The efficacy of Tai Chi Chuan in older adults: a systematic review

OBJECTIVES: The purpose of this study was to assess the effect of Tai Chi Chuan (TCC) on fall prevention, balance and cardiorespiratory functions in the elderly. METHODS: A systematic review was carried out according to the Cochrane standards. A computerized literature search was carried out. Studies were selected when they had an experimental design; the age of the study population was >50; one of the interventions was a form of TCC; and when falls, balance or cardiorespiratory functions were used as an outcome measure. A total of seven studies were included, with in total 505 participants, of whom all but 27 were healthy seniors, age between 53 and 96 years. RESULTS: In most studies, the intervention of TCC is a modified Yang style, varying from 10 to 24 forms. The intensity of TCC varies from 1 h weekly for 10 weeks to 1 h every morning for 1 year. One study used falls as outcome measure and reported a beneficial effect of 47% in the TCC group. All studies mention a beneficial effect of TCC, but in most studies this conclusion was based on a pre-post analysis. CONCLUSION: There is limited evidence that TCC is effective in reducing falls and blood pressure in the elderly.     

Taichiquan acutely increases heart rate variability

A group of 15 elderly men and 14 young male students of physical education made twice a series of Taichiquan (TCQ) practices. Their electrocardiograms were recorded on tape-recorder and heart rates and heart rate variability (HRV) were calculated from digitized data. Here we report the results of recordings in supine positions before and after the first and second series of TCQ. Intervals between heart beats (RRIs) and their standard deviation (SDNN) increased in older men from recordings before the exercise to postexercise. In young subjects the SDNN and total variance (TV) of RRIs increased. HRV increases immediately after TCQ-exercise in young and old male healthy subjects. Whether these practices have permanent effects and effects in patients need controlled and prospective studies.     

太极拳锻炼对2型糖尿病的疗效观察及其机制探讨

目的 :观察太极拳锻炼对 2型糖尿病人的疗效 ,并对其机制进行探讨。方法 :1 2例老年2型糖尿病患者进行为期 8周的太极拳锻炼 ,观察锻炼前和锻炼后空腹、锻炼 8周结束时一次性运动前和运动后即刻空腹血糖 (glucose)、血浆胰岛素 (Ins)及红细胞胰岛素受体 (InR)等指标的变化。血糖、胰岛素的测定用临床常规检验法 ,红细胞胰岛素受体用改良Gambhir法。结果 :(1 )经过 8周锻炼后 ,糖尿病人安静状态下前后对比 :血糖水平降低(P <0 0 5 ) ,Ins水平未见显著变化 ,低亲和力胰岛素受体数目 (r2 )及低亲和力胰岛素受体结合容量 (R2 )增加 (P <0 0 5 )。 (2 )锻炼 8周结束时 ,一次性运动后即刻与运动前安静状态下比较 :血糖、高、低胰岛素受体数目 (r1、r2 )和高、低胰岛素受体结合容量(R1、R2 )均升高 (P <0 0 5 ) ,而胰岛素水平未见显著变化。结论 :(1 )长期太极拳锻炼在维持糖尿病患者正常的胰岛素分泌水平的基础上 ,能有效降低血糖水平 ;(2 )胰岛素受体活性的增加可能是太极拳运动对 2型糖尿病产生疗效的一种机制     

Tai Chi in Australia: acceptable and effective approach to improve balance and mobility in older people?

Objective: To evaluate the effects of 24 form Tai Chi Quan (TCQ) on balance and related measures, and factors associated with participation in the program. Methods: Twenty‐three older subjects (mean age 71.0 years, SD 5.6 years) commenced the three times weekly 1 h TCQ sessions. Subjects were measured on balance (Functional Reach, Step Test), gait (velocity, double support phase duration), activity level, leg muscle strength, and the Modified Falls Efficacy Scale (MFES) before and following the 3 month program. Participants also completed a survey investigating participation and perceived benefit of the program. Results: Nineteen participants completed the program, averaging attendance at 68% of classes. There was significant improvement in balance (Step Test, P < 0.01) and non‐significant improvement in gait double support duration (P = 0.04), Functional Reach (P = 0.04) and activity level (P = 0.06). Most participants incorporated some home practice as well as the formal program, and reported both the physical (balance) components and remembering sequences of movements as the most challenging aspects of the program. Conclusions: Twenty‐four form TCQ is a practical form of exercise for older people that improves dynamic balance performance.     

简易太极拳运动对中年女性身体机能的影响

目的观察简易太极拳运动对中年女性身体机能的影响。方法对60名中年女性实施16周太极拳锻炼，观察其血压、心率、肺活量等身体机能的变化。结果锻炼后，本组对象的安静心率与血压降低，心血管运动试验指数提高，肺活量增加（P〈0．05～0．01）。结论太极拳运动是一种有效提高中年女性身体机能的健身方式。     

太极拳在冠心病心脏康复中的研究进展

太极拳秉承了中国古代哲学阴阳辨证及道教“太极”理念,又暗合中医阴阳五行及经络学说思想,长期锻炼有益于人的身心健康。近年来关于太极拳在冠心病心脏康复中的一系列研究表明,太极拳运动不仅减轻冠心病患者临床症状,提高生活质量,并且有效干预冠心病危险因素如高血压、高血脂、高血糖,改善不良情绪,延缓动脉粥样硬化,修复血管内皮功能,调控心脏自主神经,降低心血管事件的再发率,改善冠心病患者的远期预后。     

我国香港、台湾地区护理管理立法可鉴之处一览

中华人民共和国卫生部颁布的《护士管理办法》,自1994年开始实施至今已经十年有余了。随着我国医疗卫生体制改革的推进,随着医疗服务市场的不断发展《,护士管理办法》的内容有待完善和修改。笔者仅以此文,介绍一下我国港台地区在护理管理方面具有特色的一些立法规定,相信会对日后完善内地护理管理工作有益。     

Reduction in fear of falling through intense tai chi exercise training in older, transitionally frail adults

OBJECTIVES: To determine whether an intense tai chi exercise program could reduce fear of falling better than a wellness education (WE) program in older adults who had fallen previously and meet criteria for transitioning to frailty. DESIGN: Cluster-randomized, controlled trial of 48 weeks' duration. SETTING: Ten matched pairs of congregate living facilities in the greater Atlanta area. PARTICIPANTS: Sample of 291 women and 20 men, aged 70 to 97. MEASUREMENTS: Activity-related fear of falling using the Activities-Specific Balance Confidence Scale (ABC) and the Fall Efficacy Scale at baseline and every 4 months for 1 year. Demographics, time to first fall and all subsequent falls, functional measures, Centers for Epidemiologic Studies Depression Scale, medication use, level of physical activity, comorbidities, and adherence to interventions. RESULTS: Mean ABC was similar in both cohort groups at the time of randomization but became significantly higher (decreased fear) in the tai chi cohort at 8 months (57.9 vs 49.0, P<.001) and at study end (59.2 vs 47.9, P<.001). After adjusting for covariates, the mean ABC after 12 months of intervention was significantly greater in the tai chi group than in the WE group, with the differences increasing with time (mean difference at 12 months=9.5 points, 95% confidence interval=4.8-14.2, P<.001). CONCLUSION: Tai chi led to a significantly greater reduction in fear of falling than a WE program in transitionally frail older adults. The mean percentage change in ABC scores widened between tai chi and WE participants over the trial period. Tai chi should be considered in any program designed to reduce falling and fear of falling in transitionally frail older adults.