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1.
Medicine (Baltimore) ; 99(16): e19681, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311942

RESUMO

BACKGROUND: Breast cancer is the most prevalent cancer in women worldwide. Treatment for breast cancer can be expensive, painful and can significantly affect the quality of life, leading to various side effects such as depression and anxiety, fatigue, sleep disorders, and cognitive impairment. Tai Chi Chuan (TCC) is the most prominent manifestation of tai chi in Chinese martial arts. TCC has been reported to be potentially effective for health and well-being of both the sick and the healthy. However, it is still controversial whether TCC benefits breast cancer patients. It is therefore of great value to evaluate the effectiveness of TCC on the psychological well-being and quality of life in people with breast cancer. METHODS: This review will summarize and meta-analyze all relevant randomized controlled trials on TCC in patients with breast cancer in the light of their anxiety, depression and fatigue level, inflammatory cytokine as well as quality of life, sleep quality, and cognitive function. The following electronic databases will be searched: PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, VIP Chinese Science and Technology Periodical Database, and Wan Fang Data. The methodologic quality of randomized controlled trials has been assessed using the Cochrane risk assessment tool. All trials included are analyzed according to the criteria of the Cochrane Handbook. Review Manager 5.3, R-3.5.1 software and grading of recommendations assessment, development, and evaluation pro-GDT online software are used for data synthesis and analysis. RESULTS: The results of this systematic review will be used to summarize and evaluate the evidence available from randomized controlled clinical trials of TCC as supportive and adjuvant therapy for breast cancer. CONCLUSION: This review will provide a detailed summary of the evidence to assess the effectiveness of TCC for breast cancer. OSF REGISTRATION: DOI 10.17605/OSF.IO/Z2FSA.


Assuntos
Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , Metanálise como Assunto , Revisões Sistemáticas como Assunto , Tai Ji , Feminino , Humanos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
Adv Exp Med Biol ; 1191: 415-449, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002940

RESUMO

Complementary and alternative medicine (CAM) encompasses a wide range of different nonmainstream therapies that have been increasingly used for treatment or adjunctive treatment of various ailments with anxiety/anxiety disorders being one of the commonly CAM (self)-medicated conditions. Thousands of published papers refer to use of CAM in various psychiatric disorders or in healthy or medically ill patients with mood or anxiety difficulties. In this chapter we focus specifically on clinically diagnosed (in line with the standard criteria) anxiety disorders and overview evidence of efficacy/safety of a range of CAM modalities: biologically based therapies (typically herbal preparations and less so nutraceuticals); manipulative and body-based therapies (acupuncture, aerobic exercise, massage, therapeutic touch, repetitive transcranial magnetic stimulation, balneotherapy, and others); mind-body therapies (yoga, Morita therapy, Tai Chi, reiki, Chinese cognitive therapy, religious and spiritual interventions, relaxation, mediation, and mindfulness-based interventions); and alternative medical systems (Ayurveda, homeopathy). We focus exclusively on randomized controlled trials and attempt to evaluate the existing body of evidence in the same manner that is applied to mainstream treatments.


Assuntos
Transtornos de Ansiedade/terapia , Terapias Complementares , Prática Clínica Baseada em Evidências , Terapia por Acupuntura , Exercício Físico , Humanos , Massagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Tai Ji , Ioga
3.
Braz J Med Biol Res ; 53(2): e9171, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32049101

RESUMO

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).


Assuntos
Terapia por Exercício/métodos , Doença de Parkinson/reabilitação , Tai Ji/métodos , Acidentes por Quedas/prevenção & controle , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença
4.
J Altern Complement Med ; 26(3): 176-189, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32013530

RESUMO

Objectives: T'ai chi (TC) has been found effective for improving chronic low back pain (cLBP). However, such studies did not include adults over 65 years of age. This study was designed to evaluate the feasibility and acceptability of TC in this population compared with Health Education (HE) and with Usual Care (UC). Design: Feasibility randomized controlled trial. Settings/Location: Participants were recruited from Kaiser Permanente Washington and classes took place in a Kaiser facility. Patients: Adults 65 years of age and older with cLBP. Interventions: Twenty-eight participants were randomized to 12 weeks of TC followed by a 24-week tapered TC program, 12 were assigned to a 12-week HE intervention and 17 were assigned to UC only. Outcome Measures: Feasibility and acceptability were determined by recruitment, retention and 12-, 26-, and 52-week follow-up rates, instructor adherence to protocol, class attendance, TC home practice, class satisfaction, and adverse events. Results: Fifty-seven participants were enrolled in two cohorts of 28 and 29 during two 4-month recruitment periods. Questionnaire follow-up completion rates ranged between 88% and 93%. Two major class protocol deviations were noted in TC and none in HE. Sixty-two percent of TC participants versus 50% of HE participants attended at least 70% of the classes during the 12-week initial intervention period. Weekly rates of TC home practice were high among class attendees (median of 4.2 days) at 12 weeks, with fewer people practicing at 26 and 52 weeks. By 52 weeks, 70% of TC participants reported practicing the week before, with a median of 3 days per week and 15 min/session. TC participants rated the helpfulness of their classes significantly higher than did HE participants, but the groups were similarly likely to recommend the classes. Conclusion: The TC intervention is feasible in this population, while the HE group requires modifications in delivery.


Assuntos
Dor Lombar/terapia , Tai Ji , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Cooperação do Paciente/estatística & dados numéricos , Inquéritos e Questionários
5.
Medicine (Baltimore) ; 99(4): e18853, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977884

RESUMO

BACKGROUND: Tai Chi is gaining an increasing popularity in rehabilitation management of chronic conditions. Yet no consensus has reached on its efficacy and safety of type 2 diabetes despite that several systematic reviews (SRs) were published on this topic. Therefore, we will conduct an overview to critically evaluate current SRs and implement an updated metaanalysis with recently published randomized controlled trials (RCTs). METHODS: A systematic literature search of relevant RCTs-based SRs will be conducted in electronic databases including Medline, Embase, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database from their inceptions to search date without language restrictions. Eligible SRs will be methodologically assessed by the assessment of multiple SRs 2 and Risk of Bias in SRs tool and their RCTs included will be extracted for further evidence synthesis. To update current meta-analysis on this topic, a supplementary search will be implemented for related newly emerged RCTs. Cochrane risk of bias assessment tool will be applied for RCTs quality evaluation. The grading of recommendations assessment, development and evaluation will be utilized for evidence quality assessment of outcomes. Study characteristic information on participants, interventions, outcomes, comparisons and conclusions will be described in detail. Review Manager V5.3 will be used for risk of bias assessment and Stata 14.0 for meta-analysis and sensitivity analysis. RESULTS: The study results will be disseminated through a peer-reviewed journal publication or conference presentation. CONCLUSIONS: This study finding will provide an updated evidence of Tai Chi for patients with type 2 diabetes mellitus (T2DM), thus to help inform clinical physicians, T2DM patients and their families to develop better rehabilitation plans and to draw more attention of decision-makers in exercise rehabilitation related policy-making.This study protocol has been applied for registration on PROSPERO platform (https://www.crd.york.ac.uk/PROSPERO/), with an assigned ID: CRD42019140988.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Tai Ji , Terapia por Exercício/métodos , Humanos , Metanálise como Assunto , Qualidade de Vida , Revisões Sistemáticas como Assunto , Resultado do Tratamento
7.
J Acupunct Meridian Stud ; 13(1): 12-18, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31863925

RESUMO

This study evaluates the effects of a short-term Cardio Tai Chi program on the cardiorespiratory fitness and hemodynamic parameters in sedentary adults. Thirty-one sedentary participants (age: 58 ± 9 years, body mass: 63 ± 12 kg) were subjected to an exercise program during 10 sessions over a 10-day period within 2 weeks. The Cardio Tai Chi program consisted in a series of three to five intervals lasting 90 s each at ∼70% maximal heart rate separated by 2-min of low-intensity recovery. Primary outcome measures were cardiorespiratory fitness (peak oxygen uptake, V˙O2peak) assessed by the Rockport walking test and resting hemodynamic parameters (systolic, diastolic, mean, and pulse pressures). We observed a significant difference of means on post-pre V˙O2peak [4.5 ml/kg/min, 95% confidence interval (CI): 3.1 to 5.8, p = 0.004], systolic blood pressure (-5.5 mmHg, 95% CI:-7.3 to -3.8, p = 0.010) and pulse pressure (-3.7 mmHg, 95% CI: -5.2 to -2.3, p = 0.028). No significant differences were observed for diastolic pressure (-1.8 mmHg, 95% CI: -2.6 to -1.0, p = 0.226), mean blood pressure (2.5 mmHg, 95% CI: 1.4 to 3.6, p = 0.302), or resting heart rate (-0.9 beat/min, 95% CI: -2.0 to 0.1, p = 0.631). Our findings suggest that engaging in a short-term Cardio Tai Chi program can improve cardiorespiratory fitness and hemodynamic parameters in sedentary adults.


Assuntos
Coração/fisiologia , Tai Ji , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Aptidão Cardiorrespiratória , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
8.
Braz J Med Biol Res ; 52(12): e8786, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31778439

RESUMO

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).


Assuntos
Terapia por Estimulação Elétrica/métodos , Insuficiência Cardíaca Sistólica/reabilitação , Extremidade Inferior/fisiopatologia , Músculo Esquelético/fisiopatologia , Tai Ji/métodos , Idoso , Doença Crônica , Insuficiência Cardíaca Sistólica/fisiopatologia , Humanos , Qualidade de Vida , Resultado do Tratamento
9.
Medicine (Baltimore) ; 98(45): e17556, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702613

RESUMO

BACKGROUND: Sleep plays a crucial role in the general health of the human body. However, sleep problems become increasingly severe with age, and its incidence is on the rise. Notably, Tai Chi exercise may be an efficacious means to ameliorate sleep problems among older adults. This is especially since Tai Chi has been widely used to manage sleep problems in China for many years, but there is limited evidence regarding its effectiveness. We will conduct this study aiming to investigate the efficacy of Tai Chi as a complementary and alternative therapy for sleep problems in older adults. METHODS: We will systematically search Scopus, Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang database from their inceptions to August 2019. Only randomized controlled trials of Tai Chi for sleep problems among older adults will be considered for inclusion and the Pittsburgh sleep quality index will be the primary outcome measurement. Moreover, study selection, data extraction, and the evaluation of the methodological quality of trials will each be independently completed by at least 2 researchers. We will employ the software Stata version 12.0 to implement the statistical analysis. RESULTS: The current systematic review and meta-analysis will provide synthesized results of the effectiveness and safety of Tai Chi exercise for sleep problems among older adults. CONCLUSION: This systematic review and meta-analysis will provide high-quality evidence on the effectiveness and safety of Tai Chi exercise for sleep problems in older adults. REGISTRATION: PEROSPERO CRD42019129782.


Assuntos
Transtornos do Sono-Vigília/terapia , Tai Ji/métodos , China , Feminino , Humanos , Masculino , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Software
10.
Medicine (Baltimore) ; 98(42): e17509, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626108

RESUMO

To research the possible role of Tai Chi in preventing cardiovascular disease and improving cardiopulmonary function in adults with obesity aged 50 years and older.Between 2007 and 2012, 120 adults with obesity, aged 50 years and older, were divided into a Tai Chi group and a control group, with 60 participants in each group. The 2 groups were evaluated for weight, waist circumference, hip circumference, blood pressure (BP), body mass index, and incidence of chronic disease during follow-up monitoring.Two- and 6-year follow-up showed that the average BP in the Tai Chi group along with either the systolic or diastolic pressure decreased significantly compared to those in the control group (P < .001). Waist and hip circumference, weight, and body mass index in the Tai Chi group were significantly reduced compared to those in the control group (P < .001). The cardiopulmonary function of the control group and the Tai Chi group changed, with the cardiac index significantly higher in the Tai Chi group than in the control group (P < .05). The Tai Chi group had significantly higher levels of lung function, including vital capacity, maximal oxygen uptake, and total expiratory time, than the control group. The total incidence of complications and mortality in the Tai Chi group were much lower than those in the control group (P < .001). The incidence of cardiovascular and cerebrovascular disease in the Tai Chi group (16.67%) was lower than that in the control group (38.33%).Tai Chi is not only a suitable exercise for elderly people with obesity, but it can also help to regulate BP, improve heart and lung function in these individuals, as well as reduce the incidence of cardiovascular disease and other chronic diseases, helping to improve their quality of life.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Obesidade/fisiopatologia , Tai Ji/métodos , Idoso , Pressão Sanguínea , Composição Corporal/fisiologia , Índice de Massa Corporal , Exercício Físico/fisiologia , Teste de Esforço , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Fatores de Tempo , Resultado do Tratamento
11.
Complement Ther Clin Pract ; 37: 140-147, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31570211

RESUMO

BACKGROUND AND PURPOSE: Balance impairment is the predominant risk factor for falls in stroke survivors. This study examined the effects of body weight support-Tai Chi (BWS-TC) footwork on balance control among stroke survivors with fear of falling (FOF). MATERIALS AND METHODS: Twenty-eight stroke survivors with FOF were randomly allocated to either control or BWS-TC groups. Those in BWS-TC underwent Tai Chi training for 12 weeks. Outcomes were assessed in all participants by evaluation of the limits of stability test, modified clinical test of sensory integration of balance, fall risk index, and Fugl-Meyer assessment of lower limbs at baseline and 12 weeks. RESULTS: The BWS-TC group displayed significant enhancement in dynamic control and vestibular and somatosensory integration. CONCLUSION: BWS-TC may enhance dynamic control and sensory integration of balance and reduce the risk of fall in stroke survivors with FOF.


Assuntos
Acidentes por Quedas/prevenção & controle , Equilíbrio Postural , Acidente Vascular Cerebral/complicações , Tai Ji , Idoso , Peso Corporal , Medo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Reabilitação do Acidente Vascular Cerebral , Sobreviventes
12.
Medicine (Baltimore) ; 98(40): e17118, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577701

RESUMO

BACKGROUND: Mild cognitive impairment (MCI) is an intermediate stage between the cognitive changes of normal aging and early dementia. Tai Chi (TC) may be particularly beneficial to patients with MCI due to its whole-body coordination characteristics. This systematic review protocol aims to outline the methods that will be used to assess the comparative effectiveness and safety of TC for MCI through a systematic review and meta-analysis. METHODS: A systematic review will identify and evaluate randomized controlled trials (RCTs) that examined the effects and safety of TC compared to a placebo, conventional treatment, and no treatment on cognitive function in individuals with MCI. Studies from databases of MEDLINE, PubMed, Embase, Global Health, Cochrane Library, and Scopus from January 1990 to March 2019 reported in English will be searched. Two independent reviewers will screen the studies for inclusion with the eligibility criteria and extract data. Risk of bias of individual studies will be assessed in line with Cochrane risk of bias tool. The overall quality of cumulative evidence will be assessed using selected Grading of Recommendations, Assessment, Development, and Evaluations criteria. Statistics will be used for heterogeneity assessment, sensitivity analysis, data synthesis, generating funnel plots, and subgroup analysis. Meta-analysis will be performed, if sufficiently homogeneous studies are found. A narrative synthesis will be conducted, grouping studies by exposure and outcome definitions, and describing any differences by subgroups. RESULTS: This study will provide practical and targeted evidence in investigating the impact of TC exercise for individuals with MCI. CONCLUSION: The findings of our study will provide updated evidence to determine whether TC is an effective intervention to patients with MCI. TRIAL REGISTRATION NUMBER: International Prospective Register for Systematic Reviews (PROSPERO) number CRD42019125104.


Assuntos
Disfunção Cognitiva/terapia , Tai Ji/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
13.
Cochrane Database Syst Rev ; 9: CD004849, 2019 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-31553478

RESUMO

BACKGROUND: Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory, autoimmune disease that results in joint deformity and immobility of the musculoskeletal system. The major goals of treatment are to relieve pain, reduce inflammation, slow down or stop joint damage, prevent disability, and preserve or improve the person's sense of well-being and ability to function. Tai Chi, interchangeably known as Tai Chi Chuan, is an ancient Chinese health-promoting martial art form that has been recognized in China as an effective arthritis therapy for centuries. This is an update of a review published in 2004. OBJECTIVES: To assess the benefits and harms of Tai Chi as a treatment for people with rheumatoid arthritis (RA). SEARCH METHODS: We updated the search of CENTRAL, MEDLINE, Embase, and clinical trial registries from 2002 to September 2018. SELECTION CRITERIA: We selected randomized controlled trials and controlled clinical trials examining the benefits (ACR improvement criteria or pain, disease progression, function, and radiographic progression), and harms (adverse events and withdrawals) of exercise programs with Tai Chi instruction or incorporating principles of Tai Chi philosophy. We included studies of any duration that included control groups who received either no therapy or alternate therapy. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: Adding three studies (156 additional participants) to the original review, this update contains a total of seven trials with 345 participants. Participants were mostly women with RA, ranging in age from 16 to 80 years, who were treated in outpatient settings in China, South Korea, and the USA. The majority of the trials were at high risk of bias for performance and detection bias, due to the lack of blinding of participants or assessors. Almost 75% of the studies did not report random sequence generation, and we judged the risk of bias as unclear for allocation concealment in the majority of studies. The duration of the Tai Chi programs ranged from 8 to 12 weeks.It is uncertain whether Tai Chi-based exercise programs provide a clinically important improvement in pain among Tai Chi participants compared to no therapy or alternate therapy. The change in mean pain in control groups, measured on visual analog scale (VAS 0 to 10 score, reduced score means less pain) ranged from a decrease of 0.51 to an increase of 1.6 at 12 weeks; in the Tai Chi groups, pain was reduced by a mean difference (MD) of -2.15 (95% confidence interval (CI) -3.19 to -1.11); 22% absolute improvement (95% CI, 11% to 32% improvement); 2 studies, 81 participants; very low-quality evidence, downgraded for imprecision, blinding and attrition bias.There was very low-quality evidence, downgraded for, blinding, and attrition, that was inconclusive for an important difference in disease activity, measured using Disease Activity Scale (DAS-28-ESR) scores (0 to 10 scale, lower score means less disease activity), with no change in the control group and 0.40 reduction (95% CI -1.10 to 0.30) with Tai Chi; 4% absolute improvement (95% CI 11% improvement to 3% worsening); 1 study, 43 participants.For the assessment of function, the change in mean Health Assessment Questionnaire (HAQ; 0 to 3 scale, lower score means better function) ranged from 0 to 0.1 in the control group, and reduced by MD 0.33 in the Tai Chi group (95% CI -0.79 to 0.12); 11% absolute improvement (95% CI 26% improvement to 4% worsening); 2 studies, 63 participants; very low-quality evidence, downgraded for imprecision, blinding, and attrition. We are unsure of an important improvement, as the results were inconclusive.Participants in Tai Chi programs were less likely than those in a control group to withdraw from studies at 8 to 12 weeks (19/180 in intervention groups versus 49/165 in control groups; risk ratio (RR) 0.40 (95% CI 0.19 to 0.86); absolute difference 17% fewer (95% CI 30% fewer to 3% fewer); 7 studies, 289 participants; low-quality evidence, downgraded for imprecision and blinding.There were no data available for radiographic progression. Short-term adverse events were not reported by group, but in two studies there was some narrative description of joint and muscle soreness and cramps; long-term adverse events were not reported. AUTHORS' CONCLUSIONS: It is uncertain whether Tai Chi has any effect on clinical outcomes (joint pain, activity limitation, function) in RA, and important effects cannot be confirmed or excluded, since all outcomes had very low-quality evidence. Withdrawals from study were greater in the control groups than the Tai Chi groups, based on low-quality evidence. Although the incidence of adverse events is likely to be low with Tai Chi, we are uncertain, as studies failed to explicitly report such events. Few minor adverse events (joint and muscle soreness and cramps) were described qualitatively in the narrative of two of the studies. This updated review provides minimal change in the conclusions from the previous review, i.e. a pain outcome.


Assuntos
Artrite Reumatoide/terapia , Tai Ji , Artralgia , Técnicas de Exercício e de Movimento , Humanos , Manejo da Dor , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
Artigo em Inglês | MEDLINE | ID: mdl-31547469

RESUMO

Theoretical explanation concerning the psychological well-being of elderly adults as they participate in a particular leisure activity has been rare. Based on the theory of planned behavior and the technology acceptance model, this study sought to understand the Tai Chi Chuan (TCC) participation influence factors, process, and psychological well-being of Chinese people. A self-developed questionnaire was developed to test the hypotheses of this study. Applying structural equation models, a survey of 769 TCC participations were used to test the theoretical model. The results indicated that perceived usefulness significantly and positively affect respondent attitude, family members' influences significantly and positively affect participants' subjective norm, and resource facilitating conditions significantly and positively affect perceived behavioral control. Perceived behavioral control, attitude, and subjective norm significantly and positively affect TCC participants. The study lends support to the notion that leisure activity participation is vital for elderly adults and their well-being, and it develops a theoretical reference model for better understanding the leisure participation perceptual reasoning processes of elderly adults. Furthermore, the results offer important implications for health policy makers, clinical prevention, and interventions using participation behavior relationships to develop well-constructed leisure programs to attract and inspire participation and, hence, improve the psychological well-being of elderly adults.


Assuntos
Comportamentos Relacionados com a Saúde , Atividades de Lazer , Tai Ji , Idoso , Envelhecimento , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida
15.
J Altern Complement Med ; 25(12): 1225-1237, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31556689

RESUMO

Objectives: Falls are common in Parkinson's disease (PD). Exercise interventions can prevent falls. This review aims to (1) explore the existing evidence regarding the cost-effectiveness of exercise-based fall prevention programs for people with PD and (2) discuss the implications of the review findings for future research and clinical practice. Design: Databases AMED Allied and Complementary Medicine, CINAHL, CRD, EBSCO, EMBASE, MEDLINE, PubMed, Scopus, and Web of Science were searched from their inception until June 2019. Randomized and nonrandomized trials that included an economic evaluation of fall prevention programs for people with PD were considered. Quality of the economic evaluation was assessed using the Consensus on Health Economic Criteria list (CHEC-list), and the methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) and Cochrane risk of bias tool. Results: Nine hundred and sixty-five studies were screened to include three studies involving 556 participants. Quality of economic evaluation assessed using CHEC-list was high. The methodological quality was high for two studies and low for one study. Tested interventions included Tai Ji Quan, physiotherapist-led, supervised, weekly and monthly balance, and strengthening exercises. The duration of the interventions ranged from 10 weeks to 6 months, while the intervention frequency ranged from two sessions per week to one session per month. Treatment sessions lasted for 60 min in all three studies. One high economic and methodological quality study comparing Tai Ji Quan with resistance and stretching exercises reported least cost resource use among Tai Ji Quan group (USD 80,441) and greater incremental number of falls prevented. All three tested interventions had an 80% probability of being cost-effective with the corresponding country-specific threshold incremental cost-effectiveness ratio values. Conclusions: The findings provide some evidence for exercise-based intervention as a cost-effective treatment option for preventing falls in PD; however, due to the limited number of available studies, heterogeneity of the interventions, and diversity of assessment settings, a firm conclusion cannot be established. Additional studies evaluating the cost-effectiveness of fall prevention programs involving larger samples and using different treatment parameters in various settings are warranted.


Assuntos
Acidentes por Quedas/prevenção & controle , Terapia por Exercício , Doença de Parkinson/terapia , Idoso , Análise Custo-Benefício , Terapia por Exercício/economia , Terapia por Exercício/métodos , Terapia por Exercício/estatística & dados numéricos , Feminino , Humanos , Masculino , Tai Ji
16.
Medicine (Baltimore) ; 98(37): e17099, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517838

RESUMO

BACKGROUND: This is the first systematic review evaluating and statistically synthesis the current studies regarding the effects of Tai Chi on pain and disability in patients with low back pain (LBP). METHODS: Seven electronic databases including PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang and VIP information from inception to early March 2019 were searched. The Physiotherapy Evidence Database (PEDro) Scale was used to assess quality of all included randomized controlled trials (RCTs). The pooled effect size (weight mean difference, WMD) and 95% confidence interval (CI) were calculated to determine the effect of Tai Chi on pain and disability among LBP patients based on random effects model. RESULTS: The aggregated results of the meta-analysis suggested that Tai Chi significantly decreased pain (WMD = -1.27, 95%CI -1.50 to -1.04, P < .00001, I = 74%) and improve function disability, Oswestry disability index (ODI) subitems: pain intensity (WMD = -1.70, 95% CI -2.63 to -0.76, P = .0004, I = 89%); personal care (WMD = -1.93, 95% CI -2.86 to -1.00, P < .0001, I = 90%); lifting (WMD = -1.69, 95% CI -2.22 to -1.15, P < .0001, I = 66%); walking (WMD = -2.05, 95% CI -3.05 to -1.06, P < .0001, I = 88%); standing (WMD = -1.70, 95% CI -2.51 to -0.89, P < .0001, I = 84%); sleeping (WMD = -2.98, 95% CI -3.73 to -2.22, P < .00001, I = 80%); social life (WMD = -2.06, 95% CI -2.77 to -1.35, P < 0.00001, I = 80%) and traveling (WMD = -2.20, 95% CI -3.21 to -1.19, P < .0001, I = 90%), Japanese Orthopedic Association (JOA) score (WMD = 7.22, 95% CI 5.59-8.86, P < .00001, I = 0%), Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) physical functioning (WMD = 3.30, 95% CI 1.92-4.68, P < .00001), and Roland-Morris Disability Questionnaire (RMDQ) (WMD = -2.19, 95% CI -2.56 to -1.82, P < .00001). CONCLUSION: We drew a cautious conclusion that Tai Chi alone or as additional therapy with routine physical therapy may decrease pain and improve function disability for patients with LBP. Further trials are needed to be conducted with our suggestions mentioned in the systematic review.


Assuntos
Dor Lombar/terapia , Manejo da Dor/normas , Tai Ji/normas , Humanos , Manejo da Dor/métodos , Modalidades de Fisioterapia/normas , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Tai Ji/métodos
17.
Complement Ther Med ; 46: 1-8, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31519264

RESUMO

OBJECTIVE: To identify empirical evidence on the effectiveness of Tai Chi in treating fibromyalgia (FM). METHOD: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the effectiveness of Tai Chi and standard care or conventional therapeutic exercise in patients with FM. PubMed, Medline, and Physiotherapy Evidence Database were searched for relevant studies published before May 2019. Treatment effectiveness was evaluated using the fibromyalgia impact questionnaire (FIQ), and the total score, pain score, sleep quality index, fatigue, depression, and quality of life were assessing among the patients. RESULTS: Six RCTs with 657 patients were included. Results of our meta-analysis indicated that Tai Chi exerts significant positive effects on reducing the total FIQ score at 12-16 weeks (standard mean difference [SMD]: -0.61; 95% confidence interval [CI]: -0.90 to -0.31) and pain score (SMD: -0.88; 95% CI: -1.58 to -0.18), improving sleep quality (SMD: -0.57; 95% CI: -0.86 to -0.28), relieving fatigue (SMD: -0.92; 95% CI: -1.81 to -0.04), alleviating depression (SMD: -0.49; 95% CI: -0.97 to -0.01), and enhancing quality of life physically (SMD: 6.21; 95% CI: 3.18-9.24) and psychologically (SMD: 5.15; 95% CI: 1.50-8.81). CONCLUSION: Tai Chi exerts significantly greater effects on patients with FM than standard care; therefore, we suggest that Tai Chi can be used as an alternative treatment. However, more large-scale, high-quality, and multicenter trials are required to provide stronger evidence on the effectiveness of Tai Chi, as an alternative to aerobic exercise, compared with conventional therapeutic exercise.


Assuntos
Fibromialgia/terapia , Terapia por Exercício/métodos , Humanos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Inquéritos e Questionários , Tai Ji/métodos
18.
Complement Ther Med ; 46: 109-115, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31519266

RESUMO

OBJECTIVE: To determine whether utilizing beginner, video-guided tai chi and qigong classes as an adjunct to physical therapy to enhance mobilization among hospitalized patients is feasible and acceptable. DESIGN: Single-arm feasibility study over a 15½-week period. SETTING: Three medical-surgical units at one hospital. INTERVENTIONS: Small-group video-guided beginner-level tai chi and qigong classes supervised by physical therapists occurred three times a week. MAIN OUTCOME MEASURES: The primary outcome was weekly class attendance. Secondary outcomes included patient and staff satisfaction, collected by surveys and semi-structured interviews. Process measures included class duration. Balancing measures included falls. RESULTS: One-hundred and fifty-seven patients were referred for recruitment, 45 gave informed consent, and 38 patients attended at least one class. The number of weekly class attendees increased during the study period. Based on first-class experience, 68% (26/38) of patients reported enjoying the class "quite a bit" or "extremely," 66% (25/38) of patients reported feeling "more mobile" afterward, and 76% (29/38) of patients agreed that the class made them more comfortable going home. Average class duration was 29 minutes. Zero falls occurred during or immediately following class. CONCLUSIONS: Video-guided tai chi and qigong classes are feasible and well-received at our hospital. Future studies of the impact on preserving mobility and function or reducing length of stay are of interest.


Assuntos
Pacientes Internados/educação , Tai Ji/educação , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Satisfação Pessoal , Qigong , Qualidade de Vida
19.
Complement Ther Med ; 46: 144-152, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31519271

RESUMO

OBJECTIVES: The aim of the current study was to assess the scientific quality of the past systematic reviews regarding the application of Tai Chi in the management of Parkinson's disease (PD) using a systematic overview. METHODS: The search of PubMed and PsycInfo in February 2018 identified k=10 relevant systematic reviews published in 2008-2017 with terms PD, Tai Chi, and review in titles or abstracts. The quality of reviews was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR2) and the quality of meta-analytic procedures was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: The k=10 systematic reviews assessed various outcomes of Tai Chi in PD using a qualitative (k = 4) or a quantitative synthesis (meta-analysis; k = 6) of data from up to 14 primary studies published in English. The review strengths were the comprehensive search for literature, data coding, and data quality assessment. The review limitations were the high overlap in the primary data and the lack of either the review protocol, the list of excluded studies or the conflict of interest statement in the primary studies. The critical problems were that the qualitative data synthesis relied on the statistical significance of results in the primary studies with small sample sizes and that the computational details of meta-analysis were inadequately reported. CONCLUSIONS: The past systematic reviews suggest that Tai Chi is a promising complementary treatment for PD. However, the quality of such past reviews is limited. Future systematic reviews can be improved by adequately reporting the methodological details and adhering to the guidelines for conducting such reviews. The clinical relevance of Tai Chi in terms of the magnitude and the longer-term durability of its outcomes should be tested in future RCTs with larger sample sizes.


Assuntos
Doença de Parkinson/terapia , Tai Ji/estatística & dados numéricos , Estudos de Avaliação como Assunto , Humanos , Revisões Sistemáticas como Assunto
20.
Complement Ther Med ; 46: 54-61, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31519288

RESUMO

OBJECTIVE: To determine the feasibility, acceptability and effects of a 12-week Tai Chi exercise program on cardiometabolic risk factors and quality of life in community-dwelling Chinese adults with metabolic syndrome. DESIGN: A single blind, pilot randomized controlled trial. SETTING/LOCATION: A general outpatient clinic of a community-based hospital in Hong Kong. SUBJECTS: Ethnic Chinese, 18 years and older, who had at least three of the five criteria of metabolic syndrome defined by the National Cholesterol Education- Adult Treatment Panel III. INTERVENTION: The Tai Chi group attended a 1 -h Tai Chi class, twice a week for 12 weeks, plus 30-minutes home practice three-times per week. The control group maintained their usual daily activities. OUTCOME MEASURES: Primary outcomes were feasibility and acceptability of the Tai Chi intervention. Secondary outcome measures were cardiometabolic risk factors, quality of life, stress and Tai Chi exercise self-efficacy. RESULTS: Study retention rate was 65% (n = 35). Overall satisfaction of completers with the Tai Chi intervention was 4.5 ±â€¯0.63 (possible range = 1-5). When compared to controls, the Tai Chi group had significantly lower systolic blood pressure (p = 0.037) at 12-weeks. Significant within group changes for the Tai Chi group included lower diastolic blood pressure (p = 0.015), higher fasting blood glucose (p = 0.009), higher waist circumference (females only, p = 0.007), and better perceived mental health (p = 0.046); while controls had significantly higher fasting blood glucose (p = 0.031), and higher waist circumference (females only, p = 0.003). CONCLUSION: The study intervention was feasible and acceptable for Chinese adults with metabolic syndrome. While not powered to find statistically significant differences, positive and negative changes were observed in some cardiometabolic risk factors and quality of life. Further investigation with a larger sample size and longer study period is needed to explore potential environmental factors that may have influenced the study results.


Assuntos
Síndrome Metabólica/terapia , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Pressão Sanguínea/fisiologia , Exercício Físico/fisiologia , Feminino , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Qualidade de Vida , Fatores de Risco , Autoeficácia , Método Simples-Cego , Tai Ji/métodos , Resultado do Tratamento
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