The Feasibility and Positive Effects of Wuqinxi Exercise on the Cognitive and Motor Functions of Patients with Parkinson's Disease: A Pilot Study.

INTRODUCTION: Parkinson's disease (PD) is a chronic degenerative disease of the central nervous system common in middle-aged and elderly people, which has a serious impact on patients' cognitive and motor functions. Exercise can improve the nonmotor symptoms of PD patients, but the optimal type of exercise for the cognitive function of patients is unclear. Therefore, the purpose of this study is the impact of 12 weeks of Wuqinxi exercise on the cognitive and motor function in PD patients. METHODS: Thirty PD patients participated in the study and were randomly assigned to two groups: Wuqinxi group (n = 15) or stretching group (n = 15). All the participants performed a 12-week exercise program twice a week, 90 min/session. The assessments were conducted before and after exercise intervention, included cognitive function (frontal assessment battery (FAB); Stroop test I and II), motor functions (Unified Parkinson's Disease Rating Scale Part III (UPDRS-III); timed up and go (TUG)). RESULTS: We found the FAB and Stroop I scores were significantly higher in the Wuqinxi group than in the stretching group. Participants in the Wuqinxi group significantly improved their UPDRS-III (17.73 ± 9.88) and TUG (10.50 ± 1.79) score after 12 weeks of training intervention. CONCLUSION: The results show that the use of Wuqinxi for rehabilitation therapy for cognition is feasible, widely accepted, and effective in patients with Parkinson's disease. This study provides preliminary evidence for further large-scale and controlled studies.

Modulation of hand motor skill performance induced by motor practice combined with matched or mismatched hand posture motor imagery.

Motor imagery (MI), the mental rehearsal of a movement without muscle activation, combined with motor practice (MP) improves the performance of athletes and promotes rehabilitation of motor function among patients with brain injury. The actual hand posture influences the mental simulation of hand movements such that the ability of MI to affect corticospinal excitability is enhanced when the actual hand posture is consistent with the imagined movement of the hand. However, how MP combined with matched or mismatched hand posture MI modulates hand motor skill performance and the underlying neural mechanisms remain unclear. Thus, we first investigated whether MI hand posture that was compatible or incompatible with the actual MP influenced motor performance and corticospinal excitability induced by MI combined with MP. Twenty-eight healthy young adults repeatedly imagined either (1) closing their right hand into a fist with the thumb on top of the fingers and then opening the hand before actually performing that exact motor action or (2) performing the same motor skill but first imagining the right thumb touching the little finger before opening the hand . Changes in the peak acceleration of the hand grasp were measured to assess motor performance. The amplitudes of motor-evoked potentials (MEPs) in a target muscle were obtained using transcranial magnetic stimulation to assess corticospinal activation, a measure of primary cortex stimulation, before, immediately after, and 20 min after the performance. When the results of two-way repeated-measures analyses of variance assessing the effects of the protocols and time on the various measurements were found to be significant, post hoc paired t tests with Bonferroni corrections for multiple comparisons were applied. The results showed that both peak grasp acceleration and corticospinal excitability significantly increased immediately and 20 min after task completion (p < 0.05 for all) only when the MI hand posture matched with that of the actual MP. We then determined whether this increased corticospinal activity was associated with decreased short-interval intracortical inhibition, as measured using paired-pulse transcranial magnetic stimulation. Similar to our previous results, we found that short-interval intracortical inhibition was significantly decreased immediately and 20 min after task completion (p < 0.05 for both) only when MI matched MP. We concluded that the increased motor performance and corticospinal excitability induced by MI and MP depended on the match between the hand posture in the MI and MP, and that this increased corticospinal excitability was associated with disinhibition of the primary motor cortex activity.

Effect of acupuncture at ST36 on motor cortical excitation and inhibition.

BACKGROUND: Acupuncture at Zusanli (ST36) is often used to facilitate motor recovery after stroke. However, the effect of acupuncture at ST36 on motor cortical excitation and inhibition remains unclear. This study aimed to explore the effect of acupuncture at ST36 on motor cortical excitation and inhibition. METHODS: Twenty healthy volunteers were recruited to receive acupuncture treatment. We selected the acupoint ST36 and its respective sham point as the experimental acupoint. Transcranial magnetic stimulation (TMS) was used to measure motor-evoked potentials (MEP) at 7 time points-before acupuncture (Pre), acupuncture (T0), 4 and 8 min after acupuncture (T4; T8), needle removal (T12), 4 and 8 min after needle removal (T16; T20). Simultaneously, paired TMS (pTMS) was employed to measure short- and long-interval intracortical inhibition (SICI [short latency intracortical inhibition]; LICI [long latency intracortical inhibition]), respectively, at three time points-before acupuncture (Pre), acupuncture (T0), needle removal (T12). After removing the acupuncture needle, all subjects were asked to quantify their Deqi sensation using a Gas table. RESULTS: The average Deqi sensation score of all subjects during acupuncture at ST36 was higher than that observed at the sham point. With acupuncture at ST36, the MEP amplitude was higher at three time points (T0, T4, T8) than at Pre, although the MEP amplitude tended toward Pre after needle removal. The MEP amplitude was also higher at the same time points (T0, T4, T8) than at the sham point. Furthermore, the Deqi sensation score was correlated with MEP amplitude. With acupuncture at ST36, SICI and LICI at T0 were higher than those at Pre, and SICI and LICI at T0 were higher than those at the sham point. CONCLUSION: Acupuncture at ST36 increased motor cortical excitation and had an effect on the remaining needle phase. Deqi sensation was correlated with MEP amplitude. Acupuncture at ST36 also decreased motor cortical inhibition.

Expertise-Level-Dependent Functionally Plastic Changes During Motor Imagery in Basketball Players.

Motor imagery is the mental process of rehearsing or simulating a given action without overt movements. The aim of the present study is to examine plastic changes in relevant brain areas during motor imagery with increasing expertise level. Subjects (novices, intermediate and elite players) performed motor imagery of basketball throws under two experimental conditions (with-ball and without-ball). We found that all basketball players exhibited better temporal congruence (between motor imagery and motor execution) and higher vividness of motor imagery than novices. The vividness of motor imagery was higher for the with-ball than for the without-ball conditions in all three subject groups. The results from functional magnetic resonance imaging (fMRI) showed three different patterns of cortical activation. Activation in the left middle frontal gyrus increased and that in the left supplementary motor area decreased with increasing levels of motor expertise. Importantly, brain activation in the left postcentral gyrus was the highest in the intermediate players compared to both novices and elite players. For the elite group, these three areas showed higher activation in the without-ball condition than the with-ball condition, while the opposite trend was found in intermediate players. Our findings suggest that the level of motor expertise may be related to high-order brain functions that are linked to different activation patterns in different brain areas.

Traditional Chinese Exercise for Cardiovascular Diseases: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Traditional Chinese exercise (TCE) has widespread use for the prevention and treatment of cardiovascular disease; however, there appears to be no consensus about the benefits of TCE for patients with cardiovascular disease. The objective of this systematic review was to determine the effects of TCE for patients with cardiovascular disease. METHODS AND RESULTS: Relevant studies were searched by PubMed, Embase, Web of Science, the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, and the China National Knowledge Infrastructure. We covered only published articles with randomized controlled trials. The outcome measures included physiological outcomes, biochemical outcomes, physical function, quality of life, and depression. A total of 35 articles with 2249 cardiovascular disease patients satisfied the inclusion criteria. The pooling revealed that TCE could decrease systolic blood pressure by 9.12 mm Hg (95% CI -16.38 to -1.86, P=0.01) and diastolic blood pressure by 5.12 mm Hg (95% CI -7.71 to -2.52, P<0.001). Patients performing TCE also found benefits compared with those in the control group in terms of triglyceride (standardized mean difference -0.33, 95% CI -0.56 to -0.09, P=0.006), 6-minute walk test (mean difference 59.58 m, 95% CI -153.13 to 269.93, P=0.03), Minnesota Living With Heart Failure Questionnaire results (mean difference -17.08, 95% CI -23.74 to -10.41, P<0.001), 36-Item Short Form physical function scale (mean difference 0.82, 95% CI 0.32-1.33, P=0.001), and Profile of Mood States depression scale (mean difference -3.02, 95% CI -3.50 to -2.53, P<0.001). CONCLUSIONS: This study demonstrated that TCE can effectively improve physiological outcomes, biochemical outcomes, physical function, quality of life, and depression among patients with cardiovascular disease. More high-quality randomized controlled trials on this topic are warranted.