The role of Tai Chi,cultural dancing,playing a musical instrument and singing in the prevention of chronic disease in Chinese older adults: a mind–body meditative approach

Older adults with chronic diseases have a high level of depression and poor mental health status. Previous public health interventions have attempted to reduce chronic disease-related health risks including depression and to improve mental health, but have had limited success. This study examined whether 15 months of regular participation in Tai Chi (TC) exercise, dancing, instrument playing and singing, as part of a mind–body meditative approach (MBMA), improves brain executive function, psychological functioning and mental health in Chinese older adults. Results indicated that the MBMA programme improved participants' executive function, psychological functioning, mental health and resilience, compared with a control group. These findings indicate that MBMA activities may be adopted as lifestyle approaches to promote mental health in different areas as follows: (1) TC and dancing have the biggest effect for reducing the prevalence of depression and for improving their mental health and resilience in older people with chronic conditions and (2) playing a musical instrument and singing have moderate effect for reducing depression symptoms and promoting mental health. The findings of the study suggest that there are mental health promotion implications relating to exercise type and minimal exercise dosage for older adults. Cultural dancing and TC may be a form of physical activity that is more likely to appeal to older people, when they are most at risk of being overweight or obese, of suffering from depression and/or of experiencing a decline in brain function. TC has been found to be highly effective in preventing depression and promoting brain executive function, and appears to be a form of physical activity that appeals to older people. Dancing, in combination with TC and singing, may be highly effective in protecting older adults from metabolic syndrome and brain function decline and in promoting a positive quality of life including psychological health. Playing a musical instrument may be used as an alternative method for maintaining good mental health in healthy people and for promoting mental health in people suffering from stress and its related depression and anxiety.     

Well-being of institutionalized elders after Yang-style Tai Chi practice

Aims and objectives. The purpose of this study was to examine the effects of Tai Chi on the physical and psychological well‐being of elders who resided in long‐term care facilities. Background. The beneficial effects of Tai Chi on elders’ well‐being have been well‐documented; however, most of the studies focused on community‐dwelling or healthier elders. Design and methods. In this longitudinal, time‐series, quasi‐experimental study, a convenience sample of 28 institutionalized elders was recruited. A six‐month Yang‐style Tai Chi intervention was administered twice a week for 60 minutes per practice. The well‐being outcome variables, including physical and mental health status, blood pressure, quality of sleep, occurrence of falls and fear of falling, were measured before the intervention and then at one‐month, two‐month, three‐month and six‐month intervals. Results. Results indicated that the physical health status and social functioning of frail elders were significantly improved after Tai Chi practice [F(4,24) = 3·42, p = 0·038; F(4,24) = 9·66, p = 0·001 respectively]. Conclusions. Tai Chi practice is beneficial for frail older people. Relevance to clinical practice. The findings provide a basis for using Yang‐style Tai Chi as a floor activity in long‐term care facilities to promote the well‐being of the older residents.     

柴胡加龙骨牡蛎汤加减联合太极拳运动治疗抑郁症40例临床观察

目的:观察柴胡加龙骨牡蛎汤加减联合太极拳运动治疗肝气阻滞兼痰热型抑郁症的临床疗效。方法:将80例肝气阻滞兼痰热型抑郁症患者随机分为治疗组和对照组,每组各40例。治疗组给予柴胡加龙骨牡蛎汤加减联合太极拳运动治疗,对照组给予盐酸帕罗西汀治疗。2组疗程均为6周。观察患者的综合疗效及抑郁自评量表(SDS)评分、汉密尔顿抑郁量表(HAMD)评分、中医证候评分、不良反应量表(TESS)评分。结果:治疗组脱落1例,对照组脱落2例。综合疗效总有效率治疗组为94.87%(37/39),对照组为81.58%(31/38),2组比较,差异有统计学意义(P<0.05);2组治疗2、4、6周后SDS、HAMD及中医证候评分均低于治疗前(P<0.01),且治疗组治疗后各时间节点的SDS、HAMD、TESS及中医证候评分均低于对照组(P<0.05或P<0.01)。结论:柴胡加龙骨牡蛎汤加减联合太极拳运动治疗肝气阻滞兼痰热型抑郁症疗效确切,且无明显不良反应,值得临床推广应用。     

Tai chi for enhanced inpatient mobilization: A feasibility study

ObjectiveTo determine whether utilizing beginner, video-guided tai chi and qigong classes as an adjunct to physical therapy to enhance mobilization among hospitalized patients is feasible and acceptable.DesignSingle-arm feasibility study over a 15½-week period.SettingThree medical-surgical units at one hospital.InterventionsSmall-group video-guided beginner-level tai chi and qigong classes supervised by physical therapists occurred three times a week.Main outcome measuresThe primary outcome was weekly class attendance. Secondary outcomes included patient and staff satisfaction, collected by surveys and semi-structured interviews. Process measures included class duration. Balancing measures included falls.ResultsOne-hundred and fifty-seven patients were referred for recruitment, 45 gave informed consent, and 38 patients attended at least one class. The number of weekly class attendees increased during the study period. Based on first-class experience, 68% (26/38) of patients reported enjoying the class “quite a bit” or “extremely,” 66% (25/38) of patients reported feeling “more mobile” afterward, and 76% (29/38) of patients agreed that the class made them more comfortable going home. Average class duration was 29 minutes. Zero falls occurred during or immediately following class.ConclusionsVideo-guided tai chi and qigong classes are feasible and well-received at our hospital. Future studies of the impact on preserving mobility and function or reducing length of stay are of interest.     

太极拳运动中上肢肌肉工作特点的研究

目的本文通过肌电测试仪测试太极拳运动中几个典型的上肢基本动作肌电值,与BIODEX等速训练仪器上最大力运动肌电值进行比较,试图了解太极拳运动中上肢肌肉工作的形式与特点,为从生理学角度深入研究太极拳运动的生物学机制提供实验依据和参考,为深入研究太极拳和轮椅太极拳的健身机制提供新的思路和方法。方法武术专业学生15名,(10男5女),选取太极拳运动上肢典型的步型和手型共6个动作,用Megawin2000表面肌电测试系统记录各动作的主要部位肌肉的积分肌电值(IEMG),然后再记录每位受试者在Biodex等速训练仪上肢肩关节三角肌三个维度最大力等速运动时的IEMG,对比分析前者和后者的积分肌电(IEMG)值和平均功率频率(MPF)值。结果太极拳上肢运动时,上肢进行野马分鬃动作时三角肌的IEMG(0.553mV o sec),为相应维度BIODEX等速训练仪上最大力IEMG(3.986mV o sec)的13%,是全部测定数据的最小百分比;上肢肌进行单边作时三角肌的IEMG(0.771mV o sec)为相应维度BIODEX等速训练仪上最大力IEMG(2.733mV o sec)的28%,是全部测定数据的最大百分比;所有IEMG比值在13~28%之间。太极拳上肢运动MPF值显著低于最大收缩时的MPF(P0.01)。结论太极拳上肢运动时,运动负荷强度为最大负荷的13%~28%,属于中低强度负荷。肌电信号频率特征MPF值提示,太极拳上肢运动时肌肉是以慢肌运动单位参与为主。太极拳上肢运动的中低强度、慢肌运动单位参与为主的运动特点,为轮椅太极的健身效果提供了依据。     

Tai Chi training for attention deficit hyperactivity disorder: A feasibility trial in college students

ObjectiveMany 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).MethodUndergraduates 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.Results21 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.ConclusionThe 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.     

太极拳对中老年人跌倒及平衡功能影响的Meta分析

目的系统评价太极拳对中老年人跌倒及平衡功能的影响。方法计算机检索PubMed、EMbase、Web of Science、The Cochrane Library、CNKI和WanFang Data数据库,搜集太极拳对中老年人平衡功能及跌倒影响的随机对照试验(RCT),检索时限均为建库至2019年8月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入20个RCT,包括3 842例中老年人。Meta分析结果显示,太极拳组能减少跌倒率[RR=0.82,95%CI(0.75,0.90),P<0.000 1],且在单腿站立时间[MD=5.76,95%CI(0.62,10.90),P=0.03]、Berg评分[MD=1.04,95%CI(0.23,1.85),P=0.01]、起立步行测试[MD=-0.71,95%CI(-0.88,-0.54),P<0.000 01]、椅子站立测试[MD=0.87,95%CI(0.05,1.70),P=0.04]等指标的改善方面均优于对照组,其差异有统计学意义。结论当前证据表明,太极拳可改善中老年人平衡功能,减少跌倒率,对中老年人跌倒有一定的防治作用。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。     

太极拳运动对高血压病(Ⅰ期)的血压及血脂的影响

目的 探讨太极拳在高血压病Ⅰ期生物行为治疗上的作用.方法 将120例入选患者随机分为太极拳组和对照组,每组各60例.两组均接受限盐膳食,前者每天进行1小时太极拳运动.观察12周后的血压和血脂变化.结果 (1)降压效果:太极拳组总有效率为88.3%,对照组为21.7%,两组有显著性差异(P＜0.05);太极拳组治疗后血压较基线明显下降(P＜0.05).(2)调脂作用:太极拳组治疗后总胆固醇(TC)、甘油三脂(TG),低密度脂蛋白(LDL-C)下降,高密度脂蛋白(HDL-C)升高有显著差(P＜0.05);而对照组变化不明显.结论 生物行为疗法太极拳对Ⅰ期高血压病有良好作用.     

太极拳对女大学生上呼吸道感染影响的研究

目的探讨不同运动量太极拳对上呼吸道感染及免疫球蛋白的影响。方法将90名女大学生分成对照组(C组),每周运动3次组(3T组),每周运动5次组(5T组),后2组进行6个月太极拳训练,对3组进行试验前后1个月关于上呼吸道感染的调查问卷及免疫球蛋白测量,然后作比较分析。结果试验前后1个月3组上呼吸道感染发病次数无差异(p>0.05),但3T、5T组试验后上呼吸道感染时间较试验前缩短(p<0.05);3T、5T组试验后IgA、IgG较试验前升高,C组IgM较试验前减低(p<0.05);3T、5T组比较,在试验前后免疫球蛋白、上呼吸道感染时间上的差异均无统计学意义(p>0.05)。结论适量太极拳运动能缩短上呼吸道感染时间,可能与IgA、IgG升高有关。     

基于关联性分析的门诊患者满意度评价指标体系优化设计

在分析现有的满意度评价指标体系构建中存在的问题的基础上,提出通过对问卷调查数据进行关联性分析来优化初始满意度评价指标的方法,从而保证评价指标之间的独立性。通过对22个初始满意度评价指标的关联性分析,确定了只有医师的医疗技术指标、等候总评价、挂号人员服务态度、收款人员服务态度、药局人员服务态度、辅助检查科室人员服务态度、检验科人员服务态度、门诊指示标志、门诊环境清洁情况和门诊看病方便程度等10个指标的评价指标体系。优化后的评价指标体系不仅保证原有问卷的信度和效度,而且也增强了患者满意度调查的实用性和评价的适用性。