Tai Chi Intervention Research Articles

Effects of Tai Chi on telomerase activity and gerotranscendence in middle aged and elderly adults in Chinese society

IntroductionTelomeres are DNA protein structures at the end of chromosomes and are linked to the physical aging process. The improvement of quality of life is closely associated with aerobic exercise, and the dynamic effects of exercise on physiology and psychology are evident with aging. Tai Chi is popularly practiced in China. However, findings on the effects of Tai Chi on telomerase activity (TA) in peripheral blood mononuclear cells, and gerotranscendence (GT), as well as the association of TA and GT with Tai Chi, have been inconsistent. PurposeThis study aims to assess TA in peripheral blood mononuclear cells, GT, and the associations between them. The associations among these variables are determined during six months of Tai Chi intervention among Chinese middle aged and elderly adults. MethodsTA assessment was obtained by TE-ELISA (human telomerase–enzyme linked immunosorbent assay), and GT was measured at the baseline level after six months of Tai Chi intervention. ResultsTA increased significantly in the Tai Chi group from 23.75 ± 3.78 u/mmol (pre-intervention) to 26.31 ± 2.93 u/mmol (after 6 months) (p < 0.05). Compared with the TA in the control group, the TA in the intervention group was statistically significant after six months (p < 0.05). Compared with the GT in the control group, the GT in the intervention group improved significantly after six months (p < 0.05). TA and GT had a positive correlation (r = 0.325, p < 0.01). ConclusionOur data illustrated that Tai Chi had a protective effect on TA and might improve the GT in Chinese middle aged and elderly adults. The TA increased with the increasing GT in Chinese middle aged and elderly adults.

Adoption of a Tai Chi Intervention, Tai Ji Quan: Moving for Better Balance, for Fall Prevention by Rural Faith-Based Organizations, 2013-2014.

BackgroundTranslating evidence-based, community-delivered, fall-prevention exercise programs into new settings is a public health priority.Community ContextOlder adults (aged ≥65 y) are at high risk for falls. We conducted a community engagement project in West Virginia to evaluate the adoption of a tai chi exercise program, Tai Ji Quan: Moving for Better Balance, by rural faith-based organizations (FBOs) and exercise instructors by recruiting 20 FBOs and 20 or more exercise instructors and by obtaining input from key stakeholders (representatives of FBOs, community representatives, exercise instructors) regarding potential barriers and facilitators to program adoption.MethodsWe used both multistage, purposeful random sampling and snowball sampling to recruit FBOs and exercise instructors in 7 West Virginia counties. Two forums were held with stakeholders to identify barriers and facilitators to program adoption. We calculated separate adoption rates for organizations and exercise instructors.OutcomeIt took up to 3 months to recruit each FBO with an adoption rate of 94%. We made 289 telephone calls, sent 193 emails and 215 letters, distributed brochures and flyers to 69 FBOs, held 118 meetings, and made 20 trips over a period of 31 days (8,933 miles traveled). Nineteen of 22 trained exercise instructors started classes, an instructor adoption rate of 86%. Key issues regarding adoption were the age requirement for participants, trust, education, and competing priorities.InterpretationAlthough we had recruitment challenges, our adoption rates were similar to or higher than those reported in other studies, and the objectives of the community engagement project were met. Clustering the FBOs and having them located closer geographically to our location may have reduced our resource use, and using a recruitment coordinator from the local community may have enabled us to gain the trust of congregants and clergy support.

Tai Chi for chronic obstructive pulmonary disease (COPD).

Tai Chi, a systematic callisthenic exercise first developed in ancient China, involves a series of slow and rhythmic circular motions. It emphasises use of 'mind' or concentration to control breathing and circular body motions to facilitate flow of internal energy (i.e. 'qi') within the body. Normal flow of 'qi' is believed to be essential to sustain body homeostasis, ultimately leading to longevity. The effect of Tai Chi on balance and muscle strength in the elderly population has been reported; however, the effect of Tai Chi on dyspnoea, exercise capacity, pulmonary function and psychosocial status among people with chronic obstructive pulmonary disease (COPD) remains unclear. • To explore the effectiveness of Tai Chi in reducing dyspnoea and improving exercise capacity in people with COPD.• To determine the influence of Tai Chi on physiological and psychosocial functions among people with COPD. We searched the Cochrane Airways Group Specialised Register of trials (which included the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED) and PsycINFO); handsearched respiratory journals and meeting abstracts; and searched Chinese medical databases including Wanfang Data, Chinese Medical Current Contents (CMCC), Chinese Biomedical Database (CBM), China Journal Net (CJN) and China Medical Academic Conference (CMAC), from inception to September 2015. We checked the reference lists of all primary studies and review articles for relevant additional references. We included randomised controlled trials (RCTs) comparing Tai Chi (Tai Chi alone or Tai Chi in addition to another intervention) versus control (usual care or another intervention identical to that used in the Tai Chi group) in people with COPD. Two independent review authors screened and selected studies. Two independent review authors extracted data from included studies and assessed risk of bias on the basis of suggested criteria listed in the Cochrane Handbook for Systematic Reviews of Interventions. We extracted post-programme data and entered them into RevMan software (version 5.3) for data synthesis and analysis. We included a total of 984 participants from 12 studies (23 references) in this analysis. We included only those involved in Tai Chi and the control group (i.e. 811 participants) in the final analysis. Study sample size ranged from 10 to 206, and mean age ranged from 61 to 74 years. Programmes lasted for six weeks to one year. All included studies were RCTs; three studies used allocation concealment, six reported blinded outcome assessors and three studies adopted an intention-to-treat approach to statistical analysis. No adverse events were reported. Quality of evidence of the outcomes ranged from very low to moderate.Analysis was split into three comparisons: (1) Tai Chi versus usual care; (2) Tai Chi and breathing exercise versus breathing exercise alone; and (3) Tai Chi and exercise versus exercise alone.Comparison of Tai Chi versus usual care revealed that Tai Chi demonstrated a longer six-minute walk distance (mean difference (MD) 29.64 metres, 95% confidence interval (CI) 10.52 to 48.77 metres; participants = 318; I(2) = 59%) and better pulmonary function (i.e. forced expiratory volume in one second, MD 0.11 L, 95% CI 0.02 to 0.20 L; participants = 258; I(2) = 0%) in post-programme data. However, the effects of Tai Chi in reducing dyspnoea level and improving quality of life remain inconclusive. Data are currently insufficient for evaluating the impact of Tai Chi on maximal exercise capacity, balance and muscle strength in people with COPD. Comparison of Tai Chi and other interventions (i.e. breathing exercise or exercise) versus other interventions shows no superiority and no additional effects on symptom improvement nor on physical and psychosocial outcomes with Tai Chi. No adverse events were reported, implying that Tai Chi is safe to practise in people with COPD. Evidence of very low to moderate quality suggests better functional capacity and pulmonary function in post-programme data for Tai Chi versus usual care. When Tai Chi in addition to other interventions was compared with other interventions alone, Tai Chi did not show superiority and showed no additional effects on symptoms nor on physical and psychosocial function improvement in people with COPD. With the diverse style and number of forms being adopted in different studies, the most beneficial protocol of Tai Chi style and number of forms could not be commented upon. Hence, future studies are warranted to address these topics.

Beneficial effects of Tai Chi for amphetamine-type stimulant dependence: a pilot study

ABSTRACTBackground: Tai Chi is a traditional Chinese sport that is classified as a moderate exercise. Recent studies have evaluated the effectiveness of Tai Chi in substance abuse rehabilitation. Objectives: The aim of this study was to assess the quality of life and physical effects of a Tai Chi intervention on individuals with amphetamine-type stimulant (stimulant) dependence. Methods: Sixty male subjects with stimulant dependence from a Shanghai Mandatory Detoxification and Rehabilitation Center participated in a 12-week trial. Tai Chi was used as an intervention in the experimental group (n = 30). The control group (n = 29) underwent standard care, which included recreation activity, gesture language exercise, and self-education. Outcome measures included the quality of life for drug addiction (QOL-DA) questionnaire [four scales consisting of physiology (e.g., energy level), psychology (e.g., depression), symptoms (e.g., physical symptoms), society (e.g., interpersonal) and fitness evaluations (assessed by body mass index, body fat, hand-grip, flexibility, balance)]. Repeated measures were used to analyze the changes over time. Results: Test scores of the QOL-DA in the Tai Chi group significantly increased after 12 weeks in the following areas: physiology, 8.71 (p = 0.005), symptoms, 4.34 (p = 0.042), society, 15.79 (p < 0.001), and total score, 10.60 (p = 0.002). A post hoc test further revealed that quality of life improved in the Tai Chi group but not in the standard care group. Physical results showed a significant interaction with balance(F(1,56) = 6.92, p = 0.011); participants in the Tai Chi group improved by 10 s while there was no change in the standard care group. Although there were no significant interactions in the fitness outcomes (i.e., hand-grip and sit-and-reach tests), the within-group factor displayed significant changes in body fat (F(1,56) = 27.79, p < 0.001) in both groups. Conclusion: This study demonstrates that Tai Chi is a promising exercise that improves quality of life for individuals with stimulant dependence.

The Impact of Tai Chi Exercise on Self-Efficacy, Social Support, and Empowerment in Heart Failure: Insights from a Qualitative Sub-Study from a Randomized Controlled Trial.

ObjectiveTo qualitatively explore perceived physical and psychosocial effects and overall patient experience associated with a 12-week tai chi (TC) intervention and an education group in a clinical trial of patients with chronic heart failure (HF).Subjects and MethodsWe randomized 100 patients with chronic systolic HF (NYHA Class 1–3, ejection fraction≤40%) to a 12-week group TC program or an education control. At 12-weeks, semi-structured interviews were conducted on a random subset (n = 32; n = 17 in TC, n = 15 in control), audiorecorded and transcribed verbatim. Two independent reviewers extracted information using grounded-theory methods for emergent themes. We explored similarities and differences in themes/sub-themes between the groups, and examined qualitative association with changes from baseline to post-intervention in previously reported quantitative measures (e.g., Minnesota Living with HF, Cardiac Exercise Self Efficacy and Profile of Mood States).ResultsThe mean age (±SD) of participants was 68±9 years, baseline ejection fraction 29±7%, and median New York Heart Association class 2 HF. We idenitifed themes related to the patient’s experience of illness, perceptions of self, and relationship to others. Specific psychosocial and physical benefits were described. Common themes emerged from both groups including: social support and self-efficacy related to activity/exercise and diet. The tai chi group, however, also exhibited a more global empowerment and perceived control. Additional themes in TC included mindfulness/self-awareness, decreased stress reactivity, and renewed social role. These themes mirrored improvements in previously reported quantitative measures (quality-of-life, self-efficacy, and mood) in TC compared to control. Patients in TC also reported physical benefits (e.g., decreased pain, improved energy, endurance, flexibility).ConclusionPositive themes emerged from both groups, although there were qualitative differences in concepts of self-efficacy and perceived control between groups. Those in tai chi reported not only self efficacy and social support, but overall empowerment with additional gains such as internal locus of control, self-awareness and stress management. Future studies of mind-body exercise might further examine perceived control, self-efficacy, and locus-of-control as potential mediators of effect.

The Efficacy Of Tai Chi Exercise For Primary Hypertension

PURPOSE: The aim of this study was to evaluate the effectiveness of Tai Chi intervention in essential hypertension. METHOD: A systematic literature search was performed in 7 databases from their respective inceptions from January 2013 to January 2015, including: PubMed, Socolar, Elsevier, Springer Link, Wiley Online Library, CNKI and Wanfang Databases.A meta-analysis was conducted by software Rev Man 5.1 to examine the pooled effect of Yang`s Tai Chi Exercise controlling hypertension upon 789 subjects from randomized controlled clinical trial. RESULTS: The results of meta-analyses showed that Yang`s Tai Chi intervention could lower blood pressure and increase the concentration of nitric oxide; Subgroup analysis showed that Tai Chi group was superior to the control group in decrease of SBP[MD=8.53, 95%CI (7.02, 10.05), P=0.31], DBP[MD=3.60, 95%CI(3.41, 3.78), P=0.91] and increase concentrations of NO[MD=5.16,95%CI(1.20, 9.12), P=0.36]. CONCLUSIONS: Tai chi exercise can increase the concentration of NO. Practicing Tai Chi for 1.5 hours per day while among 65%~85% of HRmax can significantly decrease the systolic blood pressure and diastolic blood pressure. And we will extend our research to the other brunches of Tai Chi including Chen`s, Sun`s, Wu`s.

Poster Number: NR 38 - The Effect of Tai Chi on Perceived Stress Levels of Older Female Adults of Non-Chinese Origin

Introduction: Tai Chi is described as a traditional Chinese exercise form derived from martial arts folk traditions. Although the benefits of Tai Chi have been demonstrated in previous studies, the benefits derived by non-Chinese older females of low socio-economic status (SES) specifically on stress levels have not been explored. The purpose of this study was to assess the effectiveness of a 16 week Tai Chi intervention for improving perceived stress levels among non-Chinese females 65 years of age or older of low SES.

Integrative medicine modality utilization and impact on quality of life in cancer patients: A single academic cancer center experience.

169 Background: The majority of patients with cancer incorporate integrative medicine strategies into their cancer experience however; patient reported preferences and impact on quality of life is limited. We present cancer patient utilization for specific integrative medicine modalities within the Mayo Clinic Arizona Comprehensive Cancer center and describe the patient perceived impact on quality of life. Methods: Patients and family members attending the 2015 Living with Cancer Symposium at Mayo Clinic Arizona completed a survey indicating whether specific integrative medicine modalities were utilized during cancer treatment and whether utilization had an impact on the patients perceived quality of life. Patient diagnoses and stage were collected. A total of 119 patient surveys were completed and analyzed. Results: The patient diagnoses included hematologic malignancies (27%), breast (25%), prostate (18%), and other (30%). Disease stage was nearly evenly distributed with stage I (21%), stage II (20%), stage III (16%), stage IV (15%), and unknown (28%). The most commonly utilized integrative modalities included nutrition (54%), natural product supplementation (34%), massage (33%), exercise (31%) including yoga (23%) and tai chi (1%), breathing and meditation interventions (26-28%), support groups (23%), and pet therapy (17%). The majority of patients (64%) reported integrative intervention utilization led to an enhanced quality of life during cancer therapy. Conclusions: At a single academic cancer center, in a cancer type and stage diverse population, the majority of patients (64%) reported improved quality of life during cancer therapy with integrative medicine intervention utilization. Nutrition, natural product supplementation, massage, exercise, and meditative modalities were most commonly utilized. Interestingly, a large proportion of patients analyzed in this questionnaire-based study were afflicted with hematologic disease, a population underrepresented in the current integrative medicine intervention research. More studies exploring the feasibility and impact of integrative therapies in the hematologic patient population are needed.

Does pain-catastrophising mediate the effect of tai chi on treatment outcomes for people with low back pain?

ObjectivesThere is evidence to support the effectiveness of tai chi for reducing pain-related symptoms across multiple musculoskeletal conditions, however, the mechanism(s) are unclear. This study explores the role of pain-catastrophising as a possible mediator in the relationship between practising tai chi and back pain symptoms. DesignExploratory mediation analyses using a Baron and Kenny approach and bootstrapping methods were employed as a secondary analysis of data from a previously published randomised controlled trial. SettingAdults with persistent low back pain were recruited via community advertisement in Sydney, NSW, Australia. InterventionsA 10-week tai chi intervention and a wait-list control. Main outcome measuresPatients completed self-assessments of pain intensity and bothersomeness using 0–10 numerical rating scales, disability using the Roland Morris Disability Questionnaire and pain catastrophising using the Pain Coping Strategies Questionnaire pre and post intervention. ResultsThe results suggest partial mediation, by which a reduction in catastrophising explained approximately 1/3 of the effect on pain intensity and bothersomeness and 2/3 of the effect on disability. ConclusionAs the first known mediation analysis of tai chi for reducing low back pain-symptoms, it provides initial evidence that it may do so by having an effect on cognitive appraisal outcomes such as pain-catastrophising and information for choosing appropriate process measures for future studies. As tai chi is growing in popularity as an alternative treatment for patients with chronic musculoskeletal conditions, it is important to gain a better understanding of how it might work using confirmatory mediation analysis alongside future RCTs.

Tai Chi training reduced coupling between respiration and postural control

In order to maintain stable upright stance, the postural control system must account for the continuous perturbations to the body’s center-of-mass including those caused by spontaneous respiration. Both aging and disease increase “posturo-respiratory synchronization;” which reflects the degree to which respiration affects postural sway fluctuations over time. Tai Chi training emphasizes the coordination of respiration and bodily movements and may therefore optimize the functional interaction between these two systems. The purpose of the project was to examine the effect of Tai Chi training on the interaction between respiration and postural control in older adults. We hypothesized that Tai Chi training would improve the ability of the postural control system to compensate for respiratory perturbations and thus, reduce posturo-respiratory synchronization. Participants were recruited from supportive housing facilities and randomized to a 12-week Tai Chi intervention (n=28; 86±5yrs) or educational-control program (n=34, 85±6yrs). Standing postural sway and respiration were simultaneously recorded with a force plate and respiratory belt under eyes-open and eyes-closed conditions. Posturo-respiratory synchronization was determined by quantifying the variation of the phase relationship between the dominant oscillatory mode of respiration and corresponding oscillations within postural sway. Groups were similar in age, gender distribution, height, body mass, and intervention compliance. Neither intervention altered average sway speed, sway magnitude or respiratory rate. As compared to the education-control group, however, Tai Chi training reduced posturo-respiratory synchronization when standing with eyes open or closed (p<0.001). Tai Chi training did not affect traditional parameters of standing postural control or respiration, yet reduced the coupling between respiration and postural control. The beneficial effects of Tai Chi training may therefore stem in part from optimization of this multi-system interaction.

Community-Based Mind–Body Meditative Tai Chi Program and Its Effects on Improvement of Blood Pressure, Weight, Renal Function, Serum Lipoprotein, and Quality of Life in Chinese Adults With Hypertension

Obesity, metabolic syndrome, dyslipidemia, and poor quality of life are common conditions associated with hypertension, and incidence of hypertension is age dependent. However, an effective program to prevent hypertension and to improve biomedical factors and quality of life has not been adequately examined or evaluated in Chinese older adults. This study aims to examine the effectiveness of a Tai Chi program to improve health status in participants with hypertension and its related risk factors such as dyslipidemia, hyperglycemia, and quality of life in older adults in China. A randomized study design was used. At the conclusion of the intervention, 266 patients remained in the study. Blood pressure and biomedical factors were measured according to the World Diabetes Association standard 2002. A standardized quality-of-life measure was used to measure health-related quality of life. It was found that a Tai Chi program to improve hypertension in older adults is effective in reducing blood pressure and body mass index, maintaining normal renal function, and improving physical health of health-related quality of life. It did not improve existing metabolic syndrome levels, lipid level (dyslipidemia) or fasting glucose level (hyperglycemia), to prevent further deterioration of the biomedical risk factors. In conclusion, Tai Chi is effective in managing a number of risk factors associated with hypertension in Chinese older adults. Future research should examine a combination of Tai Chi and nutritional intervention to further reduce the level of biomedical risks.

The Comparison Of Sleep Quality And Depression After Tai Chi Intervention On Methamphetamine-type Drug Abusers In China

Tai Chi (TC) is recognized as being beneficial for men and women over a wide age range, several studies evaluated the effect of Tai Chi on psychological responses including depression, distress, well-being, life satisfaction, perception of health. PURPOSE: The aim of this study was to assess the sleep quality and depression of methamphetamine-type-drug abusers after 12 weeks TC intervention. 82 female methamphetamine-type drug abusers from a Shanghai compulsory detoxification institution (SCDI) took part in a 12 weeks trial. Participants were randomly assigned to TC group (N=43) and Standard Care (SC) group (N=39). SC intervention consisted of the 9th Guang Bo Ti Cao (broadcast gymnastics), sign language exercise and self-education. METHODS: Pittsburgh Sleep Quality Index (PSQI) and Self-rating Depression Scale (SDS) were administrated by experienced investigators. An in-group comparison of the pre- and post-test scores was performed by conducting paired sample t-tests, whereas between-group comparisons of pre-test scores and 12-week post-test scores were performed by conducting independent t-tests. Paired sample t-test was conducted for in-group comparison, and the independent t-test was used for between-group comparison. RESULTS: The between-group independent t-test results of SDS and PSQI indicated that there was no significant difference between TC and SC groups at the baseline. The scores of SDS were 48.5±8.2 in TC and 49.9±9.3 in SC group. The total scores of PSQI were 5.07±2.43 in TC and 5.89±3.25 in SC group, respectively. The post-test results of SDS displayed no significant difference between TC and SC groups but the score of SDS in TC group was 48.8 while the score of SDS in SC group increased to 52.6, almost 4 points higher than TC group. The total score of post-test PSQI indicated that there was a significant difference between TC and SC groups (p=0.045) with a total score of PSQI in TC of 3.86±2.71 and in SC of 5.32±3.02. The TC’s total score decreased with more than 1 point comparing to the baseline, while the SC’s total score only showed a slight decrease. CONCLUSIONS: The findings of this study showed that TC can improve the sleep quality and ameliorate depression for methamphetamine-type drug abusers. It is also noteworthy to indicate that a TC intervention has organisational advantages as well, because it is low-cost and can be self-managed by participants.

Effect of an Exercise and Dietary Intervention on Cognitive Function in Obese Older Women

BACKGROUND: Cognitive decline in older adults is a public health problem and prior research shows that higher levels of physical activity and dietary factors are associated with higher cognitive function. However, it is unclear how an exercise and diet intervention affects cognitive function in obese older women. PURPOSE: To examine the effect of a combined Tai Chi (TC), resistance training (RT), and diet intervention on cognitive function and to evaluate the relationship between cognitive function and physical function in older obese women. METHODS: This was a non-randomized study where 31 obese (BMI= 37.6 ± 4.5 kg/m2) older (age= 65.1 ± 8.4 years) women (61% African-American) were recruited to a 12-week intervention (EXD) group or to a control (CON) group. Cognitive function was measured via the Repeatable Battery for the Assessment of Neurological Status (RBANS) test. Other outcomes were grip strength, 4 m walk, leg strength, chair stands, and timed up and go. Baseline measures were assessed under standardized conditions prior to the start and at the end of the study by trained staff supervised by a licensed speech-language pathologist. The EXD group (n=17; 5 dropouts) engaged in three 45 min TC sessions and two 45 min RT sessions per week. A registered dietitian conducted the behaviorally based diet sessions once a week. The CON group (n=8; 1 missing data) was asked to maintain a normal lifestyle. Pearson correlations were done for baseline physical function and RBANS score and analysis of covariance was used to compare RBANS score change between groups adjusted for baseline. RESULTS: RBANS score was positively correlated with grip strength (r = 0.51) and negatively correlated with timed up and go, (r = -0.40), chair stand (r = -0.28) and gait speed (r = -0.37) times (all p<0.05). Baseline RBANS score (87.5 ± 19.5) and baseline age were not correlated and RBANS scores were not different between groups (p= 0.80). There were no differences in RBANS score change in the EXD vs. CON groups (3.1 ± 2.0 vs. 2.5 ± 2.9; p=0.86). CONCLUSIONS: An exercise and diet intervention does not change cognitive function in older obese women, but baseline cognitive function is moderately correlated with physical function. A longer intervention needs to be tested in a larger sample to verify these results. Supported by the College of Environment and Life Sciences Community Access to Research and Extension Services (CELS CARES) grant, USDA, at the University of Rhode Island.

Evaluating the Exercise Prescription and Instructional Methods of Tai Chi Studies Aimed at Improving Balance

Tai Chi is recommended to improve balance among older adults, yet there are no specific guidelines for the exercise prescription (ExRx) or instructional methods of Tai Chi practice. PURPOSE: Our systematic review addressed these gaps. METHODS: Electronic databases identified randomized controlled trials (RCTs) of Tai Chi interventions aimed at improving balance among older adults (≥60yr) without severe debilitating diseases. We developed a 13-item scale to evaluate the ExRx (i.e., time, frequency, intervention length; n=3) and instructional (e.g., style, number of forms, form name; n=10) methods. RESULTS: 26 trials yielded 27 interventions. On average Tai Chi was performed 2.8±1.4 sessions·wk−1 for 56.5±14.4 min·session−1 for 19.7±12.7 wk. Most trials reported all three ExRx methods items with a mean satisfaction rate of 92.6±18.9%. In contrast, the mean satisfaction rate was 41.1±17.7% for the 10 instructional methods items, a significantly lower rate than the ExRx methods (p=0.03). Surprisingly, less than half of the trials reported unsupervised practice (14%), progression (24%), or the use of breathing (31%) and relaxation techniques (17%). Of greater concern, the instructional methods most important for targeting Tai Chi practice to improve balance were routinely not disclosed, with only 48.1% reporting style, 51.9% reporting movement principles, and 14.3% reporting form names. CONCLUSION: Most Tai Chi trials disclosed their ExRx methods, yet routinely failed to report instructional methods. In order to increase the effectiveness of Tai Chi to improve balance among older adults, future RCTs should reveal both their ExRx and instructional methods, especially those methods that target balance.

Evidence base of clinical studies on Tai Chi: a bibliometric analysis.

BackgroundThe safety and health benefits of Tai Chi mind-body exercise has been documented in a large number of clinical studies focused on specific diseases and health conditions. The objective of this systematic review is to more comprehensively summarize the evidence base of clinical studies of Tai Chi for healthcare.Methods and FindingsWe searched for all types of clinical studies on Tai chi in PubMed, the Cochrane Library and four major Chinese electronic databases from their inception to July 2013. Data were analyzed using SPSS17.0 software. A total of 507 studies published between 1958 and 2013 were identified, including 43 (8.3%) systematic reviews of clinical studies, 255 (50.3%) randomized clinical trials, 90 (17.8%) non-randomized controlled clinical studies, 115 (22.7%) case series and 4 (0.8%) case reports. The top 10 diseases/conditions was hypertension, diabetes, osteoarthritis, osteoporosis or osteopenia, breast cancer, heart failure, chronic obstructive pulmonary disease, coronary heart disease, schizophrenia, and depression. Many healthy participants practiced Tai Chi for the purpose of health promotion or preservation. Yang style Tai Chi was the most popular, and Tai Chi was frequently practiced two to three 1-hour sessions per week for 12 weeks. Tai Chi was used alone in more than half of the studies (58.6%), while in other studies Tai Chi was applied in combination with other therapies including medications, health education and other physical therapies. The majority of studies (94.1%) reported positive effects of Tai Chi, 5.1% studies reported uncertain effects and 0.8% studies reported negative effects. No serious adverse events related to Tai Chi were reported.ConclusionsThe quantity and evidence base of clinical studies on Tai Chi is substantial. However, there is a wide variation in Tai Chi intervention studied and the reporting of Tai Chi intervention needs to be improved. Further well-designed and reported studies are recommended to confirm the effects of Tai Chi for the frequently reported diseases/conditions.

The Effects of Tai Chi on Peripheral Somatosensation, Balance, and Fitness in Hispanic Older Adults with Type 2 Diabetes: A Pilot and Feasibility Study.

Peripheral neuropathy and loss of somatosensation in older adults with type 2 diabetes can increase risk of falls and disability. In nondiabetic older adult population Tai Chi has been shown to enhance balance and fitness through improvements in somatosensation and neuromuscular control, and it is unclear if Tai Chi would elicit similar benefits in older adults with diabetes. Therefore, the purpose of this study was to investigate the effects of an 8-week, three-hour-per-week Tai Chi intervention on peripheral somatosensation in older adults with type 2 diabetes. Participants were eight Hispanic older adults with type 2 diabetes who participated in the Tai Chi intervention and a convenience sample of Hispanic older adults as a referent group. Baseline and postintervention assessments included ankle proprioception, foot tactile sense, plantar pressure distribution, balance, and fitness. After intervention, older adults with type 2 diabetes showed significant improvements in ankle proprioception and fitness and decreased plantar pressure in the forefoot, with no statistical effect noted in balance or tactile sensation. Study results suggest that Tai Chi may be beneficial for older adults with diabetes as it improves ankle proprioception; however, study findings need to be confirmed in a larger sample size randomized controlled trial.

IMPACT ON DIET QUALITY AND RESILIENCE IN URBAN COMMUNITY DWELLING OBESE WOMEN WITH A NUTRITION AND PHYSICAL ACTIVITY INTERVENTION

Objective: To examine the effect of a Tai Chi, resistance training, and behaviorally-based diet education intervention on dietary quality as well as resilience and physical resilience in obese older women. Design: Community health outreach with a quasi-experimental design. Setting: An urban senior center in Rhode Island. Participants: Thirty-three women, 85% were minorities, with mean age of 65±8.2 years and BMI of 37.3±4.6 kg/m2, were enrolled in the study at baseline however only 17 women in the intervention (EXD) group and 9 women in the wait-list control (CON) group completed the study. Measurement: Dietary quality and nutrition risk were measured using the Dietary Screening Tool (DST), resilience was measured by the Resilience Scale, and physical resilience was examined using the Physical Resilience Scale. Intervention: Participants in the EXD group engaged in 12 weeks of Tai Chi, resistance training, and behaviorally-based diet education. The diet education was based off of the modified Dietary Approaches to Stop Hypertension (DASH) diet and led by a Registered Dietitian. Results: There was no change in dietary quality by group or time. However the EXD group had significantly higher dietary quality compared to the control group (p=0.025) at post intervention, although there was no difference in nutrition risk category. There was no change seen in overall resilience, however the EXD group improved physical resilience (p=0.048). Conclusion: A community health outreach that involved Tai Chi, resistance training, and behaviorally-based diet education may promote higher dietary quality as well as improve physical resilience in obese older women.

A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome.

Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety.

The effects of tai chi in centrally obese adults with depression symptoms.

This study examined the effects of Tai Chi, a low-impact mind-body movement therapy, on severity of depression, anxiety, and stress symptoms in centrally obese people with elevated depression symptoms. In total, 213 participants were randomized to a 24-week Tai Chi intervention program or a wait-list control group. Assessments were conducted at baseline and 12 and 24 weeks. Outcomes were severity of depression, anxiety, and stress symptoms, leg strength, central obesity, and other measures of metabolic symptom. There were statistically significant between-group differences in favor of the Tai Chi group in depression (mean difference = −5.6 units, P < 0.001), anxiety (−2.3 units, P < 0.01), and stress (−3.6 units, P < 0.001) symptom scores and leg strength (1.1 units, P < 0.001) at 12 weeks. These changes were further improved or maintained in the Tai Chi group relative to the control group during the second 12 weeks of follow-up. Tai Chi appears to be beneficial for reducing severity of depression, anxiety, and stress and leg strength in centrally obese people with depression symptoms. More studies with longer follow-up are needed to confirm the findings. This trial is registered with ACTRN12613000010796.

Tai chi as an alternative and complimentary therapy for anxiety: a systematic review.

Anxiety has become a global public health problem. Tai chi offers one possible way of reducing anxiety. The purpose of this study was to examine studies from 1989 to March 2014 to assess whether tai chi can be an efficacious approach for managing anxiety. A systematic search of Medline, CINAHL, and Alt HealthWatch databases was conducted for quantitative articles involving applications of tai chi for anxiety. A total of 17 articles met the inclusion criteria. Of these, 8 were from the United States, 2 from Australia, 2 from Japan, 2 from Taiwan, and 1 each from Canada, Spain, and China. Statistically significant results of anxiety reduction were reported in 12 of the studies reviewed. Despite the limitations of not all studies using randomized controlled designs, having smaller sample sizes, having different outcomes, having nonstandardized tai chi interventions, and having varying lengths, tai chi appears to be a promising modality for anxiety management.