were: personal efficacy beliefs, tai chi intervention active ingredients, and outcome expectations. Social Cognitive Theory underscored stroke survivors' personal efficacy beliefs, behavior, and outcome expectations, while Complex Systems Biology highlighted the active ingredients of the tai chi intervention they experienced. Participation in the 8-week tai chi intervention led to perceived physical, mental, and social benefits post stroke.
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Taylor-Piliae RE, Morrison HW, Hsu CP, Whitman S, Grandner M. The Feasibility of Tai Chi Exercise as a Beneficial Mind-Body Intervention in a Group of Community-Dwelling Stroke Survivors with Symptoms of Depression. Evid Based Complement Alternat Med 2021; 2021:8600443. [PMID: 34765010 DOI: 10.1155/2021/8600443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/08/2021] [Accepted: 10/15/2021] [Indexed: 11/18/2022]
Abstract
Depression is prevalent among one-third to two-thirds of acute and chronic stroke survivors. Despite the availability of pharmacotherapies and/or psychotherapies, depression persists, even for 5–10 years after stroke, reflecting limited treatment responses and/or adherence to this conventional care. Mind-body interventions are commonly used among adults to ameliorate depressive symptoms. Thus, the feasibility of Tai Chi, alongside conventional care, to manage poststroke depression was investigated using a single-group pre-post intervention design. Recruitment and retention, intervention adherence, safety, acceptability, and fidelity were assessed. Symptoms of depression, anxiety, and stress were assessed using standardized questionnaires, objective sleep was assessed via a research-grade triaxial accelerometer, and blood samples were taken to measure oxidative stress, inflammatory markers, and a neurotrophic growth factor using commercially available kits per manufacturer's protocol. Pre-post intervention changes were assessed using paired t-tests. We enrolled stroke survivors (N = 11, mean age = 69.7 ± 9.3) reporting depression symptoms. After the intervention, we observed significant reductions in symptoms of depression (−5.3 ± 5.9, p=0.01), anxiety (−2.2 ± 2.4, p=0.01), and stress (−4.6 ± 4.8, p=0.01), along with better sleep efficiency (+1.8 ± 1.8, p=0.01), less wakefulness after sleep onset (−9.3 ± 11.6, p=0.04), and less time awake (−9.3 ± 11.6, p=0.04). There was a 36% decrease in oxidative stress (p=0.02), though no significant changes in the other biomarkers were found (all p values >0.05). Tai Chi exercise is a feasible intervention that can be used alongside conventional care to manage poststroke depression, aid in reducing symptoms of anxiety and stress, and improve sleep.
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Zhang J, Lyu S, Yin H, Ma J, Chen Z, Cui M, Wei Q, Yuan W, Li Y. Investigation of the quality of life of patients with coronary heart disease during COVID-19 and analysis of influencing factors. PSYCHOL HEALTH MED 2021; 27:409-420. [PMID: 34030533 DOI: 10.1080/13548506.2021.1930074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
At present, coronavirus disease 2019 (COVID-19) has become a global public health emergency, bringing a great threat to human health. This study aims to evaluate and analyze the factors that influence the quality of life (QOL) of patients with coronary heart disease (CHD) during COVID-19 to provide a realistic basis for improving their QOL. A total of 70 patients with CHD were selected through convenience sampling from three heart rehabilitation centers. The cross-sectional survey of the study cases were carried out using an online survey platform. All of the participants completed a general situation questionnaire, and QOL was assessed through the 36-item Short Form Health Survey. Results showed that the overall QOL of patients with CHD during COVID-19 was poor, having an average score of 65.99 ± 10.97. Moreover, multivariate linear regression analysis showed that worry about COVID-19 (P < 0.05) and different exercise intervention types (P < 0.05) were the main factors affecting the QOL of patients. On the one hand, positive measures should be taken to provide psychological counseling to ease their sense of concern. On the other hand, engaging in exercise is more important for these patients to improve physical function, particularly Tai Chi exercises.
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Affiliation(s)
- Jianwei Zhang
- College of Physical Education and Sports, Beijing Normal University, Beijing, China 100875
| | - Shaojun Lyu
- College of Physical Education and Sports, Beijing Normal University, Beijing, China 100875
| | - Hengchan Yin
- College of Physical Education and Sports, Beijing Normal University, Beijing, China 100875
| | - Jing Ma
- Department of Cardiology, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing
| | - Zaihao Chen
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Meize Cui
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Qiuyang Wei
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Wen Yuan
- College of Wushu, Beijing Sports University, Beijing, China
| | - Yameng Li
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
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Ma J, Zhang JW, Li H, Zhao LS, Guo AY, Chen ZH, Yuan W, Gao TM, Li YM, Li CH, Wang HW, Song B, Lu YL, Cui MZ, Wei QY, Lyu SJ, Yin HC. Safety and effectiveness of a Tai Chi-based cardiac rehabilitation programme for chronic coronary syndrom patients: study protocol for a randomised controlled trial. BMJ Open 2020; 10:e036061. [PMID: 32624473 PMCID: PMC7337900 DOI: 10.1136/bmjopen-2019-036061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Preliminary evidence from clinical observations suggests that Tai Chi exercise may offer potential benefits for patients with chronic coronary syndrom (CCS). However, the advantages for CCS patients to practice Tai Chi exercise as rehabilitation have not been rigorously tested and there is a lack of consensus on its benefits. This study aims to develop an innovative Tai Chi Cardiac Rehabilitation Program (TCCRP) for CCS patients and to assess the efficacy, safety and acceptability of the programme. METHODS AND ANALYSIS We propose to conduct a multicentre randomised controlled clinical trial comprising of 150 participants with CCS. The patients will be randomly assigned in a 1:1 ratio into two groups. The intervention group will participate in a supervised TCCRP held three times a week for 3 months. The control group will receive supervised conventional exercise rehabilitation held three times a week for 3 months. The primary and secondary outcomes will be assessed at baseline, 1 month, 3 months after intervention and after an additional 3-month follow-up period. Primary outcome measures will include a score of 36-Item Short Form Survey and Chinese Perceived Stress Scale. The secondary outcome measures will include body composition, cardiopulmonary exercise test, respiratory muscle function, locomotor skills, echocardiogram, New York Heart Association classification, heart rate recovery time and laboratory examination. Other measures also include Seattle Angina Scale, Pittsburgh Sleep Quality Index, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and Berg Balance Scale. All adverse events will be recorded and analysed. ETHICS AND DISSEMINATION This study conforms to the principles of the Declaration of Helsinki and relevant ethical guidelines. Ethical approval has been obtained from the Ethics Committee of Chinese People's Libration Army General Hospital (approval number: S2019-060-02). Findings from this study will be published and presented at conferences for widespread dissemination of the results. TRIAL REGISTRATION NUMBER NCT03936504.
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Affiliation(s)
- Jing Ma
- Department of Cardiology, First Medical Center of Chinese People's Libration Army General Hospital, Beijing, China
| | - Jian Wei Zhang
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Hua Li
- Department of Cardiovascular Medicine, Anzhen Community Health Service Center, Chaoyang District, Beijing, China
| | - Lian Shan Zhao
- Department of Cardiovascular Medicine, Beijing Shuili Hospital, Beijing, China
| | - Ai Ying Guo
- Department of Cardiovascular Medicine, Anzhen Community Health Service Center, Chaoyang District, Beijing, China
| | - Zai Hao Chen
- College of Wushu, Beijing Sport University, Beijing, China
| | - Wen Yuan
- College of Wushu, Beijing Sport University, Beijing, China
| | - Tian Ming Gao
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Ya Meng Li
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Cui Han Li
- College of Wushu, Beijing Sport University, Beijing, China
| | - Hong Wei Wang
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Bo Song
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Yu Long Lu
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Mei Ze Cui
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Qiu Yang Wei
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Shao Jun Lyu
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Heng Chan Yin
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
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Abstract
BACKGROUND Exercise-based cardiac rehabilitation is safe and effective for adults with chronic heart failure (CHF), yet services are greatly underutilized. However, tai chi is a popular and safe form of exercise among older adults with chronic health conditions. OBJECTIVE A systematic review and meta-analysis was conducted to examine the benefits of tai chi exercise among persons with CHF. METHODS An electronic literature search of 10 databases (Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Embase, OpenGrey, PsycARTICLES, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science) was conducted from January 1, 2004, to August 1, 2019. Clinical trials that examined tai chi exercise, were published in English or German languages, and conducted among participants with CHF were included. Comprehensive Meta-Analysis version 2.0 software (Biostat, Inc) was used to calculate effect sizes (ie, Hedges g) and 95% confidence intervals using random effects models. RESULTS A total of 6 studies met the inclusion criteria, enrolling 229 participants (mean age, 68 years; 28% women; mean ejection fraction = 37%). At least 3 studies reported outcomes for exercise capacity (n = 5 studies), quality of life (n = 5 studies), depression (n = 4 studies), and b-type natriuretic peptide (n = 4 studies), allowing for meta-analysis. Compared with controls, tai chi participants had significantly better exercise capacity (g = 0.353; P = .026, I = 32.72%), improved quality of life (g = 0.617; P = .000, I = 0%), with less depression (g = 0.627; P = .000, I = 0%), and decreased b-type natriuretic peptide expression (g = 0.333; P = .016, I = 0%). CONCLUSION Tai chi can be easily integrated into existing cardiac rehabilitation programs. Further research is needed with rigorous study designs and larger samples before widespread recommendations can be made.
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Abstract
With the increasing number of cardiovascular patients, more and more people are living with diseases. Cardiac rehabilitation (CR) is an effective treatment and prevention measure for cardiovascular disease (CVD), which aims to relieve both psychological and physiological stress of CVD, reduce risk of death from CVD, improve cardiovascular function and patients' quality of life. Tai Chi is popular in China and mainly used as a daily leisure activity for the elderly to strengthen their bodies. This review discusses whether Tai Chi could be taken as a positive intervention in CR and what is the exact role and its mechanisms as exercise therapy for CVD. The authors detail the role of Tai Chi on CR from the aspects of exercise capacity, risk factors of CVD and psychological factors, etc., as well as highlight the limitation of Tai Chi research at present.
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Affiliation(s)
- Duan Cheng
- Department of Rehabilitation, Acupuncture and Moxibustion and Massage College • Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Bo Wang
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Qian Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Yan Guo
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
| | - Lei Wang
- Department of Rehabilitation, Acupuncture and Moxibustion and Massage College • Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
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Liu J, Yu P, Lv W, Wang X. The 24-Form Tai Chi Improves Anxiety and Depression and Upregulates miR-17-92 in Coronary Heart Disease Patients After Percutaneous Coronary Intervention. Front Physiol 2020; 11:149. [PMID: 32218741 PMCID: PMC7078346 DOI: 10.3389/fphys.2020.00149] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 02/11/2020] [Indexed: 12/15/2022] Open
Abstract
Background Anxiety and depression are common symptoms in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). The 24-form Tai Chi may exert a protective function for CHD patients after PCI by improving anxiety and depression. Methods Patients who received PCI after 1–4 days were randomly assigned to the 24-form Tai Chi group (TG) and the control group (CG). The differences in anxiety and depression, using the Medical Outcomes Study 36−item Short−Form Health Survey (SF-36), before and after an average of 10 months of Tai Chi intervention were compared in both groups to analyze the effects of Tai Chi on the emotion and the life quality of CHD patients. Meanwhile, the relative levels of miR-17-92 were measured by using real-time qPCR. The association between the relative levels of miR-17-92 and the anxiety and the depression of CHD patients after PCI was analyzed. Adjusted Cox models were used to explore the effect of Tai Chi exercise in CHD patients. Results After 10 months of intervention, the changes in the anxiety subscale (P = 0.002), in the depression subscale (P = 0.008), and in the stress (P = 0.015) scores were higher in the TG group when compared to those of the CG group. The proportion of anxious (P = 0.045) and depressed subjects (P = 0.042) in the TG group was lower than that in the CG group. On the other hand, the increase in the SF-36 scores and in the relative levels of miR-17-92 was significantly higher in the TG group when compared with that of the CG group (P < 0.05). The serum level of miR-17-92 had a negative correlation with the anxiety, the depression, and the stress scores (P < 0.01). Conclusion The 24-form Tai Chi improved the anxiety and the depression symptoms and upregulated the miR-17-92 levels in CHD patients after PCI.
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Affiliation(s)
- Jia Liu
- Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China
| | - Ping Yu
- Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China
| | - Wei Lv
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, China
| | - Xinxin Wang
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, China
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Zheng G, Zheng X, Li J, Duan T, Ling K, Tao J, Chen L. Effects of Tai Chi on Cerebral Hemodynamics and Health-Related Outcomes in Older Community Adults at Risk of Ischemic Stroke: A Randomized Controlled Trial. J Aging Phys Act 2019; 27:678-87. [DOI: 10.1123/japa.2018-0232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study investigated the effects of Tai Chi compared with no exercise control on the cerebral hemodynamic parameters and other health-related factors in community older adults at risk of ischemic stroke. A total of 170 eligible participants were randomly allocated to Tai Chi or control group. The cerebral hemodynamic parameters and physical fitness risk factors of cardiovascular disease were measured at baseline, 12 weeks, and 24 weeks. After the 12-week intervention, Tai Chi significantly improved the minimum of blood flow velocity (BFVmin); BFVmean; pulsatility index and resistance index of the right anterior cerebral artery; and BFVmax, BFVmin, and BFVmeanparameters of the right middle cerebral artery. Tai Chi training also decreased triglyceride, fasting blood glucose, and homocysteine levels, and improved balance ability. Therefore, the supervised 12-week Tai Chi exercise had potential beneficial effects on cerebral hemodynamics, plasma risk factors, and balance ability in older community adults at risk of ischemic stroke.
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Li J, Hsu CC, Lin CT. Leisure Participation Behavior and Psychological Well-Being of Elderly Adults: An Empirical Study of Tai Chi Chuan in China. Int J Environ Res Public Health 2019; 16:ijerph16183387. [PMID: 31547469 PMCID: PMC6765932 DOI: 10.3390/ijerph16183387] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/07/2019] [Accepted: 09/09/2019] [Indexed: 01/07/2023]
Abstract
Theoretical explanation concerning the psychological well-being of elderly adults as they participate in a particular leisure activity has been rare. Based on the theory of planned behavior and the technology acceptance model, this study sought to understand the Tai Chi Chuan (TCC) participation influence factors, process, and psychological well-being of Chinese people. A self-developed questionnaire was developed to test the hypotheses of this study. Applying structural equation models, a survey of 769 TCC participations were used to test the theoretical model. The results indicated that perceived usefulness significantly and positively affect respondent attitude, family members' influences significantly and positively affect participants' subjective norm, and resource facilitating conditions significantly and positively affect perceived behavioral control. Perceived behavioral control, attitude, and subjective norm significantly and positively affect TCC participants. The study lends support to the notion that leisure activity participation is vital for elderly adults and their well-being, and it develops a theoretical reference model for better understanding the leisure participation perceptual reasoning processes of elderly adults. Furthermore, the results offer important implications for health policy makers, clinical prevention, and interventions using participation behavior relationships to develop well-constructed leisure programs to attract and inspire participation and, hence, improve the psychological well-being of elderly adults.
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Affiliation(s)
- Jing Li
- Program in Management, Dayeh University, Changhua 51591, Taiwan.
- College of Music and Movie, Tianjin Normal University, Tianjin 300387, China.
| | - Chia-Chien Hsu
- Department of Tourism, Shih Hsin University, Taipei 116, Taiwan.
| | - Ching-Torng Lin
- Department of Information Management, Dayeh University, Changhua 51591, Taiwan.
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Conboy L, Krol J, Tomas J, Yeh GY, Wayne P, Salmoirago-Blotcher E. Tai Chi for heart attack survivors: qualitative insights. BMJ Support Palliat Care 2019; 10:e44. [PMID: 30948446 DOI: 10.1136/bmjspcare-2018-001685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/18/2019] [Accepted: 03/06/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Cardiac rehabilitation (CR) programmes are standard of care for patients following a coronary event. While such exercise-based secondary prevention programme do offer benefits, they are used by less than 30% of eligible patients and attrition within these programmes is high. This project is a nested qualitative assessment of a pilot programme considering Tai Chi (TC) as an alternative to CR. We hypothesised that TC may overcome several key barriers to CR. METHODS A semistructured focus group agenda was used to assess three key domains of feasibility: (1) patients' experiences, (2) reasons/barriers for not having attended CR and (3) any improvements in physical activity and other secondary outcomes (quality of life, weight, sleep). A thematic analysis was used to better understand the key concepts. RESULTS This high-risk group of patients reported that they enjoyed TC exercise, and felt confident and safe doing it. TC practice was reported to support other types of physical activity allowing for a generalisation of positive effects. DISCUSSION This analysis is consistent with published reports of TC practice improving mood and psychological well-being. Qualitative methods allowed us to find emergent experiential reports of behaviour change factors found in established behaviour change theories.
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Affiliation(s)
- Lisa Conboy
- Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA .,New England School of Acupuncture, Massachusetts College of Pharmacy and Health Sciences, Worcester, Massachusetts, USA
| | - Julie Krol
- Miriam Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Jose Tomas
- Miriam Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Gloria Y Yeh
- Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.,Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Peter Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Chan AWK, Chair SY, Lee DTF, Leung DYP, Sit JWH, Cheng HY, Taylor-piliae RE. Tai Chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: A randomised controlled trial. Int J Nurs Stud 2018; 88:44-52. [DOI: 10.1016/j.ijnurstu.2018.08.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/25/2018] [Accepted: 08/23/2018] [Indexed: 12/21/2022]
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16
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Liu T, Chan AW, Liu YH, Taylor-Piliae RE. Effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being, and cardiovascular risk reduction among patients with coronary heart disease: A systematic review and meta-analysis. Eur J Cardiovasc Nurs 2017; 17:368-383. [PMID: 29256626 DOI: 10.1177/1474515117749592] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Tai Chi is an attractive exercise to improve cardiovascular health. This review aimed to synthesize articles written both in Chinese and in English to evaluate the effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being and cardiovascular diseases risk reduction for coronary heart diseases patients. METHODS PRISMA guidelines were used to search major health databases to identify randomized controlled trials or non-randomized controlled clinical trials that evaluated Tai Chi intervention compared with active or non-active control groups in coronary heart disease patients. When suitable, data were pooled using a random-effects meta-analysis model. RESULTS Thirteen studies met the inclusion criteria. Tai Chi groups showed a large and significant improvement in aerobic endurance compared with both active and non-active control interventions (standard mean difference (SMD) 1.12; 95% confidence interval (CI): 0.58-1.66; p <0.001). Tai Chi groups also showed a significantly lower level of anxiety (SMD=9.28; CI: 17.46-1.10; p=0.03) and depression (SMD=9.42; CI: 13.59-5.26; p <0.001), and significantly better quality of life (SMD=0.73; 95% CI: 0.39-1.08; p <0.001) compared with non-active control groups. CONCLUSION Significant effects of Tai Chi have been found in improving aerobic endurance and psychosocial well-being among coronary heart disease patients. Tai Chi could be a cost-effective and safe exercise option in cardiac rehabilitation. However, the effect of Tai Chi on cardiovascular disease risk reduction has not been amply investigated among coronary heart disease patients. Caution is also warranted in view of a small number of studies for this meta-analysis and potential heterogeneity in differences in the varied designs of Tai Chi intervention.
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Affiliation(s)
- Ting Liu
- 1 Faculty of Medicine, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Aileen Wk Chan
- 1 Faculty of Medicine, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yun Hong Liu
- 1 Faculty of Medicine, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Salmoirago-Blotcher E, Wayne PM, Dunsiger S, Krol J, Breault C, Bock BC, Wu WC, Yeh GY. Tai Chi Is a Promising Exercise Option for Patients With Coronary Heart Disease Declining Cardiac Rehabilitation. J Am Heart Assoc 2017; 6:JAHA.117.006603. [PMID: 29021268 PMCID: PMC5721863 DOI: 10.1161/jaha.117.006603] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND More than 60% of patients decline participation in cardiac rehabilitation after a myocardial infarction. Options to improve physical activity (PA) and other risk factors in these high-risk individuals are limited. We conducted a phase 2 randomized controlled trial to determine feasibility, safety, acceptability, and estimates of effect of tai chi on PA, fitness, weight, and quality of life. METHODS AND RESULTS Patients with coronary heart disease declining cardiac rehabilitation enrollment were randomized to a "LITE" (2 sessions/week for 12 weeks) or to a "PLUS" (3 sessions/week for 12 weeks, then maintenance classes for 12 additional weeks) condition. PA (accelerometry), weight, and quality of life (Health Survey Short Form) were measured at baseline and 3, 6, and 9 months after baseline; aerobic fitness (stress test) was measured at 3 months. Twenty-nine participants (13 PLUS and 16 LITE) were enrolled. Retention at 9 months was 90% (LITE) and 88% (PLUS). No serious tai chi-related adverse events occurred. Significant mean between group differences in favor of the PLUS group were observed at 3 and 6 months for moderate-to-vigorous PA (100.33 min/week [95% confidence interval, 15.70-184.95 min/week] and 111.62 min/week; [95% confidence interval, 26.17-197.07 min/week], respectively, with a trend toward significance at 9 months), percentage change in weight, and quality of life. No changes in aerobic fitness were observed within and between groups. CONCLUSIONS In this community sample of patients with coronary heart disease declining enrollment in cardiac rehabilitation, a 6-month tai chi program was safe and improved PA, weight, and quality of life compared with a 3-month intervention. Tai chi could be an effective option to improve PA in this high-risk population. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT02165254.
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Affiliation(s)
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Shira Dunsiger
- The Miriam Hospital and The Warren Alpert Medical School of Brown University, Providence, RI
| | | | | | - Beth C Bock
- The Miriam Hospital and The Warren Alpert Medical School of Brown University, Providence, RI
| | - Wen-Chih Wu
- The Miriam Hospital and The Warren Alpert Medical School of Brown University, Providence, RI
| | - Gloria Y Yeh
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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Chen YW, Hunt MA, Campbell KL, Peill K, Reid WD. The effect of Tai Chi on four chronic conditions—cancer, osteoarthritis, heart failure and chronic obstructive pulmonary disease: a systematic review and meta-analyses. Br J Sports Med 2015; 50:397-407. [DOI: 10.1136/bjsports-2014-094388] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2015] [Indexed: 01/15/2023]
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Salmoirago-Blotcher E, Wayne P, Bock BC, Dunsiger S, Wu WC, Stabile L, Yeh G. Design and methods of the Gentle Cardiac Rehabilitation Study--A behavioral study of tai chi exercise for patients not attending cardiac rehabilitation. Contemp Clin Trials 2015; 43:243-51. [PMID: 26115880 DOI: 10.1016/j.cct.2015.06.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 06/18/2015] [Accepted: 06/20/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Cardiac rehabilitation (CR) programs reduce overall and cardiovascular mortality in patients with a history of acute coronary events or revascularization procedures, but only 30% of patients enroll in CR and attrition rates reach up to 60%. Tai chi, a mind-body practice based on light/moderate aerobic exercise accompanied by meditative components could be a possible exercise option for patients who do not attend CR. METHODS/DESIGN Sixty patients will be randomized to a "LITE" condition (one tai chi session twice weekly for 12 weeks) or to a "PLUS" condition (one tai chi session 3 times weekly for 12 weeks, followed by maintenance classes 1-2 times weekly for an additional 12 weeks). Measurements will be conducted at baseline, 3-, 6-, and 9 months after enrollment. The primary outcome is to determine the feasibility, acceptability and safety of each dose. Secondary outcomes include estimates of effect size of each dose on accelerometry-assessed physical activity; the proportion of patients meeting current recommendations for physical activity; and measures of fitness, quality of life, body weight, and sleep. In addition, we will collect exploratory information on possible mediators (exercise self-efficacy, perceived social support, resilience, mindfulness, and depression). CONCLUSIONS Findings from this pilot study will provide preliminary indications about the usefulness of tai chi as an exercise option for patients not attending traditional CR programs. Results will also shed light on the possible mechanisms by which tai chi practice may improve overall physical activity among patients with atherosclerotic coronary heart disease.
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Affiliation(s)
| | - Peter Wayne
- Osher Center for Integrative Medicine, Brigham and Women Hospital, Harvard Medical School, United States
| | - Beth C Bock
- The Miriam Hospital, The Warren Alpert Medical School of Brown University, United States
| | - Shira Dunsiger
- The Miriam Hospital, The Warren Alpert Medical School of Brown University, United States
| | - Wen-Chih Wu
- The Miriam Hospital, The Warren Alpert Medical School of Brown University, United States
| | | | - Gloria Yeh
- Beth Israel Deaconess Medical Center, Harvard Medical School, United States
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Shi ZM, Wen HP, Liu FR, Yao CX. The effects of tai chi on the renal and cardiac functions of patients with chronic kidney and cardiovascular diseases. J Phys Ther Sci 2014; 26:1733-6. [PMID: 25435688 PMCID: PMC4242943 DOI: 10.1589/jpts.26.1733] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 05/16/2014] [Indexed: 12/02/2022] Open
Abstract
[Purpose] To assess the effects of Tai Chi on the renal and cardiac functions of patients
with chronic kidney disease (CKD) and cardiovascular disease (CVD). [Subjects and Methods]
Twenty-one patients with CKD and CVD were randomly divided into control and exercise
groups. The exercise group performed Tai Chi training for 30 minutes three to five times a
week for 12 weeks, while the control group did not. All patients’ renal and cardiac
functions and blood lipid parameters were measured at baseline and after 12 weeks.
[Results] The 12 weeks Tai Chi intervention improved the estimated glomerular filtration
rate (eGFR), left ventricular ejection fraction (LVEF), and the high density lipoprotein
(HDL) level, and decreased the serum creatintine (Scr) level, heart rate (HR), systolic
blood pressure (SBP), diastolic blood pressure (DBP), and the total cholesterol (CH),
triglyceride (TG) and low density lipoprotein (LDL) levels. The change in eGFR correlated
negatively with the changes in CH, TG and LDL, and positively with the change in HDL. In
addition, the change in SBP correlated positively with the changes in CH, TG and LDL, and
negatively with the change in HDL. [Conclusion] Tai Chi training might improve the renal
and cardiac functions of CKD and CVD patients via improved regulation of lipid
metabolism.
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Affiliation(s)
- Zhi-Min Shi
- Medical College of Hebei University of Engineering, China
| | - Hai-Ping Wen
- Medical College of Hebei University of Engineering, China
| | | | - Chun-Xia Yao
- Medical College of Hebei University of Engineering, China
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Lan C, Chen SY, Wong MK, Lai JS. Tai chi chuan exercise for patients with cardiovascular disease. Evid Based Complement Alternat Med 2013; 2013:983208. [PMID: 24348732 DOI: 10.1155/2013/983208] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 08/19/2013] [Accepted: 09/23/2013] [Indexed: 01/19/2023]
Abstract
Exercise training is the cornerstone of rehabilitation for patients with cardiovascular disease (CVD). Although high-intensity exercise has significant cardiovascular benefits, light-to-moderate intensity aerobic exercise also offers health benefits. With lower-intensity workouts, patients may be able to exercise for longer periods of time and increase the acceptance of exercise, particularly in unfit and elderly patients. Tai Chi Chuan (Tai Chi) is a traditional Chinese mind-body exercise. The exercise intensity of Tai Chi is light to moderate, depending on its training style, posture, and duration. Previous research has shown that Tai Chi enhances aerobic capacity, muscular strength, balance, and psychological well-being. Additionally, Tai Chi training has significant benefits for common cardiovascular risk factors, such as hypertension, diabetes mellitus, dyslipidemia, poor exercise capacity, endothelial dysfunction, and depression. Tai Chi is safe and effective in patients with acute myocardial infarction (AMI), coronary artery bypass grafting (CABG) surgery, congestive heart failure (HF), and stroke. In conclusion, Tai Chi has significant benefits to patients with cardiovascular disease, and it may be prescribed as an alternative exercise program for selected patients with CVD.
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Abstract
Background: Physical activity can improve exercise capacity, quality of life and reduce mortality and hospitalization in patients with heart failure (HF). Adherence to exercise recommendations in patients with HF is low. The use of exercise games (exergames) might be a way to encourage patients with HF to exercise especially those who may be reluctant to more traditional forms of exercise. No studies have been conducted on patients with HF and exergames. Aim: This scoping review focuses on the feasibility and influence of exergames on physical activity in older adults, aiming to target certain characteristics that are important for patients with HF to become more physically active. Methods: A literature search was undertaken in August 2012 in the databases PsychInfo, PUBMED, Scopus, Web of Science and CINAHL. Included studies evaluated the influence of exergaming on physical activity in older adults. Articles were excluded if they focused on rehabilitation of specific limbs, improving specific tasks or describing no intervention. Fifty articles were found, 11 were included in the analysis. Results: Exergaming was described as safe and feasible, and resulted in more energy expenditure compared to rest. Participants experienced improved balance and reported improved cognitive function after exergaming. Participants enjoyed playing the exergames, their depressive symptoms decreased, and they reported improved quality of life and empowerment. Exergames made them feel more connected with their family members, especially their grandchildren. Conclusion: Although this research field is small and under development, exergaming might be promising in order to enhance physical activity in patients with HF. However, further testing is needed.
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Affiliation(s)
| | - Tiny Jaarsma
- Department of Social and Welfare studies, Faculty of Health Science, Linköping University, Sweden
| | - Anna Strömberg
- Department of Medical and Health Science, Division of Nursing Science, Faculty of Health Science, Linköping University, Sweden
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Affiliation(s)
- Silke Apers
- Department of Public Health and Primary Care, KU Leuven, Belgium
| | - Koen Luyckx
- School Psychology and Child and Adolescent Development, KU Leuven, Belgium
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven, Belgium
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium
- The Heart Centre, Copenhagen University Hospital, Denmark
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Lan C, Chen SY, Lai JS, Wong AM. Tai chi chuan in medicine and health promotion. Evid Based Complement Alternat Med 2013; 2013:502131. [PMID: 24159346 DOI: 10.1155/2013/502131] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 06/29/2013] [Indexed: 12/28/2022]
Abstract
Tai Chi Chuan (Tai Chi) is a Chinese traditional mind-body exercise and recently, it becomes popular worldwide. During the practice of Tai Chi, deep diaphragmatic breathing is integrated into body motions to achieve a harmonious balance between body and mind and to facilitate the flow of internal energy (Qi). Participants can choose to perform a complete set of Tai Chi or selected movements according to their needs. Previous research substantiates that Tai Chi has significant benefits to health promotion, and regularly practicing Tai Chi improves aerobic capacity, muscular strength, balance, health-related quality of life, and psychological well-being. Recent studies also prove that Tai Chi is safe and effective for patients with neurological diseases (e.g., stroke, Parkinson's disease, traumatic brain injury, multiple sclerosis, cognitive dysfunction), rheumatological disease (e.g., rheumatoid arthritis, ankylosing spondylitis, and fibromyalgia), orthopedic diseases (e.g., osteoarthritis, osteoporosis, low-back pain, and musculoskeletal disorder), cardiovascular diseases (e.g., acute myocardial infarction, coronary artery bypass grafting surgery, and heart failure), chronic obstructive pulmonary diseases, and breast cancers. Tai Chi is an aerobic exercise with mild-to-moderate intensity and is appropriate for implementation in the community. This paper reviews the existing literature on Tai Chi and introduces its health-promotion effect and the potential clinical applications.
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Abstract
The traditional hospital-based model of cardiac rehabilitation faces substantial challenges, such as cost and accessibility. These challenges have led to the development of alternative models of cardiac rehabilitation in recent years. The aim of this study was to identify and critique evidence for the effectiveness of these alternative models. A total of 22 databases were searched to identify quantitative studies or systematic reviews of quantitative studies regarding the effectiveness of alternative models of cardiac rehabilitation. Included studies were appraised using a Critical Appraisal Skills Programme tool and the National Health and Medical Research Council's designations for Level of Evidence. The 83 included articles described interventions in the following broad categories of alternative models of care: multifactorial individualized telehealth, internet based, telehealth focused on exercise, telehealth focused on recovery, community- or home-based, and complementary therapies. Multifactorial individualized telehealth and community- or home-based cardiac rehabilitation are effective alternative models of cardiac rehabilitation, as they have produced similar reductions in cardiovascular disease risk factors compared with hospital-based programmes. While further research is required to address the paucity of data available regarding the effectiveness of alternative models of cardiac rehabilitation in rural, remote, and culturally and linguistically diverse populations, our review indicates there is no need to rely on hospital-based strategies alone to deliver effective cardiac rehabilitation. Local healthcare systems should strive to integrate alternative models of cardiac rehabilitation, such as brief telehealth interventions tailored to individual's risk factor profiles as well as community- or home-based programmes, in order to ensure there are choices available for patients that best fit their needs, risk factor profile, and preferences.
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Affiliation(s)
- Robyn A Clark
- School of Nursing and Midwifery, Flinders University, Adelaide, Australia
| | - Aaron Conway
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University Technology, Australia
| | | | - Wendy Keech
- National Heart Foundation of Australia, Australia
| | - Rosy Tirimacco
- Integrated Cardiovascular Clinical Network, South Australia
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Nieva R, Safavynia SA, Lee Bishop K, Laurence S. Herbal, vitamin, and mineral supplement use in patients enrolled in a cardiac rehabilitation program. J Cardiopulm Rehabil Prev 2012; 32:270-7. [PMID: 22878561 DOI: 10.1097/HCR.0b013e31825f78f0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
PURPOSE The use of complementary and alternative medicine is common and continues to rise each year, both in the general population and among those with cardiovascular disease. While some supplements may incur risk, particularly when used concomitantly with cardiovascular medications, others have proven benefits. However, supplements such as antioxidants and many herbs can have significant interactions with cardiovascular medications. This study aimed to identify the percentage of patients enrolled in a cardiac rehabilitation program taking herbal, vitamin, and mineral supplements. METHODS Electronic and paper charts of 235 patients enrolled in a phase 3 cardiac rehabilitation program were reviewed. Their demographics, medical history, and medications were stratified in an Excel chart, using a large matrix from which data were imported into Matlab for analysis. Custom Matlab programs were created and compiled to determine variables of interest, including percentages of patients with a specific medical condition taking certain supplements. RESULTS Sixty-seven percent of patients enrolled in the cardiac rehabilitation program were taking vitamins, with or without minerals (67%, 158 of 235). Multivitamin is the most common form of supplement (51%, 119 of 235), followed by fish oil/omega-3 polyunsaturated fatty acids (27%, 64 of 235). CONCLUSION The majority of patients in a phase 3 cardiac rehabilitation program are taking some form of herbal, vitamin, or mineral supplement. Given frequent, complicated patient medication regimens, it is important to educate patients on the potential benefits as well as lack of evidence and possible dangers of supplements.
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Cano de la Cuerda R, Alguacil Diego IM, Alonso Martín JJ, Molero Sánchez A, Miangolarra Page JC. Cardiac rehabilitation programs and health-related quality of life. State of the art. Rev Esp Cardiol 2011; 65:72-9. [PMID: 22015019 DOI: 10.1016/j.recesp.2011.07.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 07/03/2011] [Indexed: 10/16/2022]
Abstract
Cardiovascular disease is the main health problem in developed countries. Prevention is presented as the most effective and efficient primary care intervention, whereas cardiac rehabilitation programs are considered the most effective of secondary prevention interventions; however, these are underused. This literature review examines the effectiveness and the levels of evidence of cardiac rehabilitation programs, their components, their development and role in developed countries, applications in different fields of research and treatment, including their psychological aspects, and their application in heart failure as a paradigm of disease care under this type of intervention. It is completed by a review of the impact of such programs on measures of health-related quality of life, describing the instruments involved in studies in recent scientific literature.
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Affiliation(s)
- Roberto Cano de la Cuerda
- Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
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