Effects of Home-Based Tai Chi and Lower Extremity Training and Self-Practice on Falls and Functional Outcomes in Older Fallers from the Emergency Department-A Randomized Controlled Trial.

OBJECTIVES: To compare the effects of guided home-based tai chi chuan (TCC) and lower extremity training (LET) and of levels of self-practice on falls and functional outcomes in older fallers. DESIGN: Randomized controlled trial. SETTING: Taipei, Taiwan. PARTICIPANTS: Individuals aged 60 and older who had fall-related emergency department visits at least 6 months before participating in the study and ambulated independently at baseline (N = 456). INTERVENTION: Six months of TCC or LET. MEASUREMENTS: Four types of fall measures (falls, time to first fall, fallers, recurrent fallers) and six functional measures (handgrip strength, balance, mobility, fear of falling, depression, cognitive function). RESULTS: The TCC group was significantly less likely than the LET group to experience any falls during the 6-month intervention (incidence rate ratio (IRR) = 0.30, 95% confidence interval (CI) = 0.15-0.60), and the effects remained significant after 12 months of follow-up (IRR = 0.32, 95% CI = 0.14-0.71). These effects remained significant for injurious falls during the 6-month intervention (IRR = 0.33, 95% CI = 0.16-0.68) and the entire 18-month study (IRR = 0.39, 95% CI = 0.18-0.83). Similar results were obtained when another two fall measures (time to first fall, number of fallers) were used. Moreover, participants who independently practiced TCC or LET seven times per week or more were significantly less likely to experience injurious falls during the 6-month intervention (IRR = 0.41, 95% CI = 0.20-0.83) and the 18-month study (IRR = 0.43, 95% CI = 0.21-0.87) than their counterparts, had a significantly longer time to first injurious fall, and were significantly less likely to have an injurious fall during the 6-month intervention. Cognitive function improved to a greater extent in the TCC group than in the LET group over the 18-month study. CONCLUSION: Home-based TCC may reduce the incidence of falls and injurious falls more than conventional LET in older fallers, and the effects may last for at least 1 year.

Effects of Hatha yoga on stress in middle-aged women.

BACKGROUND: Stress is considered a crucial trigger for physical and mental illness. Stress reduction is a known long-term benefit of regular Hatha yoga practice. The efficacy of a single-session Hatha yoga class on stress reduction is not currently known. PURPOSE: This study investigated the comparative effectiveness of a single 90-minute Hatha yoga class and an 8-week, 90-minute-class-per-week course. METHODS: We used a quasiexperimental design and recruited 63 female community residents in New Taipei City aged 40-60 years. Participants were randomly divided into an experimental group (n = 30) and a control group (n = 33). The experimental group received the 8-week Hatha yoga course. The control group received no intervention. The Perceived Stress Scale (PSS) and heart rate variability (HRV) assessed stress reduction effectiveness. Chi-square, independent t test, paired t test, and generalized estimating equations were used for data analysis. RESULTS: After a single 90-minute class of Hatha yoga, experimental group PSS scores were significantly less than those of the control group (p = .001). Although experimental group HRV (low-frequency norm and high-frequency norm) had improved, these changes were not statistically significant (p = .059). PSS scores for the single 90-minute class and 8-week course did not significantly differ (p = .157) and HRV of statistics is significant (p = .005). Generalized estimating equations analyzed changes in the effectiveness over time of stress reduction (HRV and PSS) after the Hatha yoga intervention. Results showed the postintervention HRV and PSS of the experimental group decreased significantly (p < .001) more than the control group. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Our findings support the position that regular, long-term practice of Hatha yoga provides clear and significant health benefits. Participation in a single 90-minute Hatha yoga class can significantly reduce perceived stress. Doing Hatha yoga regularly can reduce perceived stress even more significantly.

Solanum erianthum intoxication mimicking an acute cerebrovascular disease.

We describe a case of Solanum erianthum poisoning that happened to a 75-year-old man. He ate the S erianthum that he gathered from the countryside, believing that it would be helpful in improving the numbness of his distal limbs. S erianthum is a solanaceous plant that contains a variable concentration of solanum alkaloids, causing gastrointestinal irritation, and tropane alkaloids that have anticholinergic properties producing typical and sometimes severe atropinelike symptoms. The diagnosis of S erianthum poisoning was made based on clinical symptoms and signs of anticholinergic syndrome associated with a history of vegetable meal from countryside and, moreover, on identification of the vegetable obtained from his family. Gastrointestinal decontamination and symptomatic treatment were useful in treatment of acute poisoning.