Tai Chi and Health-Related Quality of Life in Nursing Home Residents

Purpose: Health-related quality of life (HRQOL) that is good is regarded as the goal of elderly residential care. However, limited evidence exists indicating a promising intervention that can achieve this goal. The aim of this study is to examine the effect of Tai Chi on HRQOL in nursing home residents.
Design: A nonequivalent pretest-posttest control-group design.
Methods: A convenience sample of 139 residents from six nursing homes in Hong Kong was used. The experimental group ( n =66) joined a 26-week Tai Chi program, while the control group ( n =73) continued with usual daily activities. The physical and mental components of HRQOL were designated as the dependent variables. Resident satisfaction was considered as a covariate. Doubly multivariate repeated measures analysis of covariance was done to examine the intervention effect.
Findings: After adjusting for the confounding effect of resident satisfaction, a statistically significant difference ( p <0.05) in the physical and mental components of HRQOL between the experimental and control groups was found. Findings showed significant improvement in HRQOL after residents practiced Tai Chi.
Conclusions: These investigators contribute additional knowledge about the health benefits of Tai Chi among nursing home residents and indicates support for its use in this population to improve HRQOL.
Clinical Relevance: Tai Chi has unique characteristics as a health exercise that is particularly suitable for nursing home residents. The inclusion of Tai Chi exercise in elderly residential care practice is recommended.     

Tai Chi practice on prefrontal oxygenation levels in older adults: A pilot study

ObjectiveThe role of exercise in preventing or delaying age-related cognitive decline is an important focus of rehabilitation. Tai Chi (TC) is a traditional Chinese exercise that has been found to improve cognitive function. However, the mechanism underlying this improvement is still unknown. We compared the effects of TC practice (mind-body exercise) and arm ergometry (AE; body focused exercise) on prefrontal cortex activity between TC practitioners and non-practitioners.DesignThis cross-sectional study included 16 older female subjects (8 TC practitioners and 8 non-practitioners). The practitioners had each practiced TC for at least 7 years. Prefrontal cortex activity was measured using the prefrontal oxygenation level obtained with near-infrared spectroscopy. During the spectroscopy measurement, the participants performed TC, after watching a video of 12-form seated Yang Style TC, and AE in a subsequent session.ResultsWe found significantly greater changes in the levels of oxyhemoglobin (HbO2; p = 0.022) and total hemoglobin (cHb; p = 0.002) in the TC condition compared with the AE condition in all participants. In the TC practitioner group, a similar trend was shown in the change of HbO2 (p = 0.117) and cHb (p = 0.051) when practicing TC versus AE. However, in the non-practitioner group, we found a statistically greater change in cHb (p = 0.005) but not in HbO2 (p = 0.056).ConclusionThe older adults had higher brain activity when practicing TC compared with AE, and a significant effect was observed in the non-practitioner group. These pilot results may provide insight into the underlying mechanism of the effectiveness of TC practice in preventing cognitive decline in older adults.     

太极拳对脑卒中后患者平衡功能效果的Meta分析

目的：探讨太极拳对脑卒中后患者平衡功能的影响。方法：检索多个中英文数据库中有关太极拳对脑卒中后患者平衡功能影响的随机对照试验（RCT）。按照纳入和排除标准筛选文献、提取资料并评价纳入研究的方法学质量后,采用RevMan5.3进行数据分析。结果：太极拳组在Berg平衡量表得分（BBS）［MD=11.43,95%CI（7.43,15.42）,P<0.00001］、减少起立行走时间（TUG）［MD=-2.26,95%CI（-5.17,0.66）,P=0.13］、肢体平衡功能（FMA）［MD=12.77,95%CI（-5.07,30.60）,P=0.16］方面优于对照组,但只有在BBS得分上差异有统计学意义,TUG和FMA方面差异没有统计学意义。结论：虽然BBS的研究结果证明太极拳有助于提高脑卒中后患者的平衡功能,但今后仍需要设计更为严谨、质量更高、更大样本量的RCT来进一步验证太极拳提高脑卒中后患者身体平衡功能、肢体平衡功能、起立行走时间等的效果。     

Effectiveness of a community-based Tai Chi program and implications for public health initiatives

OBJECTIVES: To establish whether the reported beneficial physiologic effects of Tai Chi when performed under stringent experimental conditions can be generalized to the community. DESIGN: Phase 1: pre-post comparison in a group inexperienced in Tai Chi. Phase 2: baseline comparison between inexperienced and experienced Tai Chi groups. SETTING: A community in Hong Kong. PARTICIPANTS: Phase 1: 51 subjects inexperienced in Tai Chi (novice group) participated in the program. Phase 2: baseline measures of the novice group were compared with those of an experienced group (n=49) who had practiced Tai Chi for at least 6 months. INTERVENTION: A Cheng 119 style program was taught by a Tai Chi master for 1.5 hours, 3 times weekly, for 12 weeks. MAIN OUTCOME MEASURES: Lung function and physical activity evaluated before and after the completion of the program. Resting heart rate, blood pressure, oxygen saturation, handgrip strength, flexibility, and balance measured at the program commencement, 6 weeks, and 12 weeks. RESULTS: Phase 1: after the program, the novice group had increased handgrip strength, flexibility, and peak expiratory flow rate. Phase 2: the experienced group had greater flexibility, lower resting heart rate but higher diastolic blood pressure than the novice group prior to training. CONCLUSIONS: A community-based Tai Chi program produces beneficial effects comparable to those reported from experimental laboratory trials of Tai Chi; therefore, it should be considered as a public health strategy.     

Comparison of the kinetic characteristics of standing and sitting Tai Chi forms

Purpose. To compare the kinetic characteristics of Tai Chi forms performed in standing and seated positions.

Methods. An experienced Tai Chi master was invited to perform the Tai Chi Qi Qong 18-form while standing and seated. Two force platforms were used to track the centre of pressure (COP) during the Tai Chi movements. Centre of mass (COM) displacement was measured using a video motion analysis system.

Results. In standing, the maximum COP displacements in the anteroposterior and mediolateral directions ranged from 2.6% to 9.5%, and 0.3% to 29.6% of the subject's height, respectively. The maximum COP displacements in sitting were smaller, with mean displacements of 0.7% and 0.1% of height in the anteroposterior and ML directions, respectively. The subject's COM moved in the vertical direction in slow, coordinated and smooth patterns.

Conclusions. The kinetic data on each of the 18 Tai Chi forms studied can guide the choice of suitable Tai Chi forms for balance training. Sitting Tai Chi is recommended for rehabilitating the balance of frail older adults who have difficulty standing. Because of the minimal demands of sitting Tai Chi for balance control, progressing to practice in standing as quickly as possible is recommended.     

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。     

太极拳运动对老年人身体素质的影响

目的:研究长期规律太极拳运动对老年人身体素质的影响.方法:随机抽取81例60～75岁老年人,均排除心血管及糖尿病等严重疾病.对其中常年无锻炼的38例为对照组;练习太极拳＞3年的43例为锻炼组.2组均进行反映灵敏素质、力量素质、平衡素质及柔韧素质的反应时,握力,闭目单足站立时间及坐位体前屈的测试.结果:与对照组比较,锻炼组男、女反应时均显著缩短(P＜0.01,0.05),握力显著增高(P＜0.01),闭目单足站立时间明显延长(P＜0.05),坐位体前屈距离明显增大(P＜0.05).结论:长期坚持太极拳锻炼,可以有效改善老年人整体身体素质,对于延缓身体机能老化有积极意义.     

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。     

太极拳练习者膝关节疼痛调查研究

目的:了解太极拳练习者膝关节疼痛的发病率。探讨太极拳练习者发生膝关节疼痛的原因和预防膝关节疼痛的方法。方法:采用现场发放问卷的方式对373位太极拳练习者的性别、年龄;练习太极拳时间;准备活动时间;准备活动形式;对拳理了解程度;学习太极拳前是否有膝关节疼痛;练习太极拳过程中是否有膝关节疼痛等问题进行调查。结果:收回有效问卷355份,练习太极拳前有膝关节疼痛131人占36.90%,练习过程中出现膝关节疼痛175人占49.30%。经统计学分析练习中膝关节疼痛发生率由于练习者性别、拳理了解程度、准备活动时间,以及练习太极拳前有无膝关节疼痛的不同而存在显著差异。练习中膝关节疼痛主要出现在屈膝重心下移和屈膝重心下移加转体的动作形式中。结论:太极拳练习会增加膝关节疼痛风险;通过加强拳理学习,适当增加准备活动时间,加强股四头肌力量和膝关节控制能力并积极治疗练习前的膝痛有助于降低练习过程中膝关节疼痛发生率。     

Effects of Sun-style Tai Chi exercise on physical fitness and fall prevention in fall-prone older adults

AIM: This paper reports a study to determine changes in the physical fitness (knee and ankle muscle strength, balance, flexibility, and mobility), fall avoidance efficacy, and fall episodes of institutionalized older adults after participating in a 12-week Sun-style Tai Chi exercise programme. BACKGROUND: Fall prevention has a high priority in health promotion for older people because a fall is associated with serious morbidity in this population. Regular exercise is effective in fall prevention for older adults because of improvements in strength and balance. Tai Chi exercise is considered to offer great potential for health promotion and rehabilitation, particularly in the maintenance of good mental and physical condition in older people. METHODS: A quasi-experimental design with a non-equivalent control group was used. Data were collected from September 2001 to January 2002. A total of 68 fall-prone older adults with a mean age of 77.8 years participated in the study, and 29 people in the Tai Chi group and 30 controls completed the post-test measures. The Tai Chi exercise programme was provided three times a week for 12 weeks in the experimental group. Data were analysed for group differences using t-tests. RESULTS: At post-test, the experimental group showed significantly improved muscle strength in knee and ankle flexors (P < 0.001) and extensors (P < 0.01), and improved flexibility (P < 0.01) and mobility (P < 0.001) compared with the control group. There was no significant group difference in fall episodes, but the relative risk ratio for the Tai Chi exercise group compared with the control group was 0.62. The experimental group reported significantly more confidence in fall avoidance than did the control group. CONCLUSION: The findings reveal that Tai Chi exercise programmes can safely improve physical strength and reduce fall risk for fall-prone older adults in residential care facilities.     

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.     

太极拳锻炼对帕金森患者的疗效观察

探讨太极拳锻炼对轻中度帕金森患者运动、平衡及步行功能的疗效。方法:将38名帕金森患者随机分为太极组与对照组各19例。2组均给予神经内科基础药物治疗,太极组患者此基础上进行太极拳锻炼。分别治疗前后对患者进行运动功能的评定,包括帕金森综合评分量表III(UPDRS III)、Berg平衡量表、15m步行速度及6min步行距离的测定,以及自身状态的评估,包括健康状态评估量表(HAQ)评分、疲劳、肌肉疼痛、跌倒恐惧感的视觉模拟量表(VAS)评分等。结果:锻炼3个月后,2组的UPDRS III评分较锻炼前均明显降低(P0.05),且太极拳组更大于对照组(P0.05);2组的Berg平衡量表评分较锻炼前明显增加,且太极拳组更大于对照组(P0.05);2组的15m步行速度和6min步行距离较锻炼前都有增加,HAQ评分、跌倒恐惧、疲劳、肌肉疼痛的VAS评分较锻炼前都有降低,但差异均无统计学意义。结论:太极锻炼可以改善轻中度帕金森患者运动功能,是改善轻中度帕金森病运动障碍和生活能力的有效的手段。     

太极拳对早期膝骨关节炎患者治疗效果及机制探讨

目的:观察太极拳对早期膝骨关节炎患者的临床疗效及初步探讨其作用机制。方法:选取我市太极拳运动员及爱好者80例,随机分为观察组和对照组,每组40例,对照组给予盐酸氨基葡萄糖胶囊(奥泰灵)治疗,观察组在对照组基础上,在专业人员的指导下进行为期五个月的太极拳锻炼。五个月后,观察其临床疗效,并初步探讨作用机制。采用膝关节等速肌力测定、视觉模拟评分(VAS)及膝关节Lysholm评分表对治疗效果进行评估。结果:对照组总有效率为67.50%,观察组总有效率为82.50%,观察组治疗效果优于对照组P<0.05;观察组治疗后膝关节屈伸肌峰力矩(PT)有明显改善,且优于对照组P<0.05;对照组治疗后屈伸肌峰力矩(PT)无明显改善,差异无统计学意义(P>0.05);治疗后观察组VAS评分及膝关节Lysholm评分改善均优于对照组(P<0.05)。结论:太极拳锻炼后可改善患者膝关节疼痛、活动受限等临床症状,优于单独口服奥泰灵治疗,可能是在一定程度上通过增加下肢肌肉力量,进而增加膝关节稳定性来改善其临床表现。     

Effects of Tai Chi on cognitive function in community-dwelling older adults: A review

As the population of the United States ages, activities to maintain or improve cognitive function will become increasingly important to preserve functional ability, independence and health-related quality of life. This article is a review of recent research on Tai Chi and cognitive function in community-dwelling older adults. Of the 12 studies reviewed, 10 reported improvement in measures of executive function, language, learning, and/or memory. Several design features make comparisons across studies challenging. As a moderate-intensity, low-impact form of exercise, Tai Chi is appropriate for older adults and seems to offer positive cognitive benefits. Recommendations for future research are provided.     

Efficacy of supervised Tai Chi exercises versus conventional physical therapy exercises in fall prevention for frail older adults: a randomized controlled trial

Purpose: To compare the effectiveness of supervised Tai Chi exercises versus the conventional physical therapy exercises in a personalized rehabilitation program in terms of the incidence and severity of falls in a frail older population. Method: The participants were frail older adults living in the community, admitted to the day hospital program in Sherbrooke, Quebec, Canada (n = 152). They were randomized to receive a 15-week intervention, either by supervised Tai Chi exercises (n = 76) or conventional physical therapy (n = 76). Fall incidence and severity were assessed using both the calendar technique and phone interviews once a month during 12 months following the end of the intervention. Other variables were collected at baseline to compare the two groups: age, comorbidity, balance, sensory interaction on balance, and self-rated health. Results: Both interventions demonstrated a protective effect on falls but Tai Chi showed a greater one (RR = 0.74; 95% CI = 0.56–0.98) as compared to conventional physical therapy exercises. Conclusions: Supervised Tai Chi exercises as part of a rehabilitation program seem to be a more effective alternative to the conventional physical therapy exercises for this specific population.

Implications for Rehabilitation

• Seniors who have fallen have a 50% chance of falling again during the following year, leading them to reduce their outings and thus decrease their social activities.

• Frail older people could benefit more from an individualized intervention than the regular group program generally used in a Tai Chi intervention.

• Tai Chi exercises seems to be a good alternative to regular physiotherapy exercises as a part of a multidisciplinary intervention in preventing a subsequent fall over a 12-month period.