Beneficial Effects and Potential Mechanisms of Tai Chi on Lower Limb Osteoarthritis: A Biopsychosocial Perspective / 中国结合医学杂志

Lower limb osteoarthritis (OA) is a chronic, multifactorial disease characterized by impaired physical function, chronic pain, compromised psychological health and decreased social functioning. Chronic inflammation plays a critical role in the pathophysiology of OA. Tai Chi is a type of classical mind-body exercise derived from ancient Chinese martial arts. Evidence supports that Tai Chi has significant benefits for relieving lower limb OA symptoms. Using a biopsychosocial framework, this review aims to elucidate the beneficial effects of Tai Chi in lower limb OA and disentangle its potential mechanisms from the perspective of biology, psychology, and social factors. Complex biomechanical, biochemical, neurological, psychological, and social mechanisms, including strengthening of muscles, proprioception improvement, joint mechanical stress reduction, change of brain activation and sensitization, attenuation of inflammation, emotion modulation and social support, are discussed.

Evidence for the efficacy of Tai Chi for treating rheumatoid arthritis: an overview of systematic reviews

ABSTRACT BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease with higher prevalence among women aged between 30 and 50 years and general prevalence of 1% worldwide. Interventions promoting improvement of quality of life for individuals with RA are required. Tai Chi appears to be a low-cost alternative, with studies showing positive results from this technique. However, regarding aspects of RA such as pain and sensitivity, studies remain inconclusive. OBJECTIVES: To compare the effectiveness of the Tai Chi method for treating patients diagnosed with rheumatoid arthritis, among systematic reviews. DESIGN AND SETTING: Overview of systematic reviews with Cochrane and non-Cochrane methodology. METHODS: Systematic reviews involving quasi-randomized and randomized clinical trials (RCTs) on use of Tai Chi, with no restrictions regarding the date and language of publication, were included. RESULTS: Three systematic reviews were included. The effects of Tai Chi associated with education and stretching exercises versus education and stretching were evaluated in these reviews. They showed that improvements in the variables of mood, depression and functional index were associated with use of Tai Chi. CONCLUSIONS: The findings suggest that clinical improvement was achieved, although not statistically significant with regard to pain and disease pattern, as assessed using the ACR20 measurement. Improvements relating to disability and quality of life were also seen. There was a low level of evidence and therefore caution in data analysis is recommended. The three studies included showed poor reliability for providing an accurate and complete summary of use of Tai Chi among people diagnosed with rheumatoid arthritis. PROSPERO: CRD42019125501.

Usuários de práticas corporais: qualidade de vida e motivos de procura pelas práticas integrativas e complementares / Users of bodily practices: quality of life and reasons for seeking integrative and complementary practices

Trata-se de um estudo exploratório e analítico de abordagem quantitativa, realizado no Serviço Integrado de Saúde (SIS), no período de junho a novembro de 2014. O SIS é um serviço público de saúde que funciona como Unidade de Referência em Práticas Integrativas e Complementares, como Programa de Extensão da Universidade Federal de Pernambuco (UFPE) e como Núcleo Comunitário de Cultura, Comunicação e Saúde, uma parceria entre UFPE e a Secretaria Municipal de Saúde do Recife. Foi implantado no início de 2013 e é referência em Práticas Integrativas para a rede de saúde do município de Recife-PE, principalmente para as Unidades de Saúde da Família. O serviço conta com aproximadamente 23 profissionais de diversas áreas: Terapia Comunitária, Tai Chi Chuan, Lian Gong, Automassagem, Aromoterapia, Flexibilidade, Bioenergética, Yoga, Biodança, Dança Circular, Psicomotricidade Relacional para jovens, Constelação Familiar e Arte Terapia para mulheres; Terapias individuais (Nutrição em alimentação saudável, Auriculoacupuntura, Osteopatia e Terapia do crânio­sacral) e outros programas terapêuticos (Programa Saúde da Coluna, Programa Saúde da Voz e Programa de Arte Terapia para problemas de obesidade).

Tratamiento conservador de la artrosis de cadera / Conservative treatment of hip osteoarthritis

Ante un escenario clínico de coxalgia por artrosis de cadera se planteó la necesidad de conocer los tratamientos con-servadores más seguros y efectivos para el manejo del dolor. El tratamiento de la artrosis requiere un enfoque integral e individualizado en función de las preferencias del paciente para lograr el máximo beneficio clínico. Existen numerosas estrategias útiles para el manejo del dolor en pacientes con artrosis de cadera siendo fuertemente recomendados de inicio la actividad física, los antiinflamatorios no esteroideos (AINE) orales y en ciertos casos los corticoides intraarticulares, tramadol o duloxetina, siempre asociado con la actividad física. Los ejercicios más recomendados son los aeróbicos y el Tai Chi o yoga. (AU)

Faced with a clinical scenario of coxalgia due to hip osteoarthritis, the need to know the safest and most effective conservative treatments for pain management arose. The treatment of osteoarthritis requires a comprehensive and individualised approach based on the patient's preferences to achieve maximum clinical benefit. There are numerous useful strategies for pain management in patients with hip osteoarthritis being strongly recommended from the beginning such as physical activity, oral non-steroidal anti-inflammatory drugs (NSAID) and in certain cases intra-articular corticosteroids, tramadol or duloxetine, always associated with physical activity. The most recommended exercises are aerobics and Tai Chi or yoga. (AU)

Effects of traditional Chinese exercises and general aerobic exercises on older adults with sleep disorders: A systematic review and meta-analysis / 中西医结合学报

BACKGROUND@#Sleep disorders are common in older adults and have a negative influence on their physical and mental health. General aerobic exercises (GAEs) have long been used in the treatment of sleep disorders as a non-pharmacological measure. However, there is no consensus on the efficacy of traditional Chinese exercises (TCEs) for treating sleep disorders in older adults and the difference between TCEs and GAEs.@*OBJECTIVE@#This study assessed the effects of TCEs and GAEs on the sleep quality of older adults and the differences between these two interventions.@*SEARCH STRATEGY@#PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, China Science Journal Database and Wanfang Data were searched from their inception to August 2020.@*INCLUSION CRITERIA@#Randomized controlled trials (RCTs) that evaluated the effects of TCEs and GAEs on older adults with sleep disorders were included.@*DATA EXTRACTION AND ANALYSIS@#Data were extracted by two researchers working independently. The risk bias of included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and the quality of evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. The Pittsburgh Sleep Quality Index (PSQI) was used to estimate sleep quality. Meta-analyses were performed to assess the total PSQI score of the exercise intervention as the primary outcome, and the scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication and daytime dysfunction were assessed as secondary outcomes. Subgroup, sensitivity, and meta-regression analyses were conducted to assess the contribution of covariables to heterogeneity.@*RESULTS@#A total of 22 RCTs (including 1747 participants) were included in the meta-analysis. The results indicated that TCEs (weighted mean difference [WMD] = -2.14, 95% confidence interval [CI] [-2.82, -1.46], P < 0.001; heterogeneity: P < 0.001, I@*CONCLUSION@#Current evidence shows that both TCEs and GAEs, as complementary and non-pharmacological approaches, help to improve the sleep quality in older adults with potentially clinical implications; however, there was not enough evidence to conclude the difference between them. More rigorous and high-quality RCTs are needed to arrive at reliable conclusions.

Biomechanical analysis of ankle-foot complex during a typical Tai Chi movement-Brush Knee and Twist Step / 生物医学工程学杂志

The purpose of this study is to analyze the biomechanics of ankle cartilage and ligaments during a typical Tai Chi movement-Brush Knee and Twist Step (BKTS). The kinematic and kinetic data were acquired in one experienced male Tai Chi practitioner while performing BKTS and in normal walking. The measured parameters were used as loading and boundary conditions for further finite element analysis. This study showed that the contact stress of the ankle joint during BKTS was generally less than that during walking. However, the maximum tensile force of the anterior talofibular ligament, the calcaneofibular ligament and the posterior talofibular ligament during BKTS was 130 N, 169 N and 89 N, respectively, while it was only 57 N, 119 N and 48 N during walking. Therefore, patients with arthritis of the ankle can properly practice Tai Chi. Practitioners with sprained lateral ligaments of the ankle joint were suggested to properly reduce the ankle movement range during BKTS.

Práticas Corporais da Medicina Tradicional Chinesa no tratamento de obesidade em adultos e idosos: qual é a eficácia e a segurança das práticas corporais da Medicina Tradicional Chinesa (MTC) para o tratamento de obesidade em adultos e/ou idosos? / Body Practices of Traditional Chinese Medicine in the treatment of obesity in adults and the elderly: what is the effectiveness and safety of body practices in Traditional Chinese Medicine (TCM) for the treatment of obesity in adults and/or the elderly?

As práticas corporais da Medicina Tradicional Chinesa (MTC) envolvem movimento ou manipulação corporal, atitude mental e respiração com intuito de equilibrar o Qi ou energia vital. As práticas da MTC são recomendadas para promoção, manutenção e recuperação da saúde, bem como prevenção de agravos e doenças. As práticas corporais da MTC, no Brasil, incluem acupuntura,lian gong, chi gong (qigong,chi kung); tui-naetai chi chuan. Estas práticas foram incorporadas no SUS mediante Portaria no 971, de 03 de maio de 2006. Qual é a eficácia/efetividade e a segurança das práticas corporais da Medicina Tradicional Chinesa (MTC), exceto acupuntura, no tratamento da obesidade em adultos e/ou idosos? As buscas foram realizadas inicialmente por revisões sistemáticas, mas nenhuma atendeu aos critérios de elegibilidade. Novas buscas foram realizadas em seis bases de dados sem restrição de ano de publicação, para identificar ensaios clínicos randomizados(ECR). Desta forma, foram incluídos ensaios clínicos randomizados em inglês, português e espanhol que avaliaram os efeitos das práticas MTC no tratamento de obesidade na população adulta e idosa. A avaliação da qualidade metodológica foi realizada por meio da ferramenta de risco de viés da Cochrane, feita por uma pesquisadora e revisada por outra. Nesta revisão rápida, produzida em três dias, foram utilizados atalhos metodológicos, de maneira que apenas o processo de seleção foi realizado em duplicidade e de forma independente. A acupuntura, embora faça parte das práticas da MTC, não foi incluída porque está sendo analisada separadamente em outras revisões realizadas por esta mesma equipe. De 1.435 publicações recuperadas nas bases de dados, foram incluídos três ensaios clínicos randomizados que atenderam aos critérios de elegibilidade. A avaliação metodológica dos ECR demonstrou risco de viés, de forma que os resultados devem ser interpretados com cautela. Os estudos mostraram não haver diferença nos resultados entre Taichi e a maioria dos comparadores, com relação aos desfechos IMC, circunferência da cintura, peso corporal, massa corporal, gordura corporal e sensação de fome. O único estudo sobre Qigong não apresentou resultados favoráveis quanto a sua eficácia na redução do peso corporal. Um estudo relatou não ter identificado eventos adversos com a prática de Taichi. Embora existam alguns resultados favoráveis a prática de Taichi, é pequena a evidência de eficácia e segurança da prática no tratamento da obesidade em adultos e idosos. Devido à escassez de evidências não é possível afirmar os reais benefícios do uso dessas tecnologias para o tratamento da obesidade.

Obesidade e Diabetes Mellitus / Obesity and Diabetes Mellitus

As Práticas Integrativas e Complementares em Saúde (PICS), denominadas como Medicinas Tradicionais, Complementares e Integrativas (MTCI) pela Organização Mundial de Saúde (OMS), foram instituídas por meio da Política Nacional de Práticas Integrativas e Complementares no SUS (PNPIC), em maio de 2006. Estas práticas são transversais em suas ações no Sistema Único de Saúde (SUS) e estão presentes em todos os pontos da Rede de Atenção à Saúde (RAS), prioritariamente na Atenção Primária à Saúde (APS), com grande potencial de atuação em rede. As PICS são ferramentas terapêuticas potentes quando aliadas ao tratamento complementar de diversas condições crônicas. Além disso, são abordagens que ampliam o olhar dos profissionais sobre o processo saúde e doença e sobre as ofertas terapêuticas de cuidado à população. Nesse contexto, as PICS são importantes aliadas, contribuindo para a promoção, prevenção e reabilitação da saúde e manejo clínico das doenças crônicas, potencializando o projeto terapêutico singular por meio de seus benefícios. Considerando a necessidade de ampliar a resolutividade do cuidado a partir de práticas seguras, eficazes e socialmente sustentáveis, este documento tem por objetivo divulgar as evidências científicas no campo das PICS de forma a apoiar os gestores na tomada de decisão, para as condições de obesidade e diabetes mellitus. Neste contexto, evidências científicas de alto grau metodológico apontam que as PICS possuem eficácia no tratamento de indivíduos com DM. A prática do yoga auxilia na melhora dos resultados glicêmicos e de outros fatores de risco da DM. A meditação tem efeito indireto sobre a redução da hemoglobina glicada (HbA1c), além de melhorar os efeitos psicológicos que perpassam as várias condições crônicas de saúde, incluindo a DM.

Effectiveness of Tai chi exercise on overall quality of life and its physical and psychological components among older adults: a systematic review and meta-analysis

With the aging of the world's population, the quality of life of older adults is becoming more important. There are many studies on the use of Tai chi exercise, a popular form of mind-body exercise practiced by older adults. However, the effectiveness of Tai chi exercise on the quality of life of older adults is unclear. For this systematic review and meta-analysis, six databases (PubMed, CENTRAL, CINAHL, EMBASE, Scopus, CNKI) were searched in English and Chinese languages to screen for relevant randomized controlled trials (RCT), and their risk of bias was assessed by two independent reviewers. The results of quality of life, physical component, and psychological component among older adults were meta-analyzed using RevMan5.3 software. The search retrieved 2577 records. After screening, a total of 10 RCTs were included in this evaluation, with a total of 1170 participants. The meta-analysis showed that compared with the control group, Tai chi exercise had a significant impact on the overall quality of life (SMD=1.23; 95%CI: 0.56-1.98; P<0.0001), and on the physical component of quality of life (MD=5.90; 95%CI: 1.05-10.75; P=0.02), but no significant impact on the psychological component of quality of life. This study had high heterogeneity. The results of this study suggest the potential use of Tai chi exercise as an activity for increased quality of life in older adults. Future research may enhance experimental rigor and explore the rationale behind Tai chi exercise.

Tai Chi versus routine exercise in patients with early- or mild-stage Parkinson's disease: a retrospective cohort analysis

Parkinson's disease cannot be cured but symptoms can be improved by making use of physical therapy. The objective of the study was to compare the effect of routine exercises and Tai Chi on physical and clinical performance in elderly people suffering from Parkinson's disease. Data from interviews, physical and clinical performance, and levodopa consumption of 500 patients with confirmed Parkinson's disease (severity level I to III) were collected and analyzed. Participants who received 80 min/day Tai Chi 3 times/week for 2 months were included in the Tai Chi (TC) group (n=250) and those who received 90 min/day routine exercise 3 times/week for 2 months were included in routine exercise (RE) group (n=250). Timed up-and-go, 50-foot speed walk, and functional reach were improved by Tai Chi and routine exercise (P<0.05 for all) but intensities of Tai Chi for improvement of such parameters was higher than routine exercise. Incidence of falls was decreased by both physical therapies (P<0.05 for all) but more for the TC group (P<0.0001, q=38.512). In the TC group, at the end of follow-up, 22 (9%) patients were successful in withdrawal of levodopa treatment. Also, the dose of levodopa was decreased in patients of the TC group who had to continue levodopa. Tai Chi had the potential to slow down the progression of symptoms of Parkinson's disease and delayed the introduction of levodopa (level of evidence: III).

Research on Function and Mechanism of Tai Chi on Cardiac Rehabilitation / 中国结合医学杂志

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.

Nota Técnica PEPIC-RS / das Nº 01/2019. Orientações para a Inserção de Práticas Corporais da Tradição Chinesa na Rede de Atenção à Saúde / Technical Note PEPIC-RS / das Nº 01/2019. Guidelines for the Insertion of Chinese Tradition Body Practices in the Health Care Network

A Organização Mundial da Saúde (OMS) promove a utilização das práticas tradicionais de saúde desde o final da década de 1970, quando criou o Programa de Medicinas Tradicionais, com objetivo de fomentar políticas nessa área. No Brasil, o Ministério da Saúde aprovou, em 2006, a Política Nacional de Práticas Integrativas e Complementares (PNPIC) no Sistema Único de Saúde (SUS), a qual recomenda a implementação de ações e serviços relativos às Práticas Integrativas e Complementares em Saúde (PICS) e no Rio Grande do Sul, em 2013, a Política Estadual de Práticas Integrativas e Complementares (PEPIC/RS) traz como um de seus objetivos oportunizar a introdução de práticas baseadas em medicinas tradicionais e naturais (MTN), com eficácia e segurança comprovadas.

Tai Chi exercise and functional electrical stimulation of lower limb muscles for rehabilitation in older adults with chronic systolic heart failure: a non-randomized clinical trial

Exercise-based training decreases hospitalizations in heart failure patients but such patients have exercise intolerance. The objectives of the study were to evaluate the effect of 12 weeks of Tai Chi exercise and lower limb muscles' functional electrical stimulation in older chronic heart failure adults. A total of 1,084 older adults with chronic systolic heart failure were included in a non-randomized clinical trial (n=271 per group). The control group did not receive any kind of intervention, one group received functional electrical stimulation of lower limb muscles (FES group), another group practiced Tai Chi exercise (TCE group), and another received functional electrical stimulation of lower limb muscles and practiced Tai Chi exercise (FES & TCE group). Quality of life and cardiorespiratory functions of all patients were evaluated. Compared to the control group, only FES group had increased Kansas City Cardiomyopathy Questionnaire (KCCQ) score (P<0.0001, q=9.06), only the TCE group had decreased heart rate (P<0.0001, q=5.72), and decreased peak oxygen consumption was reported in the TCE group (P<0.0001, q=9.15) and FES & TCE group (P<0.0001, q=10.69). FES of lower limb muscles and Tai Chi exercise can recover the quality of life and cardiorespiratory functions of older chronic heart failure adults (trial registration: Research Registry 4474, January 1, 2015).

Revisión de los beneficios de la intensidad y modalidades de ejercicio físico sobre el estrés psicológico / Review of the benefits of physical exercise on psychological stress based on intensity and mode / Revisão dos benefícios da intensidade e modalidades do exercício físico sobre o estresse psicológico

Resumen Azofeifa-Mora, C.A. (2018). Revisión de los beneficios de la intensidad y modalidades del ejercicio físico sobre el estrés psicológico. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 16(1), 1-21. El propósito de esta revisión sistemática fue hacer un recuento de los principales resultados de la intensidad del ejercicio físico, así como del entrenamiento aeróbico, fuerza muscular, yoga, tai chi y pilates como estrategias de afrontamiento en la disminución del estrés psicológico. Para ello se realizó una búsqueda en diversas bases de datos (Google Académico, SportDiscus, Science Direct, Scopus, Springer Link) de artículos científicos publicados desde el 2010 hasta el 2017, bajo las siguientes palabras claves (en español e inglés): estrés psicológico, ejercicio, entrenamiento aeróbico, fuerza, yoga, pilates, tai chi, intensidad, cortisol y actividad física. Para un total de 32 artículos utilizados. Según estos artículos, la mayor intensidad al momento de practicar ejercicio físico produce mayores beneficios sobre la disminución del estrés psicológico; además, el entrenamiento aeróbico y la práctica de yoga son las modalidades sobre las cuales recaen los mayores beneficios, según los resultados mostrados en las investigaciones, en la disminución del estrés psicológico y, por el contrario, en cuanto al entrenamiento de la fuerza muscular, el tai chi y los pilates es necesaria una mayor cantidad de estudios para poder determinar su efectividad en el manejo del estrés.

Abstract Azofeifa-Mora, C.A. (2018). Review of the benefits of physical exercise on psychological stress based on intensity and mode. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 16(1), 1-21.The purpose of this systematic review was to summarize the main results of physical exercise based on intensity and mode, including aerobic training, muscle strength, yoga, tai chi and Pilates as coping strategies to reduce psychological stress. Consulting several databases (Google Scholar, SportDiscus, Science Direct, Scopus, and Springer Link), a search was conducted for scientific articles published from 2010 to 2017, using the following keywords in English and Spanish: stress, physiological stress, wellness, exercise, aerobic training, strength training, endurance training, intensity, physical activity y burnout. A total of 32 articles was selected. According to these articles, the greater the intensity when practicing physical exercise, the greater the benefits to reduce psychological stress. In addition, aerobic and yoga exercises are the modes with the most benefits to reduce stress based on the results in the articles consulted. On the contrary, as far as training for muscular strength, tai chi and Pilates require further studies to be able to determine their effectiveness in managing stress.

Resumo Azofeifa-Mora, C.A. (2018). Revisão dos benefícios da intensidade e modalidades do exercício físico sobre o estresse psicológico. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 16(1), 1-21. O propósito desta revisão sistemática foi fazer uma recontagem dos principais resultados da intensidade do exercício físico, bem como do treinamento aeróbico, força muscular, ioga, Tai chi e Pilates como estratégias para enfrentar a luta na diminuição do estresse psicológico. Para isso, realizou-se uma busca em diversas bases de dados (Google Acadêmico, SportDiscus, Science Direct, Scopus, Springer Link) de artigos científicos publicados desde 2010 até 2017, usando as seguintes palavras chaves (em Espanhol e Inglês): estresse psicológico, exercício, treinamento aeróbico, força, ioga, Pilates, Tai chi, intensidade, cortisol e atividade física, totalizando 32 artigos utilizados. Segundo esses artigos, a maior intensidade no momento de praticar exercício físico produz maiores benefícios sobre a diminuição do estresse psicológico; além disso, o treinamento aeróbico e a prática de ioga são as modalidades sobre as quais recaem os maiores benefícios, segundo os resultados mostrados nas pesquisas, na diminuição do estresse psicológico e, pelo contrário, com relação ao treinamento da força muscular, o Tai chi e o Pilates requerem uma maior quantidade de estudos para poder determinar sua efetividade no manejo do estresse. Azofeifa-Mora, C.A. (2018). Revisão dos benefícios da intensidade e modalidades do exercício físico sobre o estresse psicológico. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 16(1), 1-21. O propósito desta revisão sistemática foi fazer uma recontagem dos principais resultados da intensidade do exercício físico, bem como do treinamento aeróbico, força muscular, ioga, Tai chi e Pilates como estratégias para enfrentar a luta na diminuição do estresse psicológico. Para isso, realizou-se uma busca em diversas bases de dados (Google Acadêmico, SportDiscus, Science Direct, Scopus, Springer Link) de artigos científicos publicados desde 2010 até 2017, usando as seguintes palavras chaves (em Espanhol e Inglês): estresse psicológico, exercício, treinamento aeróbico, força, ioga, Pilates, Tai chi, intensidade, cortisol e atividade física, totalizando 32 artigos utilizados. Segundo esses artigos, a maior intensidade no momento de praticar exercício físico produz maiores benefícios sobre a diminuição do estresse psicológico; além disso, o treinamento aeróbico e a prática de ioga são as modalidades sobre as quais recaem os maiores benefícios, segundo os resultados mostrados nas pesquisas, na diminuição do estresse psicológico e, pelo contrário, com relação ao treinamento da força muscular, o Tai chi e o Pilates requerem uma maior quantidade de estudos para poder determinar sua efetividade no manejo do estresse.

Tai chi chuan melhora funcionalidade e qualidade de vida em homens idosos com baixa densidade mineral óssea / Tai Chi Chuan improves functionality and quality of life in elderly men with low bone mineral density

Objetivo: Avaliar efeitos do Tai Chi Chuan (TCC) na capacidade funcional (CF) e na qualidade de vida (QV) de homens idosos com baixa densidade mineral óssea (DMO). Método: Estudo quasi-experimental, controlado, cego, com 41 idosos (≥ 60 anos) divididos em dois grupos: grupo experimental ­ G1 (TCC; n = 20; 69,2 ± 6,2 anos) e grupo controle ­ G2 (controle; n = 21; 69,0 ± 5,7 anos). A DMO (coluna lombar e colo do fêmur) foi avaliada com raios-x de dupla energia (DEXA). Para aferir CF foram utilizados: testes de resistência aeróbia (RA); de força e flexibilidade de membros superiores e inferiores; de equilíbrio em condições estática, dinâmica e funcional; e de alcance funcional, assim como para risco de quedas. A QV foi pesquisada pelo questionário SF-36 (MOS 36 ltem Short-Form Health Survey). O G1 praticou TCC estilo Yang, com 24 movimentos por 12 semanas, 2 vezes por semana, em intensidade leve; o G2 não praticou atividade física orientada. Resultados: Praticantes de TCC apresentaram valores significativamente maiores em resistência aeróbia, em força de membros superiores e inferiores, e para equilíbrio dinâmico. Ao aferir a QV, surgiu significância para escore total, assim como para as dimensões de capacidade funcional, estado geral de saúde, vitalidade e saúde mental. Discussão: Constataram-se efeitos benéficos do TCC em CF e QV, o que agrega evidências à sua utilização em homens idosos com baixa DMO. Conclusão: O TCC é eficaz na melhora da CF e da QV em homens idosos com baixa DMO.

Objective: The purpose was to assess the effect of Tai Chi Chuan (TCC) on functional capacity (FC) and quality of life (QoL) in elderly men with low bone mineral density (BMD). Methods: This quasi-experimental, controlled blinded trial evaluated 41 senior men (≥ 60 years), divided into two groups: control group 1 ­ G1 (TCC; n = 20; 69.2 ± 6.2 years) and control group 2 ­ G2 (control; n = 21; 69.0 ± 5.7 years). The BMD (of lumbar spine and femur neck) was assessed by dual energy x-ray absorptiometry (DEXA). FC was assessed for aerobic endurance, for upper and lower limbs strength and flexibility, for static, dynamic and functional balance testes, and for risk of falls. QoL was assessed by the SF-36 questionnaire (MOS 36-item Short-Form Health Survey). G1 practiced the 24-form Yang style of TCC, for 12 weeks twice a week on low intensity; G2 did not practice oriented physical activity. Results: TCC practitioners had significantly higher scores for aerobic endurance, upper and lower limbs strength, and dynamic balance. In terms of QoL, values were significantly better in total score and aspects such as FC, general health, vitality, and mental health. DISCUSSION: TCC was proven beneficial to FC and QoL scores, which adds evidence for its practice by elderly men with low BMD. Conclusion: TCC training is effective in improving FC and QoL in elderly men with low BMD.

Sessão de Tai Chi Chuan promove hipotensão pós-exercício e redução da sobrecarga cardiovascular em idosos hipertensos / Tai Chi Chuan session promotes post-exercise hypotension and reduces cardiac overload in elderly hypertensive patients

Modelo: Estudo intervencional, prospectivo e quantitativo. Objetivo: Analisar o comportamento da pressão arterial (PA) e duplo produto (DP) de idosos hipertensos, após uma sessão de Tai Chi Chuan (TCC). Métodos: Participaram do estudo 20 idosos hipertensos em que as variáveis hemodinâmicas foram medidas pré-sessão de TCC e sessão controle (sem exercício), e monitorada durante 60 minutos após término da sessão de TCC e controle. Foi respeitado um intervalo de 7 dias entre uma sessão e outra. Resultados: Após término da sessão de TCC, a frequência cardíaca permaneceu elevada por 30 minutos retornado aos valores pré-exercício a partir do 40° minuto. Observou-se redução significativa da pressão arterial média (PAM) a partir do 10° minuto, e redução significativa da pressão arterial sistólica (PAS) e diastólica (PAD) a partir do 20° minuto até o 60° minuto após sessão de TCC (p<0,001). Houve redução em relação aos valores pré-exercício de aproximadamente -22/-18 mmHg para PAS e PAD respectivamente (p<0,001). Observou-se redução significativa do duplo produto (DP) a partir do 30° minuto, continuando a reduzir até o 60° minuto após TCC (p<0,001). A magnitude de redução do DP comparado ao momento pré-exercício foi na ordem de 1675 (p<0,001). Conclusão: Esses achados sugerem que única sessão de TCC promove hipotensão pós-exercício (HPE) e reduz a sobrecarga cardíaca em idosos com HAS. (AU)

Design: Interventional study, prospective and quantitative study. Objective: To determine blood pressure and double product values of elderly hypertensive patients, after a single Tai Chi Chuan (TCC) session. Methods: Twenty elderly hypertensive patients participated in the study, in which the hemodynamic variables were measured pre-TCC session and control session (without exercise), and monitored for 60 minutes after the end of both sessions. Each session had an interval of 7 days. Results: The results showed that at the end of the TCC, the heart rate remained elevated for 30 minutes, returning to pre-exercise values from the 40th minute. Significant reduction in mean blood pressure (MBP) from the 10th minute, and significant reduction in systolic (SBP) and diastolic (DBP) blood pressure from the 20th minute to the 60th minute after TCC session (p<0.001) were observed. A magnitude reduction compared to pre-exercise was around -22 / -18 mmHg for SBP and DBP respectively (p<0.001). Significant reduction of the DP was observed from the 30th minute, and reduced until the 60th minute after TCC (p<0.001). The magnitude of DP reduction compared to pre-exercise was around -1675 (p<0.01). Conclusions: These findings show that single TCC session promotes post-exercise hypotension (PEH) and reduces cardiac overload in elderly hypertensive patients. (AU)

Experiencias de los adultos mayores en la pr ctica del Tai Chi Qi Gong. Tumbes, Perú / Experiences of older adults in the practice of Tai Ji Qi Gong, Tumbes, Peru

El tai-chi qi gong es una combinación de ejercicio físico y técnicas de relajación, utilizado para mejorar la salud física y mental de sus practicantes. Objetivos: develar y analizar comprehensivamente las experiencias de los adultos mayores en la práctica del tai chi qi gong en una posta médica de EsSalud, Tumbes–Perú. Material y métodos: investigación cualitativa, desarrollada bajo el enfoque acción participación. Los sujetos de investigación fueron los adultos mayores que asisten al Programa del Adulto Mayor. La información fue recogida mediante entrevistas a profundidad considerando en todo momento los principios éticos del Informe de Belmont; el tamaño de la muestra se determinó por el método de saturación; obteniéndose siete discursos representativos, el tratamiento de los datos fue mediante el método de análisis de contenido. Resultados: Tai chi qi gong: una experiencia positiva. II. Experimentado los beneficios del tai chi con las siguientes sub categorías disminuyendo dolencias corporales, aumentado la agilidad corporal, mejorando el estado de ánimo, liberando tensiones mentales. III. Practicando los ejercicios del tai chi en casa. Conclusiones: la práctica del tai chi qi gong tiene consecuencias muy favorables para la salud de los adultos mayores porque permite desarrollar en gran manera el sentido de equilibrio, con un importante mejoramiento de su condición física, funcional y emocional y un claro aumento del nivel de calidad de vida.

Tai ji qi gong is a combination of exercise and relaxation techniques used to improve physical and mental health of its practitioners. Objectives: unmasking and comprehensively analyze the experiences of older adults in the practice of tai chi qi gong at a health post EsSalud, Tumbes - Peru. Material and Methods: qualitative research, developed under the action approach participation. Research subjects were older adults who attend the Elderly Program. The information was collected through in-depth interviews at all times considering the ethical principles of the Belmont Report; the sample size was determined by the method of saturation; yielding seven representative speeches, treatment of data was by the method of content analysis. Results: Tai chi qi gong: A positive experience. II. Experienced the benefits of tai chi with the following sub categories decreasing bodily ailments, increased body agility, improving mood, releasing mental stress. III. Practicing tai chi exercises at home. Conclusions: the practice of tai chi qi gong has very favorable to the health of older adults consequences because it allows develop greatly the sense of balance, with a significant improvement in their physical, functional and emotional condition and a clear increase in the level of quality of life.

Práctica de taichí y nivel de estrés en adultos mayores en un centro de atención de medicina complementaria / Practice of tai chi and stress level in older adults in a center of attention of complementary medicine

Objetivo: Evaluar si existe asociación entre el nivel de estrés en adultos mayores de 60 años y la práctica del Tai Chi en un centro de atención de la ciudad de Trujillo. Materiales y Métodos: Estudio transversal. Se evaluó a 98 asegurados adultos mayores de 60 años. 49 de ellos realizan la práctica de Tai Chi en los Círculos de Salud del Centro de Medicina Complementaria, EsSalud - Trujillo (grupo estudio) y 49 que no practican Tai Chi (grupo control). La recolección de datos se realizó utilizando un instrumento adaptado para medir características generales (edad, sexo), características de la práctica de Tai Chi (tiempo de práctica, frecuencia, tiempo por sesión) y nivel de estrés (leve, moderado y severo) en adultos mayores. Resultados: La totalidad de adultos mayores que practican Tai Chi presentaron un nivel de estrés leve. En el grupo control, 65.3% demostraron tener nivel de estrés moderado, seguido del 26.5% con nivel de estrés alto. El sexo femenino, la edad y la realización o no del Tai-Chi están asociados con el puntaje final del instrumento de evaluación de nivel de estrés (p<0.05). Las personas del grupo Tai-Chi presentaron 19 puntos menos (IC95% 17.3-22.5) en la evaluación de nivel de estrés independientemente al sexo y la edad. Conclusiones: Existe asociación entre el nivel de estrés y la práctica del Tai Chi en asegurados mayores de 60 años en un centro de atención en Trujillo. Se recomienda realizar más estudios para evaluar la verdadera influencia de la práctica de Tai Chi en el manejo del estrés en adultos mayores.

Effect of Tai Ji Quan Training on Strength and Function of Lower Limbs in the Aged / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Tai Ji Quan (TJQ) training on strength and function of lower limbs in the aged.</p><p><b>METHODS</b>Sixty senile subjects were recruited and assigned to the TJQ group and the control group (imparting health knowledge)by random digit table. Patients in the TJQ group received 24-style TJQ training for 18 months (60 min each time, 5 times per week), while those in the control group were imparted with sarcopenia related causes, pathogeneses, prevention and control measures. The maximum isometric strength of bilateral iliopsoas, quadriceps femoris, tibialis anterior muscle, hamstrings; the time for 5 sitting-up tests and Time Up and Go Test (TUGT), one-leg standing time with closed eyes test; and the score of Berg balance scale were compared between the two groups.</p><p><b>RESULTS</b>Compared with before treatment, muscle strength increased in the TJQ group with an average increased capacity (rate) as follows, bilateral iliopsoas 5.5 kg (16.9%), quadriceps femoris 5.5 kg (26.2%), and tibialis anterior muscle 8.5 kg (36.2%) (all P < 0.05). The time for TUGT and 5 sitting-up tests was shortened by 1.3 s (16.7%) and 0.9 s (14.5%) respectively in the TJQ group. The time for one-leg standing time with closed eyes test was increased by 8.4 s (left) and 9.1 s (right) respectively. The score of Berg balance scale increased by 4.3% (P < 0.05). Compared with the control group, bilateral quadriceps femoris and tibialis anterior muscle strength increased significantly (P < 0.01); the time for TUGT and 5 sitting-up tests, the time for one-leg standing time with closed eyes test, scores of Berg balance scale were all improved in the TJQ group after intervention (P < 0.05).</p><p><b>CONCLUSION</b>TJQ training could improve strength of iliopsoas, quadriceps femoris, tibialis anterior muscle in the aged, elevate their balance and locomotor activities, and possibly prevent and treat sarcopenia.</p>

Effect of Tai Chi on muscle strength of the lower extremities in the elderly / 中国结合医学杂志

<p><b>OBJECTIVE</b>Aging is associated with a progressive decline in muscle strength, muscle mass and impaired physical function, which reduces mobility and impairs quality of life in the elderly population. The 6-12 months of exercise can enhance the muscle strength, but these improvements can only be maintained for a short period. In this study, we investigated the effects of long-term Tai Chi (TC) exercise on muscle strength of lower extremities.</p><p><b>METHODS</b>A cross-sectional study was conducted in 205 long-term TC practitioners (age: 60-89 years) and 205 age and gentle matched controls who did not practice TC. Each of the activity group was further divided into three distinct age groups: G1, 60-69 years; G2, 70-79 years; and G3, 80-89 years. Hand-held dynamometery was used to measure the maximum isometric strength of iliopsoas, quadriceps femoris, tibialis anterior and hamstrings in both sides of the participants. Unpaired t tests were performed to compare the difference of strength between the TC and non-Tai Chi (NTC) groups. Multivariate analysis of variance (MANOVA) was used to compare the lower muscle strengths among the different age groups in the TC and NTC groups. Pearson's correlations were used to quantify the linear relationship between the months of TC practice and lower limbs muscle strength.</p><p><b>RESULTS</b>The inter-rater reliabilities of iliopsoas, quadriceps femoris, tibialis anterior and hamstrings were intraclass correlation coeffificient (ICC) (1,1) = 0.895 (0.862-0.920), ICC (2,2) = 0.905 (0.874-0.928), ICC (3,3) = 0.922 (0.898-0.941) and ICC (4,4) = 0.930 (0.908-0.947). The strength of the muscles in the TC group did not differ among different age groups (P>0.05). The strength of iliopsoas, quadriceps femoris, tibialis anterior and hamstrings in TC group was higher than that in the NTC group (P<0.05). A correlation between muscle strength and extension of the exercise period was positive (P<0.05).</p><p><b>CONCLUSIONS</b>Results shed light on the orientation and magnitude of long-term TC in preventing muscle strength loss with aging. TC might be a good form to slow down the trend of age-related decline in muscle strength in community-dwelling population.</p>