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1.
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
2.
Medicina (Kaunas) ; 55(5)2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31036791

RESUMO

Objective: The aim of this meta-analytic review was to quantitatively examine the effects of traditional Chinese exercises (TCE) on pain intensity and back disability in individuals with low back pain (LBP). Methods: Potential articles were retrieved using seven electronic databases (Medline, Embase, Cinahl, Web of Science, Cochrane library, China National Knowledge Infrastructure, and Wanfang). The searched period was from inception to 1 March 2019. Randomized controlled trials (RCTs) assessing the effect of TCE on pain intensity and back disability in LBP patients were included. Pooled effect sizes were calculated using the random-effects models and 95% confidence interval (95% CI). Results: Data from eleven RCTs (886 individuals with LBP) meeting the inclusion criteria were extracted for meta-analysis. Compared with the control intervention, TCE induced significant improvements in the visual analogue scale (VAS) (Hedge's g = -0.64, 95% CI -0.90 to -0.37, p < 0.001), Roland-Morris Disability Questionnaire (RMDQ) (Hedge's g = -0.41, 95% CI -0.79 to -0.03, p = 0.03), Oswestry Disability Index (ODI) (Hedge's g = -0.96, 95% CI -1.42 to -0.50, p < 0.001), and cognitive function (Hedge's g = -0.62, 95% CI -0.85 to -0.39, p < 0.001). In a meta-regression analysis, age (ß = 0.01, p = 0.02) and total exercise time (ß = -0.0002, p = 0.01) were associated with changes in the VAS scores, respectively. Moderator analyses demonstrated that Tai Chi practice (Hedge's g = -0.87, 95% CI -1.38 to -0.36, p < 0.001) and Qigong (Hedge's g = -0.54, 95% CI -0.86 to -0.23, p < 0.001) reduced VAS scores. Interventions with a frequency of 1-2 times/week (Hedge's g = -0.53, 95% CI -0.98 to -0.07, p = 0.02) and 3-4 times/week (Hedge's g = -0.78, 95% CI -1.15 to -0.42, p < 0.001) were associated with reduced VAS scores, but this significant reduction on this outcome was not observed in the weekly training frequency of ≥5 times (Hedge's g = -0.54, 95% CI -1.16 to 0.08, p = 0.09). Conclusions: TCE may have beneficial effects for reducing pain intensity for individuals with LBP, regardless of their pain status.


Assuntos
Dor Lombar/terapia , Tai Ji/normas , Adulto , Humanos , Dor Lombar/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Tai Ji/métodos
3.
J Holist Nurs ; 37(2): 163-174, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30111233

RESUMO

PURPOSE: To evaluate the feasibility of Tai Chi (TC) and electronic tablet (ET) interventions on older adults' cognition and health and to explore participants' perceptions of intervention activities. DESIGN: An emergent embedded experimental mixed methods design was used in which the qualitative strand helped explain intervention results. METHOD: Older adults who participate in TC classes will have improved cognition and health compared with older adults who participate in ET classes. Twenty-six participants from two assisted living residences were recruited and randomized to receive nine TC or ET classes. The Modified Mini Mental State Exam was used to measure cognition and the SF-12v2 assessed perceived health before and after the intervention. Participants were invited to share perceptions of the two interventions. Institutional review board approval was obtained and participants provided signed consent for both quantitative and qualitative strands. FINDINGS: There was no significant difference within or between groups on cognition and health scores. CONCLUSIONS: TC and ET use are activities that can be delivered in the community and have the potential to promote compensatory scaffolding as described by the revised scaffolding theory of aging and cognition. Future research should involve larger samples and teaching methods that promote learning postures.


Assuntos
Cognição , Nível de Saúde , Tai Ji/normas , Interface Usuário-Computador , Idoso , Idoso de 80 Anos ou mais , Computadores de Mão/normas , Feminino , Grupos Focais/métodos , Humanos , Masculino , Projetos Piloto , Pesquisa Qualitativa , Tai Ji/métodos
4.
J Holist Nurs ; 37(2): 189-199, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30227765

RESUMO

PURPOSE: To contribute to the treatment fidelity literature by providing real-world examples and suggestion for future research and potential clinical application, this article reports on implementation, assessment, and evaluation of treatment fidelity in mind-body self-care approaches in at-risk women. METHOD: Aligning with best practices, treatment fidelity was integrated into three randomized clinical trials. The first examined the effects of a tai chi intervention designed to decrease cardiometabolic risk factors in women; the second examined the effects of a tailored guided imagery intervention on pregnancy outcomes in African American women; and the third explored effects of a mindful physical activity intervention (yoga) on psychological outcomes in women with moderate to severe depressive symptoms. FINDINGS: Each of the studies successfully designed, implemented, and evaluated strategies to address recommended treatment fidelity components. These strategies provided qualitative and quantitative data that informed intervention refinement, directions for future research, and application in clinical practice. CONCLUSIONS: The treatment fidelity framework used here is based on best practices and was a feasible and reliable approach for ensuring and reporting on treatment fidelity, which is contributing to future research to foster translation of potentially effective mind-body self-care approaches into practice.


Assuntos
Terapias Mente-Corpo/normas , Resultado do Tratamento , Adolescente , Adulto , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/terapia , Feminino , Humanos , /normas , Terapias Mente-Corpo/métodos , Fatores de Risco , Tai Ji/métodos , Tai Ji/normas
5.
J Holist Nurs ; 36(2): 147-158, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29172896

RESUMO

PURPOSE: Explore the feasibility of a Tai Chi intervention to improve musculoskeletal pain, emotion, cognition, and physical function in individuals with posttraumatic stress disorder. DESIGN: Two-phase, one-arm quasi-experimental design. METHOD: Phase 1: 11 participants completed one Tai Chi session, feasibility questionnaire, and were offered participation in Phase 2, a 12-week Tai Chi intervention. Ten participants participated in Phase 2. Pain intensity, interference, physical function scales, an emotional battery, and cognition tests were used for pre- and postintervention outcome measures. Paired t tests and thematic analysis were used for analysis. FINDINGS: In Phase 1, most felt Tai Chi would benefit health (90.9%) and expressed interest in continuing Tai Chi (6.73 out of 7). Phase 2 results showed improvement in fear-affect (raw t = -2.64, p = .03; age adjusted t = -2.90, p = .02), fear-somatic arousal (raw t = -2.53, p = .035), List Sorting Working Memory (raw t = 2.62, p = .031; age adjusted t = 2.96, p = .018), 6-Minute Walk Test ( t = 3.541, p = .008), and current level of Pain Intensity ( t = -4.00, p = .004). CONCLUSIONS: Tai Chi is an acceptable, holistic treatment to individuals with musculoskeletal pain and posttraumatic stress disorder. It may reduce pain, improve emotion, memory, and physical function.


Assuntos
Dor Crônica/terapia , Transtornos de Estresse Pós-Traumáticos/terapia , Tai Ji/normas , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/terapia , Manejo da Dor/métodos , Manejo da Dor/normas , Projetos Piloto , Qualidade de Vida/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários , Tai Ji/métodos
6.
West J Nurs Res ; 36(7): 855-74, 2014 08.
Artigo em Inglês | MEDLINE | ID: mdl-24622155

RESUMO

Exercise and training programs improve strength, functional balance, and prevent falls in a variety of populations. This article presents the qualitative findings related to the perceived benefits of participants in a randomized controlled trial that compared the effectiveness of group exercise on gait and balance in persons with peripheral neuropathy (PN). Participants with moderately severe PN were randomized into groups that received 10-week classes of Functional Balance Training (FBT) or Tai Chi or education alone. Perceptions of the intervention were overwhelmingly positive regardless of the study group. Perceived benefits reported by participants in the FBT and Tai Chi groups included awareness of how to deal with the effects of neuropathy by implementing balance strategies and a heightened sense of walking to prevent falls. This study offers a guide to design future exercise studies that promote simple balance exercises that can be performed in group settings.


Assuntos
Benefícios do Seguro/estatística & dados numéricos , Percepção , Doenças do Sistema Nervoso Periférico/terapia , Tai Ji/normas , Adaptação Fisiológica , Idoso , Idoso de 80 Anos ou mais , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural , Pesquisa Qualitativa , Tai Ji/educação , Tai Ji/estatística & dados numéricos
7.
Am J Phys Med Rehabil ; 83(9): 735-45, 2004 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-15314540

RESUMO

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.


Assuntos
Pessoas com Deficiência/reabilitação , Promoção da Saúde/métodos , Equilíbrio Postural , Tai Ji , Acidentes por Quedas/prevenção & controle , Fenômenos Fisiológicos Cardiovasculares , Ensaios Clínicos Controlados como Assunto , Medicina Baseada em Evidências , Humanos , Manejo da Dor , Aptidão Física , Qualidade de Vida , Autoeficácia , Tai Ji/métodos , Tai Ji/normas , Resultado do Tratamento
8.
Nurs Times ; 100(18): 28-9, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15151003

RESUMO

Falls prevention is a key area of health promotion that is familiar to all nurses who work with older people. However, the suggestion that t'ai chi should be used as a prevention intervention may be new to many nurses. The evidence supporting t'ai chi and many other forms of exercise have been evaluated within the National Institute for Clinical Evidence (NICE) falls guidance. This should enable nurses to look at the prevention interventions that they currently recommend and question the evidence for or against their effectiveness. Nurses should also be able to identify factors that may present as barriers to participation.


Assuntos
Acidentes por Quedas/prevenção & controle , Terapia por Exercício/métodos , Geriatria/métodos , Acidentes por Quedas/estatística & dados numéricos , Atividades Cotidianas , Idoso , Medicina Baseada em Evidências , Terapia por Exercício/normas , Avaliação Geriátrica , Geriatria/normas , Humanos , Guias de Prática Clínica como Assunto , Fatores de Risco , Tai Ji/métodos , Tai Ji/normas , Caminhada/normas , Levantamento de Peso/normas
9.
J Cardiovasc Nurs ; 19(1): 48-57, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-14994782

RESUMO

PURPOSE: Meta-analysis involves the integration of several studies with small sample sizes, enabling the investigator to summarize research results into useful clinical information. Tai Chi exercise has recently gained the attention of Western researchers as a potential form of aerobic exercise. A goal of this meta-analysis was to estimate the effect of Tai Chi exercise on aerobic capacity. METHODS: A computerized search of 7 databases was done using key words and all languages. Sixteen study elements were critically appraised to determine study quality. D-STAT software was used to calculate the standardized mean differences (ESsm) and the 95% confidence intervals (CI), using means and standard deviations (SD) reported on aerobic capacity expressed as peak oxygen uptake (VO2peak) (mL x kg(-1) x min(-1)). RESULTS: Of 441 citations obtained, only 7 focused on aerobic capacity in response to Tai Chi exercise (4 experimental and 3 cross-sectional). Older adults including those with heart disease participated (n = 344 subjects); on average men were aged 55.7 years (SD = 12.7) and women 60.7 years (SD = 6.2). Study quality scores ranged from 22 to 28 (mean = 25.1, SD = 2.0). Average effect size for the cross-sectional studies was large and statistically significant (ESsm = 1.01; CI = +0.37, +1.66), while in the experimental studies the average effect size was small and not significant (ESsm = 0.33; CI = -0.41, +1.07). Effect sizes of aerobic capacity in women (ESsm = 0.83; CI = -0.43, +2.09) were greater than those for men (ESsm = 0.65; CI = -0.04, +1.34), though not statistically significant. Aerobic capacity was higher in subjects performing classical Yang style (108 postures) Tai Chi (ESsm = 1.10; CI = +0.82, +1.38), a 52-week Tai Chi exercise intervention (ESsm = 0.94; C = +0.06, +1.81), compared with sedentary subjects (ESsm = 0.80; CI = +0.19, +1.41). CONCLUSIONS: This meta-analysis suggests that Tai Chi may be an additional form of aerobic exercise. The greatest benefit was seen from the classical Yang style of Tai Chi exercise when performed for 1-year by sedentary adults with an initial low level of physical activity habits. Recommendations for future research are provided and the effect sizes generated provide information needed for sample size calculations. Randomized clinical trials in diverse populations, including those with chronic diseases, would expand the current knowledge about the effect of Tai Chi on aerobic capacity.


Assuntos
Tolerância ao Exercício , Tai Ji , Intervalos de Confiança , Estudos Transversais , Modificador do Efeito Epidemiológico , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio , Aptidão Física , Projetos de Pesquisa/normas , Tai Ji/métodos , Tai Ji/normas , Fatores de Tempo , Resultado do Tratamento
10.
Arch Phys Med Rehabil ; 84(5): 683-6, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12736881

RESUMO

OBJECTIVES: To identify a balance measure that can best distinguish Tai-Chi from non-Tai-Chi practitioners and to examine whether longer Tai-Chi practice results in better balance control. DESIGN: Cross-sectional comparative study. SETTING: Community. PARTICIPANTS: Nineteen Tai-Chi practitioners (who practiced Tai Chi for 30-45min at least 3/wk for >1y) and 19 healthy subjects with regular exercise habits (who practiced Tai Chi for 30-45min at least 3/wk for >1y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Scores on 2 clinical tests (functional reach, gait) and 1 laboratory test (postural sway). RESULTS: Tai-Chi practitioners had better clinical test scores for functional reach, gait speed, stride length, and sway parameters during single-leg stance (P<.05). Sway in mediolateral direction during single-leg stance was the balance performance variable that best discriminated the Tai-Chi group from non-Tai-Chi group. More experience practicing Tai Chi was associated with better balance performance. CONCLUSIONS: Tai-Chi practitioners performed better both in clinical and laboratory tests when compared with subjects who did not practice Tai Chi. More Tai-Chi experience was associated with better postural control.


Assuntos
Avaliação Geriátrica , Equilíbrio Postural , Postura , Tai Ji/normas , Atividades Cotidianas , Idoso , Estudos Transversais , Análise Discriminante , Feminino , Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Fatores de Tempo , Resultado do Tratamento
11.
Geriatr Nurs ; 22(4): 198-200, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11505246

RESUMO

Tai chi, a type of low-intensity exercise, has received growing attention in both eastern and western cultures, especially its use with the most rapidly increasing segment of the population-elders. Previous research findings further supported the idea that tai chi is appropriate for elderly populations and helps promote their well-being. In this article, the beneficial effects of tai chi for elders are summarized, resources to increase awareness about the exercise are provided, and ways to promote tai chi in elderly populations are suggested.


Assuntos
Idoso/psicologia , Enfermagem Geriátrica/métodos , Tai Ji/métodos , Atitude Frente a Saúde , Enfermagem Geriátrica/educação , Enfermagem Geriátrica/normas , Enfermagem Geriátrica/tendências , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Serviços de Informação , Internet , Educação de Pacientes como Assunto , Tai Ji/educação , Tai Ji/enfermagem , Tai Ji/psicologia , Tai Ji/normas , Tai Ji/tendências
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