Effects of T'ai Chi exercise on fibromyalgia symptoms and health-related quality of life

BACKGROUND: Fibromyalgia (FM), one of the most common musculoskeletal disorders, is associated with high levels of impaired health and inadequate or limited symptom relief. The cause of this complex syndrome is unknown, and there is no known cure. Numerous research results indicate that a combination of physical exercise and mind-body therapy is effective in symptom management. T'ai Chi, an ancient Chinese exercise, combines physical exercise with mindbody therapy. PURPOSE: To investigate the effects of T'ai Chi exercise on FM symptoms and health-related quality of life. DESIGN: Pilot study, one group pre-to-post posttest design. METHODS: Participants with FM (n = 39) formed a single group for 6 weeks of 1-hour, twice weekly T'ai Chi exercise classes. FM symptoms and health-related quality of life were measured before and after exercise. FINDINGS: Twenty-one participants completed at least 10 of the 12 exercise sessions. Although the dropout rate was higher than expected, measurements on both the Fibromyalgia Impact Questionnaire (FIQ) (Buckhardt, Clark, & Bennett, 1991) and the Short Form-36 (SE-36) (Ware & Sherbourne, 1992) revealed statistically significant improvement in symptom management and health-related quality of life. IMPLICATIONS FOR NURSING RESEARCH: Knowledge of interventions to enhance health for the patient with musculoskeletal problems is a National Association of Orthopaedic Nurses priority. Tai Chi is potentially beneficial to patients with FM. Further research is needed to support evidence-based practice.     

Health-related quality of life in the elderly practicing T'ai Chi Chuan

OBJECTIVE: Previous studies have shown health benefits of T'ai Chi Chuan (TCC). In Taiwan, TCC is a form of exercise that is widely practiced by the elderly. The aim of this cross-sectional study was to investigate the effects of TCC on the health-related quality of life (HRQOL) in the senior population. METHODS: Subjects who regularly practiced TCC in Taiwan were selected by random sampling and included 140 seniors (77 males and 63 females, aged 40-70 years). The questionnaire was separated into 2 parts: demographic information and the SF-36 questionnaire, which used 8 domains to evaluate the subjects' HRQOL. The results were compared with those of 560 age- and sex-matched control subjects that were taken from the general population (308 males and 252 females). Multiple regression analysis was used to compare the quality of life in each of the 8 domains between the 2 groups. RESULTS: The TCC group showed significantly higher quality-of-life scores than the control group in each of the 8 domains with the exception of the bodily pain scales. Using multiple linear regression adjusted for covariates, the TCC group had significantly higher scores in physical functioning, physical roles, general health, vitality, and social-functioning scales than the control group. In most of the domains in both the TCC group and the control group, quality of life became worse with increased age, whereas the scores in vitality and social-functioning domains of the TCC group showed a reverse trend; they remained unchanged or even improved with increased age. CONCLUSIONS: Our study supports the hypothesis that TCC improves quality of life among the elderly in Taiwan, but further study must be conducted to more conclusively show the link between TCC and health-related QOL.     

A Pilot Study Exploring the Effects of a 12-Week T'ai Chi Intervention on Somatic Symptoms of Depression in Patients with Heart Failure

Abstract Background: Patients with chronic heart failure (HF) and with elevated depression symptoms are at greater risk of morbidity and mortality. Somatic symptoms of depression are particularly prevalent in HF and are related to worse disease prognosis. T'ai chi practice is related to increased emotional well-being in various clinical populations; however, relatively little is known about t'ai chi's effects on somatic versus cognitive symptom dimensions of depression in HF. Purpose: The objective of the study was to measure whether a t'ai chi intervention effectively reduces somatic and/or cognitive symptoms of depression in patients with HF. Methods: Patients with HF were assigned to either t'ai chi training (n=16) or a usual-care group (n=12). At baseline and after the 12-week intervention period, participants were evaluated for changes in depressive symptoms using Beck Depression Inventory (BDI) total scores (BDI-t) and subcategorized scores of BDI-somatic (BDI-s) and BDI-cognitive (BDI-c), and for symptoms of fatigue using the Multidimensional Fatigue Symptom Inventory-Short Form. Results: Patients with HF in the t'ai chi group compared to the usual-care group had reduced BDI-s (p≤0.017), but not BDI-c (p=0.50) scores from pre- to postintervention. Although t'ai chi did not significantly reduce fatigue, changes in physical fatigue (p≤0.05) were independently associated with changes in BDI-t scores. Conclusions: T'ai chi practice reduced somatic symptoms of depression, which have been linked to worse prognosis in HF. Reductions in fatigue appear to explain some but not all of the reductions in somatic symptoms of depression.     

Characteristics of foot movement in Tai Chi exercise

BACKGROUND AND PURPOSE: The concept of proper foot movement is always emphasized in practicing Tai Chi (TC). The purposes of this study were to describe the foot movement characteristics of TC and to compare duration of single- and double-limb support time during TC and during walking. SUBJECTS: Sixteen experienced TC practitioners participated in the study. METHODS: The participants' performance of a whole set of 42-form TC movements was recorded with 2 cameras. A motion analysis system was used to identify the supporting and stepping characteristics of the foot during the practice. RESULTS: Seven foot support patterns and 6 step directions were identified. The results revealed that, compared with normal walking, TC movement had more double-limb support and less single-limb support in terms of total duration. The duration of each support pattern was longer, and movement from one pattern to the next was slow. The duration of each step direction was short, and changes of direction were frequent. DISCUSSION AND CONCLUSION: Support patterns changed slowly, and, combined with various step directions, they were found to be better than those of walking in simulating the gait challenges that may be encountered in daily activities.     

Effectiveness of Tai Chi exercise in improving aerobic capacity: a meta-analysis

PURPOSE: Meta-analysis involves the integration of several studies with small sample sizes, enabling the investigator to summarize research results into useful clinical information. Tai Chi exercise has recently gained the attention of Western researchers as a potential form of aerobic exercise. A goal of this meta-analysis was to estimate the effect of Tai Chi exercise on aerobic capacity. METHODS: A computerized search of 7 databases was done using key words and all languages. Sixteen study elements were critically appraised to determine study quality. D-STAT software was used to calculate the standardized mean differences (ESsm) and the 95% confidence intervals (CI), using means and standard deviations (SD) reported on aerobic capacity expressed as peak oxygen uptake (VO2peak) (mL x kg(-1) x min(-1)). RESULTS: Of 441 citations obtained, only 7 focused on aerobic capacity in response to Tai Chi exercise (4 experimental and 3 cross-sectional). Older adults including those with heart disease participated (n = 344 subjects); on average men were aged 55.7 years (SD = 12.7) and women 60.7 years (SD = 6.2). Study quality scores ranged from 22 to 28 (mean = 25.1, SD = 2.0). Average effect size for the cross-sectional studies was large and statistically significant (ESsm = 1.01; CI = +0.37, +1.66), while in the experimental studies the average effect size was small and not significant (ESsm = 0.33; CI = -0.41, +1.07). Effect sizes of aerobic capacity in women (ESsm = 0.83; CI = -0.43, +2.09) were greater than those for men (ESsm = 0.65; CI = -0.04, +1.34), though not statistically significant. Aerobic capacity was higher in subjects performing classical Yang style (108 postures) Tai Chi (ESsm = 1.10; CI = +0.82, +1.38), a 52-week Tai Chi exercise intervention (ESsm = 0.94; C = +0.06, +1.81), compared with sedentary subjects (ESsm = 0.80; CI = +0.19, +1.41). CONCLUSIONS: This meta-analysis suggests that Tai Chi may be an additional form of aerobic exercise. The greatest benefit was seen from the classical Yang style of Tai Chi exercise when performed for 1-year by sedentary adults with an initial low level of physical activity habits. Recommendations for future research are provided and the effect sizes generated provide information needed for sample size calculations. Randomized clinical trials in diverse populations, including those with chronic diseases, would expand the current knowledge about the effect of Tai Chi on aerobic capacity.     

改良太极运动对老年女性膝OA患者下肢肌力与心肺耐力的影响

目的:探讨为期12周的改良太极运动对老年女性膝骨关节炎患者下肢肌力及心肺耐力的影响.方法:将40例老年女性KOA患者采用数字随机法分为太极组(n=20)和对照组(n=20),进行为期12周的干预.在治疗前后进行表面肌电(sEMG)、心血管功能、肺功能检查和6分钟步行实验(6MWT)测试.结果:治疗12周后,与治疗前相比...     

Change in perceived psychosocial status following a 12-week Tai Chi exercise programme

AIM: This paper reports a study to examine change in psychosocial status following a 12-week Tai Chi exercise intervention among ethnic Chinese people with cardiovascular disease risk factors living in the United States of America. BACKGROUND: Regular participation in physical activity is associated with protection against cardioavascular disease, and improvements in physical and psychological health. Increasing amounts of scientific evidence suggests that mind-body exercise, such as Tai Chi, are related to improvements in mental health, emotional well-being, and stress reduction. No prior study has examined the effect of a Tai Chi exercise intervention on psychosocial status among people with cardiovascular disease risk factors. METHODS: This was a quasi-experimental study. Participants attended a 60-minute Tai Chi exercise class three times per week for 12 weeks. Data were collected at baseline, 6 and 12 weeks following the intervention. Psychosocial status was assessed using Chinese versions of Cohen's Perceived Stress Scale, Profile of Mood States, Multidimensional Scale of Perceived Social Support, and Tai Chi exercise self-efficacy. RESULTS: A total of 39 participants, on average 66-year-old (+/-8.3), married (85%), Cantonese-speaking (97%), immigrants participated. The majority were women (69%), with < or =12 years education (87%). Statistically significant improvements in all measures of psychosocial status were found (P < or = 0.05) following the intervention. Improvement in mood state (eta2 = 0.12), and reduction in perceived stress (eta2 = 0.13) were found. In addition, Tai Chi exercise statistically significantly increased self-efficacy to overcome barriers to Tai Chi (eta2 = 0.19), confidence to perform Tai Chi (eta2 = 0.27), and perceived social support (eta2 = 0.12). CONCLUSIONS: Tai Chi was a culturally appropriate mind-body exercise for these older adults, with statistically significant psychosocial benefits observed over 12-weeks. Further research examining Tai Chi exercise using a randomized clinical trial design with an attention-control group may reduce potential confounding effects, while exploring potential mechanisms underlying the relaxation response associated with mind-body exercise. In addition, future studies with people with other chronic illnesses in all ethnic groups are recommended to determine if similar benefits can be achieved.     

The duration and plantar pressure distribution during one-leg stance in Tai Chi exercise

BACKGROUND: Tai Chi exercise improved the balance control and muscle strength of the lower extremities. The aim of this study is to quantify the one-leg stance duration and plantar pressure distribution during the one-leg stance in Tai Chi and to try to elaborate on its probable effects on the ability to balance on one leg. METHODS: Sixteen experienced Tai Chi practitioners participated in this study. The Novel Pedar-X insole system was used to record the plantar forces during the execution of a set of 42-form Tai Chi movements and during normal walking. The one-leg stance duration and plantar pressure distribution during the one-leg stance were analyzed. FINDINGS: In Tai Chi exercise, the total duration spent in the one-leg stance was less (p<0.05), the duration of each one-leg stance was longer (p<0.01) and the medial-lateral displacement of the centre of pressure was greater (p<0.05) than during normal walking. The peak pressure and pressure-time integral of the second and third metatarsal heads and the fourth and fifth metatarsal heads were significantly greater (p<0.05) than those of other plantar regions during the one-leg stance in normal walking, whereas the peak pressure and pressure-time integral of the first metatarsal head and the great toe were significantly greater (p<0.05) than those of other plantar regions during the one-leg stance in Tai Chi exercise. INTERPRETATION: The longer duration of each one-leg stance and the plantar pressure distribution characteristics during the one-leg stance in Tai Chi exercise may be associated with an improved ability to balance on one leg. The findings may provide useful information toward the development of strengthening programs, strategies for the prevention of falls, and the promotion of a physically active lifestyle.     

简化太极拳运动对减轻社区老年人害怕跌倒的效果研究

目的 评价简化太极拳运动对社区老年人害怕跌倒心理和平衡能力的影响。 方法 根据纳入排除标准选取80名社区老年人作为研究对象,采用随机数字表法分为试验组和对照组各40名。试验组在对照组干预措施的基础上进行简化太极拳运动,对照组接受健康宣教和随访,干预时间均为6个月。干预前后分别评价两组害怕跌倒心理水平、平衡能力、是否跌倒等指标。 结果 两组共72名老年人完成研究。试验组简化太极拳运动干预集中练习和居家个人练习依从性较好,分别为75.68%和64.86%。干预后,试验组的害怕跌倒心理水平和平衡能力均优于干预前和对照组,差异有统计学意义（P<0.05)。但干预后,两组是否跌倒比较,差异无统计学意义（P＞0.05),两组组内干预前后纵向比较,差异均有统计学意义（P=0.001)。 结论 简化太极拳运动适合害怕跌倒的老年人练习,能够显著减轻老年人害怕跌倒心理水平和提高老年人平衡能力。     

太极拳对老年慢性阻塞性肺疾病患者肺功能和运动耐力影响的Meta分析

背景：研究显示太极拳运动能够缓解慢性阻塞性肺疾病患者肺功能下降,提高运动耐力,但也有研究发现太极拳运动对慢性阻塞性肺疾病患者的肺功能和运动耐力并没有达到改善的效果。
　　目的：系统评价太极拳锻炼对老年慢性阻塞性肺疾病患者肺功能和运动耐力的影响。
　　方法：计算机检索PubMed,EMBASE,Web of Science,The Cochrane Library英文数据库和中国知网、万方和维普中文数据库中1980年1月至2014年7月间的文献资料。纳入太极拳对老年慢性阻塞性肺疾病患者干预的随机对照试验,包括太极拳运动干预组和常规药物或是健康教育对照组。
　　结果与结论：共计纳入6个随机对照试验,共406例患者。Meta分析结果显示,与对照组相比,太极拳运动明显改善了慢性阻塞性肺疾患者第1秒用力呼气容积与用力肺活量比值百分比水平(MD=4.62,95%CI：0.73-8.51,P=0.02)、第1秒用力呼气容积占预计值百分比水平(MD=4.95,95%CI：0.33-9.57,P=0.04)、6 min步行距离水平(MD=33.81,95%CI：6.00-61.62,P=0.02),但第1秒用力呼气容积在太极拳组与对照组间未见显著性差异(MD=0.02,95%CI：-0.10-0.14,P=0.76)。结果证实,太极拳运动有效了改善老年慢性阻塞性肺疾病患者的肺功能和运动耐力,对老年慢性阻塞性肺疾病患者产生了积极的康复效果。     

Analyzing pacemaker leads: application of a form of energy

In the province of Ontario, analyzing of pacemaker leads is a delegated controlled act. This article describes the certification/recertification process for analyzing of pacemaker leads at the Hamilton Health Sciences Corporation.     

Improved insulin sensitivity after a single bout of exercise is curvilinearly related to exercise energy expenditure

A single bout of moderate-intensity exercise increases whole-body insulin sensitivity for 12-48 h post-exercise; however, the relationship between exercise energy expenditure and the improvement in insulin sensitivity is not known. We hypothesized that the exercise-induced increase in whole-body insulin sensitivity, assessed with HOMA(IR) (homoeostasis model assessment of insulin resistance), is directly related to the energy expended during exercise. We studied 30 recreationally active non-obese men (age, 27+/-5 years; body mass index, 24+/-2 kg/m(2)) in the post-absorptive state on two separate occasions: once after exercising at 60% of VO(22peak) (peak oxygen consumption) for 30-120 min on the preceding afternoon (expending a total of 1.28-5.76 MJ) and once after an equivalent period of rest. Blood samples were obtained the following morning. Exercise-induced changes in HOMA(IR) were curvilinearly related to exercise energy expenditure (r=-0.666, P=0.001) with a threshold of approx. 3.77 MJ (900 kcal) for improvements in HOMA(IR) to be manifested. In particular, HOMA(IR) was reduced by 32+/-24% (P=0.003) in subjects who expended more than 3.77 MJ during exercise, but did not change for those who expended fewer than 3.77 MJ (-2+/-21%; P=0.301). Furthermore, the magnitude of change in HOMA(IR) after exercise was directly associated with baseline (i.e. resting) HOMA(IR) (r=-0.508, P=0.004); this relationship persisted in multivariate analysis. We conclude that improved whole-body insulin resistance after a single bout of exercise is curvilinearly related to exercise energy expenditure, and requires unfeasible amounts of exercise for most sedentary individuals.     

长期太极拳锻炼改善中老年人认知能力的作用

目的:观察长期太极拳锻炼对中老年人的认知能力影响,并与无体育锻炼习惯的中老年人进行比较。方法:实验于2002-10-01/07上午8:00～12:00在阜阳师范学院体育系运动生理实验室进行。①选择健康中老年阜阳市市民101人,年龄45～74岁。其中53人为锻炼组,均为参加太极拳活动半年及半年以上者;48人为对照组,是无体育锻炼习惯的中老年人。②所有受试者测定认知功能,包括平均反应时间,最佳反应时间,手脚交叉运动总时间,手脚交叉运动正确次数,手脚运动平均时间,记忆能力,手臂稳定性,注意集中时间,注意分散次数,表象旋转。③两组受试者均分为45～54岁、55～64岁、65～74岁3个年龄段进行比较;锻炼组按锻炼年限分为≤3年、4～6年、≥7年3个年限进行组内比较。结果:93人进入结果分析。①除最佳反应时外,其他各个指标(包括平均反应时、注意力、协调技能、记忆力和表象能力)锻炼组均优于对照组(P<0.05)。②认知能力的各个指标(最佳反应时除外),锻炼组在3个年龄段均优于对照组(P<0.05),两组的认知能力都是随年龄段增长而下降,但锻炼组下降较缓慢。③锻炼组组内的3种不同锻炼年限段比较,锻炼年限较长者的认知能力的各个指标(最佳反应时除外)均优于锻炼年限短者(P<0.05)。结论:长期进行太极拳锻炼有利于中老年人的认知能力的维持和促进。     

长期太极拳锻炼改善中老年人认知能力的作用

目的：观察长期太极拳锻炼对中老年人的认知能力影响，并与无体育锻炼习惯的中老年人进行比较。方法：实验于2002-10—01／07上午8：00～12：00在阜阳师范学院体育系运动生理实验室进行。①选择健康中老年阜阳市市民101人，年龄45-74岁。其中53人为锻炼组，均为参加太极拳活动半年及半年以上者；48人为对照组，是无体育锻炼习惯的中老年人。②所有受试者测定认知功能，包括平均反应时间，最佳反应时间，手脚交叉运动总时间，手脚交叉运动正确次数，手脚运动平均时间，记忆能力，手臂稳定性，注意集中时间，注意分散次数，表象旋转。③两组受试者均分为45-54岁、55-64岁、65—74岁3个年龄段进行比较；锻炼组按锻炼年限分为≤3年、4-6年、≥7年3个年限进行组内比较。结果：93人进人结果分析。①除最佳反应时外，其他各个指标（包括平均反应时、注意力、协调技能、记忆力和表象能力）锻炼组均优于对照组（P〈0．05）。②认知能力的各个指标（最佳反应时除外），锻炼组在3个年龄段均优于对照组（P〈0．05），两组的认知能力都是随年龄段增长而下降，但锻炼组下降较缓慢。③锻炼组组内的3种不同锻炼年限段比较，锻炼年限较长者的认知能力的各个指标（最佳反应时除外）均优于锻炼年限短者（P〈0．05）。结论：长期进行太极拳锻炼有利于中老年人的认知能力的维持和促进。     

Coordination exercise and postural stability in elderly people: Effect of Tai Chi Chuan

OBJECTIVE: To evaluate the effects of coordination exercise on postural stability in older individuals by Chinese shadow boxing, Tai Chi Chuan (TCC). DESIGN: Cross-sectional study. SETTING: Research project in a hospital-based biomechanical laboratory. PARTICIPANTS: The TCC group (n = 25) had been practicing TCC regularly for 2 to 35 years. The control group (n = 14) included healthy and active older subjects. INTERVENTION: Static postural stability test: progressively harder sequential tests with 6 combinations of vision (eyes open, eyes closed, sway-referenced) and support (fixed, sway-referenced); and dynamic balance test: 3 tests of weight shifting (left to right, forward-backward, multidirectional) at 3 speeds. MAIN OUTCOME MEASURES: Static and dynamic balance of Sensory Organization Testing (SOT) of the Smart Balance Master System. RESULTS: In static postural control, the results showed no differences between the TCC or control group in the more simple conditions, but in the more complicated SOT (eyes closed with sway surface, sway vision with sway surface), the TCC group had significantly better results than the control group. The TCC group also had significantly better results in the rhythmic forward-backward weight-shifting test. Duration of practice did not seem to affect the stability of elder people. CONCLUSION: The elderly people who regularly practiced TCC showed better postural stability in the more challenged conditions than those who do not (eg, the condition with simultaneous disturbance of vision and proprioception). TCC as a coordination exercise may reduce the risk of a fall through maintaining the ability of posture control.