Qigong and Tai Chi as Therapeutic Exercise: Survey of Systematic Reviews and Meta-Analyses Addressing Physical Health Conditions.

CONTEXT: Many researchers are interested in the Eastern therapeutic exercise of qigong and tai chi, performed as qigong. A review of systematic studies through April 2010 found evidence supporting tai chi as effective for preventing falls, improving psychological health, and promoting healthy aging. OBJECTIVE: The review intended to provide an updated survey of recent systematic reviews to establish the current-2016-level of scientific evidence assessing the therapeutic benefits of qigong exercise for clinical applications related to physical health. METHODS: The data sources included PubMed, SCOPUS, and CINAHL, using the major terms qigong OR tai chi AND review. Studies were included in the review if they (1) were systematic reviews and meta-analyses; (2) had been published as full text in the English language; (3) were published between January 2010 and December 2016; (4) had tai chi or qigong as the primary intervention of interest; (5) addressed a defined, physical-health complaint; and (6) included ≥3 randomized clinical trials. Reviews addressing nonclinical topics, mental health, and cognition were excluded. RESULTS: The extensive search identified 41 relevant systematic reviews and meta-analyses. Five areas of clinical application were supported. The review showed independent research evidence that was sufficient to support tai chi performed as qigong as a primary intervention for balance training and fall prevention. When compared with more traditional interventions, tai chi was found to have equal, and in some instances, superior effects, as well as cost-effectiveness. In addition, qigong, and tai chi performed as qigong, were found to have a complementary or alternative role in management of cancer, chronic obstructive pulmonary disease, Parkinson's disease, and cardiac and cardiovascular disorders. CONCLUSIONS: A growing body of evidence supports qigong and tai chi performed as qigong as valid complementary or alternative therapeutic exercises. Many aspects of the clinical study and application in this area remain to be explored.

Physical activity benefits and needs in adults with intellectual disabilities: systematic review of the literature.

Regular physical activity is vital for adult individuals with intellectual disabilities. The purpose of this review was to assess critically the evidence on effectiveness of physical activity interventions for adults with intellectual disability. An electronic database search was conducted. Research was then assessed for methodological rigor, and strength of the evidence was determined. Eleven clinical studies met inclusion criteria. Interventions studied included a variety of physical activity modes. Critical review revealed moderate to strong evidence that physical activity positively affected balance, muscle strength, and quality of life in individuals with intellectual disability. The authors also found that the research in this area needs to be translated into practice, specifically the development of physical activity programs that are adaptable to the needs of individuals with intellectual disability.

Rasch Analysis of the Fullerton Advanced Balance (FAB) Scale.

PURPOSE: This cross-sectional study explores the psychometric properties and dimensionality of the Fullerton Advanced Balance (FAB) Scale, a multi-item balance test for higher-functioning older adults. METHODS: Participants (n=480) were community-dwelling adults able to ambulate independently. Data gathering consisted of survey and balance performance assessment. Psychometric properties were assessed using Rasch analysis. RESULTS: Mean age of participants was 76.4 (SD=7.1) years. Mean FAB Scale scores were 24.7/40 (SD=7.5). Analyses for scale dimensionality showed that 9 of the 10 items fit a unidimensional measure of balance. Item 10 (Reactive Postural Control) did not fit the model. The reliability of the scale to separate persons was 0.81 out of 1.00; the reliability of the scale to separate items in terms of their difficulty was 0.99 out of 1.00. Cronbach's alpha for a 10-item model was 0.805. Items of differing difficulties formed a useful ordinal hierarchy for scaling patterns of expected balance ability scoring for a normative population. CONCLUSION: The FAB Scale appears to be a reliable and valid tool to assess balance function in higher-functioning older adults. The test was found to discriminate among participants of varying balance abilities. Further exploration of concurrent validity of Rasch-generated expected item scoring patterns should be undertaken to determine the test's diagnostic and prescriptive utility.

Tai Chi Chuan in the management of Parkinson's disease and Alzheimer's disease.

BACKGROUND: Parkinson's disease (PD) and Alzheimer's disease (ALZ) represent later-life onset neurodegenerative disorders that gradually rob those afflicted of their quality of life. PURPOSE: This chapter offers practice-based recommendations on how instruction and practice of Tai Chi Chuan (TCC) can be adapted for individuals with PD and those with ALZ. RESEARCH EVIDENCE: Practice of TCC is widely advocated as an exercise option in PD; however, little validating research exists. Even less is known about feasibility of applications of TCC for individuals with ALZ. CLINICAL IMPRESSIONS: The slow, rhythmic pace of functionally based exercises, internal organ stimulation, flexibility maintenance, balance-training effects, and general health benefits of TCC and Tai Chi-like exercise practice have clinical relevance for both conditions. Falls prevention, tremor reduction and motor control may be of most importance in management of PD. Behavioral and general health benefits as well as slowing of functional and cognitive decline are considerations with ALZ. RECOMMENDATIONS: Strategies of exercise adaptation include use of Tai Chi-like exercise for individuals with ALZ and those in middle or late stages of PD as well as providing instructional resources and training for caregivers and exercise aides to facilitate practice as a part of daily life.

Taiji for individuals with Parkinson disease and their support partners: a program evaluation.

BACKGROUND AND PURPOSE: Exercise is advocated in the management of Parkinson disease (PD), however, little is known regarding the potential benefits of complementary mind/body exercise for this clinical population. The purpose of this pilot program evaluation was to gain insight into participant and instructor perceptions of the perceived benefits and potential utility of a taiji exercise program. PROGRAM EVALUATION: Program participants (N=15) included 8 individuals with PD and 7 support partners with no history of PD. Group taiji instruction was offered in 45-minute weekly sessions, for 12 weeks at a community facility. Post-program evaluation included administration of a survey questionnaire, thematic analysis of a focus group discussion, instructor reflections, and review of attendance records. RESULTS: Benefits were perceived by participants in physical, psychological, and social domains. Thirteen of the survey respondents, including 6 of the 8 respondents with PD reported perceiving a physical benefit attributed to taiji practice. Improved balance was reported most frequently. Instructor observations and participant testimony suggest movement capability for individuals with Parkinsons may also be improved by performing taiji. CONCLUSION: This preliminary research provides support for further Taiji Buddy program examination and application.

Comprehensive therapeutic benefits of Taiji: a critical review.

This literature review offers physical rehabilitation professionals an update on the current breadth and strength of research evidence regarding comprehensive therapeutic benefits of Taiji practice. A critical analysis distinguishes between what is known from controlled clinical research and what is suggested in preliminary research. Of >200 published reports examined, 17 controlled clinical trials were judged to meet a high standard of methodological rigor. Controlled research evidence was found to confirm therapeutic benefits of Taiji practice with regard to improving quality of life, physical function including activity tolerance and cardiovascular function, pain management, balance and risk of falls reduction, enhancing immune response, and improving flexibility, strength, and kinesthetic sense. Preliminary research on implementation feasibility of Taiji programming exists for a variety of clinical populations. Further controlled clinical study is justified for a wide variety of clinical contexts.