Improve Cardiovascular Function with Qigong

Improve Cardiovascular Function with Qigong

 

By John M. de Castro, Ph.D.

 

“Heart rate, respiratory rate, systolic blood pressure and rate-pressure product were significantly decreased during Qi-training. From these results, we suggest that… Qi-training has psychological effects that indicate stabilization the of cardiovascular system.” – Michelle Fletcher

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. Lifestyle changes have proved to be quite effective in reducing the risk of cardiovascular disease. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to be helpful for producing the kinds of other lifestyle changes needed such as smoking cessationweight reduction and stress reduction.

 

Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Since Tai Chi and Qigong are both mindfulness practices and exercises, they may be an acceptable and effective method to reduce the risk of cardiovascular disease.

 

In today’s Research News article “Qigong for the primary prevention of cardiovascular disease.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6956616/), Hartley and colleagues review, summarize, and perform a meta-analysis of the published research literature on the effectiveness of Qigong practice to reduce the risk of cardiovascular disease. They identified 12 published randomized controlled trials with a total of 1369 participants.

 

They report that in a couple of studies that followed up 20 to 30 years after Qigong training that there was a significant reduction in all-cause mortality. They also report that Qigong training produced significant reductions in systolic blood pressure and blood fat levels including total cholesterol, triglycerides, and low-density lipoproteins. They found that the published trials, though, had significant risks of bias.

 

The primary conclusion was that larger better controlled trials are needed. But the results are promising and suggest that Qigong training reduced risk factors for cardiovascular disease. This gentle exercise may be an effective treatment to change lifestyle, increasing exercise, decreasing the likelihood of cardiovascular disease, and maybe increasing longevity.

 

So, improve cardiovascular function with Qigong.

 

“tai chi may help lower blood pressure. A review of 26 studies found average drops of several points in blood pressure values in people who did tai chi.” – Harvard Heart Letter

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Hartley, L., Lee, M. S., Kwong, J. S., Flowers, N., Todkill, D., Ernst, E., & Rees, K. (2015). Qigong for the primary prevention of cardiovascular disease. The Cochrane database of systematic reviews, 2015(6), CD010390. https://doi.org/10.1002/14651858.CD010390.pub2

 

Abstract

Background

Two major determinants of cardiovascular disease (CVD) are a sedentary lifestyle and stress. Qigong involves physical exercise, mind regulation and breathing control to restore the flow of Qi (a pivotal life energy). As it is thought to help reduce stress and involves exercise, qigong may be an effective strategy for the primary prevention of CVD.

Objectives

To determine the effectiveness of qigong for the primary prevention of CVD.

Search methods

We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (November 2014, Issue 10 of 12); MEDLINE (Ovid) (1946 to 2014 October week 4); EMBASE Classic + EMBASE (Ovid) (1947 to 2014 November 4); Web of Science Core Collection (1970 to 31 October 2014); Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database and Health Economics Evaluations Database (November 2014, Issue 4 of 4). We searched several Asian databases (inception to July 2013) and the Allied and Complementary Medicine Database (AMED) (inception to December 2013), as well as trial registers and reference lists of reviews and articles; we also approached experts in the field and applied no language restrictions in our search.

Selection criteria

Randomised controlled trials lasting at least three months involving healthy adults or those at high risk of CVD. Trials examined any type of qigong, and comparison groups provided no intervention or minimal intervention. Outcomes of interest included clinical CVD events and major CVD risk factors. We did not include trials that involved multi‐factorial lifestyle interventions or weight loss.

Data collection and analysis

Two review authors independently selected trials for inclusion. Two review authors extracted data from included studies and assessed the risk of bias.

Main results

We identified 11 completed trials (1369 participants) and one ongoing trial. Trials were heterogeneous in participants recruited, qigong duration and length of follow‐up periods. We were unable to ascertain the risk of bias in nine trials published in Chinese, as insufficient methodological details were reported and we were unable to contact the study authors to clarify this.

We performed no meta‐analyses, as trials were small and were at significant risk of bias. Clinical events were detailed in subsequent reports of two trials when statistically significant effects of qigong were seen for all‐cause mortality, stroke mortality and stroke incidence at 20 to 30 years after completion of the trials. However, these trials were designed to examine outcomes in the short term, and it is not clear whether qigong was practised during extended periods of follow‐up; therefore effects cannot be attributed to the intervention. None of the included studies reported other non‐fatal CVD events.

Six trials provided data that could be used to examine the effects of qigong on blood pressure. Reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were seen in three and two trials, respectively. Three trials examined the effects of qigong on blood lipids when favourable effects were seen in one trial for total cholesterol, low‐density lipoprotein (LDL) cholesterol and triglycerides, and two trials showed favourable effects on high‐density lipoprotein (HDL) cholesterol. The only trial considered at low risk of selection and detection bias did not demonstrate statistically significant effects on CVD risk factors with qigong, but this study was small and was underpowered. None of the included studies reported incidence of type 2 diabetes (T2D), adverse events, quality of life or costs.

Authors’ conclusions

Currently, very limited evidence is available on the effectiveness of qigong for the primary prevention of CVD. Most of the trials included in this review are likely to be at high risk of bias, so we have very low confidence in the validity of the results. Publication of the ongoing trial will add to the limited evidence base, but further trials of high methodological quality with sufficient sample size and follow‐up are needed to be incorporated in an update of this review before the effectiveness of qigong for CVD prevention can be established.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6956616/

 

Improve Cognition and Balance in Older Adults with Tai Chi

Improve Cognition and Balance in Older Adults with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai chi combines the physical components needed to stay upright—leg strength, flexibility, range of motion, and reflexes—all of which tend to decline with age. . . “It’s like practicing tightrope walking on the ground. You’re practicing your balance and you’re teaching your body to be more sensitive and have greater strength.” – Stanwood Chang

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly. It is obviously important to discover methods to improve balance and decrease the number of falls in older adults.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Indeed, Tai Chi training has been shown to reduce cognitive decline and to reduce the frequency of falls in the elderly.

 

In today’s Research News article “Correlation Between Cognition and Balance Among Middle-Aged and Older Adults Observed Through a Tai Chi Intervention Program.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00668/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1302118_69_Psycho_20200416_arts_A), Xiao and colleagues recruited middle age and older health adults (average age of 59 years). They received Tai Chi training for 1 hour, 3 days per week, for 12 weeks. They were measured before and after training for global cognitive function, static and dynamic balance, body size, lower limb strength, and aerobic endurance.

 

They found in comparison to baseline after Tai Chi training there were significant increases in global cognitive function, and static and dynamic balance. Also, they found that before training the higher the levels of both dynamic and static balance the higher the levels of cognitive function. In addition, they found that the greater the increase in both static and dynamic balance after Tai Chi training, the greater the increase in cognitive function. These improvements were found to be related to increases in lower limb strength.

 

These results are interesting as both balance and cognition decline with age. Tai Chi training has been shown in prior research to reduce the decline in both with aging. To my knowledge this is the first time that these improvements appear to be linked where improvements in balance co-occur with improvements in balance. These results suggest that Tai Chi training in older adults may delay cognitive decline and also delay decline in balance. This may tend to reduce the likelihood of falls and precipitous loss of cognitive ability.

 

These findings support the use of Tai Chito improve balance and cognition in older adults. Some advantages of Tai Chi include the facts that it is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to improve balance and reduce falls and delay cognitive decline in older individuals.

 

So, improve cognition and balance in older adults with Tai Chi.

 

When you’re practicing the movements, you’re shifting your weight from one foot to the other to maintain balance. By doing (tai chi), you become more aware of the position of your body in space — which is something we become less aware of as we age.” – Michael Irwin

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Xiao T, Yang L, Smith L, Loprinzi PD, Veronese N, Yao J, Zhang Z and Yu JJ (2020) Correlation Between Cognition and Balance Among Middle-Aged and Older Adults Observed Through a Tai Chi Intervention Program. Front. Psychol. 11:668. doi: 10.3389/fpsyg.2020.00668

 

Abstract

Background: Age-associated decline in cognition and balance may cause severe ability loss for daily living activities among middle-aged and older adults. The relationship between cognition and balance in this aging population remains to be explored.

Objective: The present study Is exploratory in nature and aimed to examine the relationship between balance (both static and dynamic components) and global cognitive function among middle-aged and older adults through Tai Chi (TC) practice as a research avenue.

Methods: A short-term (12 weeks) intervention of TC was conducted among middle-aged and older adults in the community setting. Global cognitive function (using the Chinese version of the Montreal Cognitive Assessment score (MoCA) and balance (i.e., one leg standing test score; Timed Up and Go Test score, TUGT) of all participants were assessed before and after the intervention. Age, body mass index (BMI), sex, and physical fitness variables (Chair Stand Test, CST; the 6-Meter Walk Test, 6MWT) were also collected as confounding factors.

Results: Significant moderator effects of baseline CST on the association between the dichotomized baseline MoCA score and the baseline left leg balance score (p = 0.0247), the baseline right leg balance score (p = 0.0140) and the baseline TUGT score (p = 0.0346) were found. Change score of left score balance (p = 0.0192) and change score of TUGT (p = 0.0162) were found to be significantly associated with change score of cognitive function.

Conclusion: Cognitive function and balance are interrelated in middle-aged and older adults. The association between global cognitive function and balance Is moderated by strength of lower limbs. The change scores of cognitive function and balance introduced by TC training were found to be positively correlated. Future research Is warranted to further confirm the cause-effect relationship of cognitive function and balance and its influencing factors among middle-aged and older adults utilizing intervention studies with larger sample sizes.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00668/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1302118_69_Psycho_20200416_arts_A

 

Reduce Anxiety and Depression in Coronary Heart Disease Patients with Tai Chi

Reduce Anxiety and Depression in Coronary Heart Disease Patients with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai chi is an interesting, promising exercise option. I think based on what we found, it’s a reasonable and safe step to offer tai chi within cardiac rehab.” – Elena Salmoriago-Blotcher

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. There are myriads of treatments that have been developed to treat cardiovascular disease including a variety of surgical procedures and medications. Importantly, lifestyle changes have proved to be quite effective. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to be helpful for producing the kinds of other lifestyle changes needed such as smoking cessationweight reduction and stress reduction.

 

Cardiac rehabilitation programs for patients recovering from implantation of a stent for coronary heart disease, emphasize lifestyle changes. Unfortunately, for a variety of reasons, 60% of coronary heart disease patients decline participation, making these patients at high risk for a heart attack.  Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Since Tai Chi is both a mindfulness practice and a gentle exercise, it may be an acceptable, safe, and effective treatment for coronary heart disease patients.

 

In today’s Research News article “The 24-Form Tai Chi Improves Anxiety and Depression and Upregulates miR-17-92 in Coronary Heart Disease Patients After Percutaneous Coronary Intervention.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078346/), Liu and colleagues recruited coronary heart disease patients who had a myocardial infarction and a stent implanted less than 4 days prior. The patients received usual care and were randomly assigned to receive either no further treatment or Tai Chi practice twice a day for 60 minutes for 10 months. They were measured before and after the 10-month practice period for anxiety, depression, perceived stress, and quality of life. In addition, blood was drawn and measured for miR-17-92.

 

They found that in comparison to baseline and the control group, the group that received Tai Chi training had significantly lower levels of anxiety, depression, and perceived stress and significantly higher levels of quality of life and miR-17-92. In addition, they found that the higher the levels of miR-17-92 the lower the levels of anxiety, depression, and perceived stress.

 

It should be noted that the control condition was not active. Future research should have an active control that performed some other activity of comparable duration, perhaps another type of exercise or health education. Nevertheless, the results show that Tai Chi practice can significantly improve the psychological well-being of coronary heart disease patients after surgery to insert a stent.

 

Prior research has demonstrated the RNA segments are associated with anxiety and depression. The current research also detected this relationship. But the study also demonstrated that the improvements in anxiety, depression, and perceived stress were associated with increased levels of miR-17-92. This may indicate a mechanism of action by which Tai Chi practice improves psychological well-being. It remains for future research to further explore this interesting possibility.

 

So, reduce anxiety and depression in coronary heart disease patients with Tai Chi.

 

Tai chi shows promise for patients with existing heart disease. Participants in the intensive tai chi program were significantly more active, lost more weight and reported a higher quality of life.” – CardioSmart

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Liu, J., Yu, P., Lv, W., & Wang, X. (2020). The 24-Form Tai Chi Improves Anxiety and Depression and Upregulates miR-17-92 in Coronary Heart Disease Patients After Percutaneous Coronary Intervention. Frontiers in physiology, 11, 149. https://doi.org/10.3389/fphys.2020.00149

 

Abstract

Background

Anxiety and depression are common symptoms in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). The 24-form Tai Chi may exert a protective function for CHD patients after PCI by improving anxiety and depression.

Methods

Patients who received PCI after 1–4 days were randomly assigned to the 24-form Tai Chi group (TG) and the control group (CG). The differences in anxiety and depression, using the Medical Outcomes Study 36−item Short−Form Health Survey (SF-36), before and after an average of 10 months of Tai Chi intervention were compared in both groups to analyze the effects of Tai Chi on the emotion and the life quality of CHD patients. Meanwhile, the relative levels of miR-17-92 were measured by using real-time qPCR. The association between the relative levels of miR-17-92 and the anxiety and the depression of CHD patients after PCI was analyzed. Adjusted Cox models were used to explore the effect of Tai Chi exercise in CHD patients.

Results

After 10 months of intervention, the changes in the anxiety subscale (P = 0.002), in the depression subscale (P = 0.008), and in the stress (P = 0.015) scores were higher in the TG group when compared to those of the CG group. The proportion of anxious (P = 0.045) and depressed subjects (P = 0.042) in the TG group was lower than that in the CG group. On the other hand, the increase in the SF-36 scores and in the relative levels of miR-17-92 was significantly higher in the TG group when compared with that of the CG group (P < 0.05). The serum level of miR-17-92 had a negative correlation with the anxiety, the depression, and the stress scores (P < 0.01).

Conclusion

The 24-form Tai Chi improved the anxiety and the depression symptoms and upregulated the miR-17-92 levels in CHD patients after PCI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078346/

 

Improve the Symptoms of Parkinson’s Disease with Mind-Body Practices

Improve the Symptoms of Parkinson’s Disease with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

The mind-body connection recognizes that emotional, mental, and behavioral factors can directly affect our health, and mind-body techniques can improve quality of life and may help reduce symptoms of disease.” – Emily Downward

 

Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. There are around seven million people worldwide and one million people in the U.S. living with PD and about 60,000 people are diagnosed with PD every year. PD is associated with aging as the vast majority of patients are diagnosed after age 50. In fact, it has been speculated that everyone would eventually develop PD if they lived long enough.

 

Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. PD itself is not fatal but is often associated with related complications which can reduce life expectancy, such as falls, choking, and cardiovascular problems. Parkinson’s Disease (PD) also has psychological effects, especially cognitive decline, anxiety, and depression. All of these symptoms result in a marked reduction in the quality of life.

 

There are no cures for Parkinson’s Disease or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients.  In addition, Tai Chi practice has been shown to improve the symptoms of Parkinson’s Disease. Hence, mind-body practices may be excellent treatments for the symptoms of Parkinson’s Disease.

 

In today’s Research News article “The Impact of Mind-body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981975/), Jin and colleagues review, summarize, and perform a meta-analysis of the effectiveness of mind-body practices for the relief of the symptoms of Parkinson’s Disease. They selected randomized controlled trials with Tai Chi, Qigong and Yoga practices for patients with Parkinson’s Disease over 40 years of age. They identified 22 studies with a total of 1199 participants, 18 of which employed Tai Chi and Qigong practices and 4 employed Yoga practice.

 

They report that the studies found that the mind-body practices produced significant improvements in overall Parkinson’s Disease motor function, walking ability, balance, depression, and quality of life. Hence, the published research studies demonstrate that mind-body practices significantly improve the physical and psychological symptoms of Parkinson’s Disease.

 

Tai Chi and Qigong practices have been demonstrated in prior research to improve balance, walking ability, depression, and quality of life in a variety of healthy and sick people. In addition yoga practice has been demonstrated to improve balance, walking ability, depression and quality of life in various populations. The present study extends these findings to patients with Parkinson’s Disease. These practices appear to be a safe and effective treatment to relieve the symptoms and suffering of patients with Parkinson’s Disease.

 

So, improve the symptoms of Parkinson’s Disease with mind-body practices.

 

Mindfulness-based interventions have the ability to reprogram brain conditioning and alter the ways in which we respond to the world. Parkinson’s patients can benefit immensely from this method as a means of decreasing stress and anxiety while slowly increasing quality of life.” – Alana Kessler

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Jin, X., Wang, L., Liu, S., Zhu, L., Loprinzi, P. D., & Fan, X. (2019). The Impact of Mind-body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-analysis. International journal of environmental research and public health, 17(1), 31. https://doi.org/10.3390/ijerph17010031

 

Abstract

Purpose: To systematically evaluate the effects of mind-body exercises (Tai Chi, Yoga, and Health Qigong) on motor function (UPDRS, Timed-Up-and-Go, Balance), depressive symptoms, and quality of life (QoL) of Parkinson’s patients (PD). Methods: Through computer system search and manual retrieval, PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang Database, and CQVIP were used. Articles were retrieved up to the published date of June 30, 2019. Following the Cochrane Collaboration System Evaluation Manual (version 5.1.0), two researchers independently evaluated the quality and bias risk of each article, including 22 evaluated articles. The Pedro quality score of 6 points or more was found for 86% (19/22) of these studies, of which 21 were randomized controlled trials with a total of 1199 subjects; and the trial intervention time ranged from 4 to 24 weeks. Interventions in the control group included no-intervention controls, placebo, waiting-lists, routine care, and non-sports controls. Meta-analysis was performed on the literature using RevMan 5.3 statistical software, and heterogeneity analysis was performed using Stata 14.0 software. Results: (1) Mind-body exercises significantly improved motor function in PD patients, including UPDRS (SMD = −0.61, p < 0.001), TUG (SMD = −1.47, p < 0.001) and balance function (SMD = 0.79, p < 0.001). (2) Mind-body exercises also had significant effects on depression (SMD = −1.61, p = 0.002) and QoL (SMD = 0.66, p < 0.001). (3) Among the indicators, UPDRS (I2 = 81%) and depression (I2 = 91%) had higher heterogeneity; according to the results of the separate combined effect sizes of TUG (I2 = 29%), Balance (I2 = 16%) and QoL (I2 = 35%), it shows that the heterogeneity is small; (4) After meta-regression analysis of the age limit and other possible confounding factors, further subgroup analysis showed that the reason for the heterogeneity of UPDRS motor function may be related to the sex of PD patients and severity of the disease; the outcome of depression was heterogeneous. The reason for this may be the use of specific drugs in the experiment and the duration of intervention in the trial. Conclusion: (1) Mind-body exercises were found to have significant improvements in motor function, depressive symptoms, and quality of life in patients with Parkinson’s disease, and can be used as an effective method for clinical exercise intervention in PD patients. (2) Future clinical intervention programs for PD patients need to fully consider specific factors such as gender, severity of disease, specific drug use, and intervention cycle to effectively control heterogeneity factors, so that the clinical exercise intervention program for PD patients is objective, scientific, and effective.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981975/

 

Improve Mood with Tai Chi or Qigong Practice

Improve Mood with Tai Chi or Qigong Practice

 

By John M. de Castro, Ph.D.

 

“adding a mind-body exercise like tai chi that is widely available in the community can improve the outcomes of treating depression in older adults. . . With tai chi, we may be able to treat these conditions without exposing patients to additional medications.” – Helen Lavretsky

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Clinically diagnosed depression affects over 6% of the population. Depression can be difficult to treat. Fortunately, Mindfulness training is also effective for treating depression.

 

Anxiety disorders and clinical depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders and for depression either alone or in combination with other therapies. Mindful Movement practices such as Qigong and Tai Chi have been found to be effective for depression and anxiety. Research has been accumulating. So, it is important to step back and examine what has been learned regarding the application of Qigong and Tai Chi practices for mood.

 

In today’s Research News article “Qigong and Tai-Chi for Mood Regulation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519567/), Yeung and colleagues review and summarize the published research studies of the effectiveness of Qigong and Tai Chi practices for improving mood.

 

They found that the published research reports that Qigong and Tai Chi practice produce significant decreases in anxiety and depression and increases in psychological well-being, self-esteem, and self-efficacy. In addition, Qigong and Tai Chi practice have been shown to be effective in reducing depression that accompanies diseases including fibromyalgia, arthritis, obesity, and cardiovascular disease.

 

The mechanisms by which Qigong and Tai Chi practice improves mood are unknown. But it has been speculated that it may work by increasing mindfulness, reduces perceived stress, improving interoception, producing neuroplastic changes in the brain, improving respiration control, and altering genes. It may be that these practices produce the benefits through a combination of mechanisms or that different mechanisms underlie different benefits. Regardless, the evidence is compelling that Qigong and Tai Chi practice have beneficial effects on the psychological well-being of healthy people and people with diseases.

 

Qigong and Tai Chi  practices are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. All of these characteristics make Qigong and Tai Chi  excellent practices for the improvement mood.

 

So, improve mood with Tai Chi or Qigong Practice.

 

“In 82% of studies, tai chi greatly improved mood and lowered anxiety. Plus, it was shown to be an effective treatment for depression.” – Harvard Health

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Yeung, A., Chan, J., Cheung, J. C., & Zou, L. (2018). Qigong and Tai-Chi for Mood Regulation. Focus (American Psychiatric Publishing), 16(1), 40–47. https://doi.org/10.1176/appi.focus.20170042

 

Abstract

Qigong and Tai-Chi are traditional self-healing, self-cultivation exercises originating in ancient China. These exercises are characterized by coordinated body posture and movements, deep rhythmic breathing, meditation, and mental focus based on traditional Chinese medicine theories. Although the exact mechanisms of Qigong’s and Tai-Chi’s effects on physical and mental well-being are unknown, these practices may be viewed as meditative movements and share many of the healing elements observed in mindfulness meditation. Clinical studies including randomized controlled trials and meta-analyses have shown that both Qigong and Tai-Chi have beneficial effects on psychological well-being and reduce symptoms of anxiety and depression. Qigong and Tai-Chi frequently involve anchoring attention to interoceptive sensations related to breath or other parts of the body, which has been shown to enhance nonreactivity to aversive thoughts and impulses. Preliminary studies suggest that the slow movements in Qigong and Tai-Chi with slowing of breath frequency could alter the autonomic system and restore homeostasis, attenuating stress related to hypothalamus-pituitary-adrenal axis reactivity and modulating the balance of the autonomic nervous system toward parasympathetic dominance. Qigong’s and Tai-Chi’s effects on emotion regulation could occur through changes in multiple prefrontal regions, the limbic system, and the striatum or in the expression of genes linked to inflammatory responses and stress-related pathways.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519567/

 

Improve Physical Function and Postural Control Complexity in Older Adults with Peripheral Neuropathy with Tai Chi

Improve Physical Function and Postural Control Complexity in Older Adults with Peripheral Neuropathy with Tai Chi

 

By John M. de Castro, Ph.D.

 

“slow and fluid movements improve the body’s alignment, posture, strength, flexibility, coordination, balance, and stamina. Many of these benefits of Tai Chi are consistent with many other forms of low-impact exercise, with the added benefit of focus on improved posture, balance, and alignment.” – Robert Humphries

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly. Falls, with or without injury, also carry a heavy quality of life impact.

 

Peripheral neuropathy can compound the effects of aging on motor ability. It involves damage to the peripheral nerves carrying information to the spinal cord and brain. This results in deficits in sensory information from the body and motor control. Peripheral neuropathy can impair muscle movement, prevent normal sensation in the arms and legs, and cause pain. In this way peripheral neuropathy may further impair older adults motor abilities and increase the likelihood of falls.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through posture, regulated breathing, mindful concentration, and gentle movements. It includes posture and balance training and has been shown to improve balance and coordination. Indeed, Tai Chi training has been shown to reduce the likelihood of falls in the elderly. One possible way that Tai Chi training may contribute to the decrease in falls is by improving postural control. This interesting speculation has not been previously investigated in older patients with peripheral neuropathy.

 

In today’s Research News article “Complexity-based measures inform Tai Chi’s impact on standing postural control in older adults with peripheral neuropathy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640896/), Manor and colleagues recruited older adults (average age 71 years) with peripheral neuropathy. They were provided 3 1-hour Tai Chi classes per week for 24 weeks. They were measured before and after training for foot sole sensation, leg strength, mobility, functional ability, and postural control, including measures of balance, speed, area under the curve, and complexity of postural control while standing.

 

They found that in comparison to baseline, after Tai Chi training there were significant improvements in foot sole sensation, leg strength, mobility, and physical function, including knee extension, walking, and speed. There was also a significant increase in postural control complexity. In addition, they found that the greater the increase in postural control complexity the greater the improvements in foot sole sensation, mobility, and functional ability.

 

This study did not have a control condition so conclusions must be tempered with the understanding that the results may have been due to time-based confounding variables. Nevertheless, the results suggest that Tai Chi practice improves the physical condition and abilities of older adults with peripheral neuropathy. Aging is associated with a loss of motoric complexity. The improvement in postural complexity observed in the present study may then represent the ability of Tai Chi practice to restore this complexity and thereby help the older adults’ physical abilities.

 

So, improve physical function and postural control complexity in older adults with peripheral neuropathy with Tai Chi.

 

We work to maintain great posture for a 60-120 minute class, reap the benefits, feel great, and then go home and try to emulate the posture in our natural environment.” – Scott

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Manor, B., Lipsitz, L. A., Wayne, P. M., Peng, C. K., & Li, L. (2013). Complexity-based measures inform Tai Chi’s impact on standing postural control in older adults with peripheral neuropathy. BMC complementary and alternative medicine, 13, 87. https://doi.org/10.1186/1472-6882-13-87

 

Abstract

Background

Tai Chi training enhances physical function and may reduce falls in older adults with and without balance disorders, yet its effect on postural control as quantified by the magnitude or speed of center-of-pressure (COP) excursions beneath the feet is less clear. We hypothesized that COP metrics derived from complex systems theory may better capture the multi-component stimulus that Tai Chi has on the postural control system, as compared with traditional COP measures.

Methods

We performed a secondary analysis of a pilot, non-controlled intervention study that examined the effects of Tai Chi on standing COP dynamics, plantar sensation, and physical function in 25 older adults with peripheral neuropathy. Tai Chi training was based on the Yang style and consisted of three, one-hour group sessions per week for 24 weeks. Standing postural control was assessed with a force platform at baseline, 6, 12, 18, and 24 weeks. The degree of COP complexity, as defined by the presence of fluctuations existing over multiple timescales, was calculated using multiscale entropy analysis. Traditional measures of COP speed and area were also calculated. Foot sole sensation, six-minute walk (6MW) and timed up-and-go (TUG) were also measured at each assessment.

Results

Traditional measures of postural control did not change from baseline. The COP complexity index (mean±SD) increased from baseline (4.1±0.5) to week 6 (4.5±0.4), and from week 6 to week 24 (4.7±0.4) (p=0.02). Increases in COP complexity—from baseline to week 24—correlated with improvements in foot sole sensation (p=0.01), the 6MW (p=0.001) and TUG (p=0.01).

Conclusions

Subjects of the Tai Chi program exhibited increased complexity of standing COP dynamics. These increases were associated with improved plantar sensation and physical function. Although more research is needed, results of this non-controlled pilot study suggest that complexity-based COP measures may inform the study of complex mind-body interventions, like Tai Chi, on postural control in those with peripheral neuropathy or other age-related balance disorders.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640896/

 

Improve Type 2 Diabetes with Mindful Movement

Improve Type 2 Diabetes with Mindful Movement

 

By John M. de Castro, Ph.D.

 

“Living with diabetes is a major life stressor, from the physical and psychological aspects of managing blood sugar and medications to the eating challenges. A great deal of what we go through in life is beyond our control. The diabetes is always going to be there, but until you connect with what you’re feeling and experiencing, you’re not going to be able to make conscious choices about living with its many challenges.” – Ivy Marcus

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. Mindful movement practices such as Tai Chi and Qigong  and yoga are mindfulness practices that are also gentle exercises. There is accumulating research on the effectiveness of these mindful movement practices for the treatment of Type 2 Diabetes. So, it makes sense to examine what has been learned.

 

In today’s Research News article “Meditative Movements for Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7016481/), Xia and colleagues review, summarize, and perform a meta-analysis of the published research literature on the effectiveness of mindful movement practices for the treatment of Type 2 Diabetes. They found 21 controlled studies; 6 employing Tai Chi practice, 3 Qigong practice, and 12 yoga.

 

They report that the published research found that mindful movement practices produced significant reductions in fasting blood glucose, glycated hemoglobin (HbA1c), and postprandial blood glucose levels. These results suggest that mindful movement practices improve glycemic control in type 2 diabetes. There were no significant differences found between different mindful movement practices.

 

They also report that the published research found that mindful movement practices produced significant reductions in total cholesterol and low-density lipoprotein cholesterol and significant increases in high-density lipoprotein cholesterol. These results suggest that mindful movement practices improve blood lipid levels in type 2 diabetes. There were no significant differences found between different mindful movement practices.

 

The improvements observed produced by Tai Chi, Qigong  and yoga practices are very important for the treatment and control of type 2 diabetes. Glycemic control is a key to successful treatment and lipid control is important for reducing cardiovascular problems that can occur. So, these exercises significantly improve the metabolic state of patients with type 2 diabetes. The fact that the different practices were equivalent in effectiveness suggests that the patient can select the practice type that they enjoy most and best suits their lifestyle.

 

So, improve Type 2 Diabetes with mindful movement.

 

Practicing mindfulness exercises and daily physical activity has been shown repeatedly to help manage stress and depression, and promote mental balance and happiness. Mindfulness exercises are therefore a crucial component in both preventing and managing type 2 diabetes, and reducing the risk of complications for type 1 and type 2 diabetics.” – Defeat Diabetes Foundation

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Xia, T., Yang, Y., Li, W., Tang, Z., Huang, Q., Li, Z., & Guo, Y. (2020). Meditative Movements for Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM, 2020, 5745013. https://doi.org/10.1155/2020/5745013

 

Abstract

Objective

Physical activity plays a specific role in the fundamental aspect of diabetes care. It is necessary to develop exercise programs for these patients. The aim of this systematic review is to summarize current evidence regarding the effectiveness of meditative movement in patients with type 2 diabetes.

Methods

The following databases were searched: PubMed, CENTRAL, Web of Science, Ovid LWW, and EMBASE. Two independent investigators searched and screened the studies by finding duplications, excluding irrelevant titles and abstracts, and then selecting eligible studies by reviewing full texts. 21 studies fulfilled the inclusion criteria. Meta-analyses were performed on glycated hemoglobin (HbA1c), fasting blood glucose (FBG) and postprandial blood glucose (PPBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and body mass index (BMI).

Results

Meta-analyses showed that meditative movements significantly improved FBG, HbA1c, PPBG, TC, LDL-C, and HDL-C. No improvement was found in BMI.

Conclusions

The results demonstrated a favorable effect or tendency of meditative movements to improve blood glucose and blood lipid levels in patients with type 2 diabetes mellitus. The special effects of meditative movements in type 2 diabetes mellitus patients need further research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7016481/

 

Improve Parkinson’s Disease Symptoms with Tai Chi

Improve Parkinson’s Disease Symptoms with Tai Chi

 

By John M. de Castro, Ph.D.

 

tai chi can be used as an add-on to current physical therapies and medications to ease some of the key problems faced by people with Parkinson’s disease.” – Peter Wayne

 

Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. There are around seven million people worldwide and one million people in the U.S. living with PD and about 60,000 people are diagnosed with PD every year. PD is associated with aging as the vast majority of patients are diagnosed after age 50. In fact, it has been speculated that everyone would eventually develop PD if they lived long enough.

 

Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. PD itself is not fatal but is often associated with related complications which can reduce life expectancy, such as falls, choking, and cardiovascular problems. Parkinson’s Disease (PD) also has psychological effects, especially cognitive decline, anxiety, and depression. All of these symptoms result in a marked reduction in the quality of life.

 

There are no cures for Parkinson’s Disease or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients.  In addition, Tai Chi practice has been shown to improve the symptoms of Parkinson’s Disease. Hence, Tai Chi  may be an excellent treatment for the symptoms of Parkinson’s Disease.

 

In today’s Research News article “Tai Chi versus routine exercise in patients with early- or mild-stage Parkinson’s disease: a retrospective cohort analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013627/), Li and colleagues recruited adult patients with Parkinson’s Disease and randomly assigned them to receive either 90 minutes, 3 times per week for two months of routine exercise or of a 6-move Yang Tai Chi practice. They were measured before and after training for walking speed, up-and-go from chair, functional reach, functional activities, and falls over 6-month periods.

 

They found that both the exercise and Tai Chi practices produced significant improvements in walking speed, up-and-go from chair, and functional reach and significantly decreased numbers of falls over the 6-month period following treatment. But the Tai Chi group had superior outcomes compared to routine exercise.  In addition, a greater number of Tai Chi participants were able to withdraw from medication or reduce medication doses. No adverse events were recorded.

 

The results suggest that both exercise and Tai Chi practices produce significant improvements in the motor symptoms of Parkinson’s Disease but Tai Chi practice produces even greater improvements. The reduction in falls observed in the Tai Chi group are particularly important as falls are a significant contributor to injuries and mortality in Parkinson’s Disease patients.

 

It’s important to note that Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. Hence, Tai Chi practice would appear to be a superior practice to be added to routine treatment for the improvements of the symptoms of Parkinson’s Disease.

 

So, improve Parkinson’s Disease symptoms with Tai Chi.

 

Daily Tai Chi practice is extremely helpful to those with chronic ailments and illnesses like cancer, heart disease, stroke, Parkinson’s, Alzheimer’s, osteoporosis, peripheral neuropathy, respiratory problems and irritable bowel syndrome to name a few,”  – Mwezo Kujiweza

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Li, Q., Liu, J., Dai, F., & Dai, F. (2020). Tai Chi versus routine exercise in patients with early- or mild-stage Parkinson’s disease: a retrospective cohort analysis. Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas, 53(2), e9171. https://doi.org/10.1590/1414-431X20199171

 

Abstract

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).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013627/

 

Improve Healthcare Workers Wellness with Tai Chi

Improve Healthcare Workers Wellness with Tai Chi

 

By John M. de Castro, Ph.D.

 

Tai chi is often described as “meditation in motion,” but it might well be called “medication in motion.” There is growing evidence that this mind-body practice . . . has value in treating or preventing many health problems.” – Harvard Womens Health

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. Improving the psychological health of health care professionals has to be a priority.

 

Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. Tai Chi and Qigong are mindfulness practices that have been shown to improve physical and psychological health. Hence, it is reasonable to examine the ability of Tai Chi practice as a means to improve the well-being of medical professionals.

 

In today’s Research News article “Tai Chi and Workplace Wellness for Health Care Workers: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982315/), Cocchiara and colleagues reviewed and summarized the published research studies on the effectiveness of Tai Chi practice on the psychological health of medical professionals. They report on the findings from 6 published research studies.

 

They report that the published studies found were not of high methodological quality and as such caution must be exercised in interpreting the findings. But the published reports suggest that Tai Chi practice improves the physical and psychological well-being of healthcare workers. It appears to work by reducing the physiological and psychological responses to stress in the workplace and this in turn results in improved well-being. Hence, although higher quality research is needed the published research suggests that Tai Chi practice is a safe and effective method of improving the well-being of healthcare workers.

 

So, improve healthcare workers wellness with Tai Chi.

 

you lose flexibility and balance as you get older, and tai chi is a way to get moving again without pounding on your joints.” – Christina Heiser

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Cocchiara, R. A., Dorelli, B., Gholamalishahi, S., Longo, W., Musumeci, E., Mannocci, A., & La Torre, G. (2020). Tai Chi and Workplace Wellness for Health Care Workers: A Systematic Review. International journal of environmental research and public health, 17(1), 343. https://doi.org/10.3390/ijerph17010343

 

Abstract

Several studies show the positive effects of new non-medical therapies known as complementary and alternative medicines (CAMs). In this context, the discipline of tai chi is obtaining a wider consensus because of its many beneficial effects both on the human body and mind. The aim of this study was to perform a systematic review of the scientific literature concerning the relationship between tai chi practice and wellness of health care workers (HCW) in their professional setting. The research was performed in September 2019, investigating the databases Cinahl, Scopus, Web of Science, and PubMed. Full-text articles, written in English language and published after 1995, were taken into account. No restrictions regarding the study design were applied. A quality assessment was developed using AMSTAR, Jadad, Newcastle–Ottawa Scale, INSA, and CASE REPORT scale. Six papers were finally included: Three clinical trials, one observational study, one systematic review, and one case report. The methodological quality of the included studies was judged as medium level. In conclusion, this systematic review suggests the potential impact of interventions such as tai chi as tools for reducing work-related stress among healthcare professionals. Further research will be needed in order to gain robust evidence of its efficacy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982315/

 

Reduce Falls in the Elderly with Exercise and Tai Chi

Reduce Falls in the Elderly with Exercise and Tai Chi

 

By John M. de Castro, Ph.D.

 

With regular practice, tai chi improves balance by strengthening muscles and co-ordination; at the same time, it strengthens the mind, thereby improving calmness and confidence in not falling. Thus, both physically and mentally, tai chi is an extremely effective exercise for fall prevention. A great bonus, at the same time, tai chi also improves almost all aspects of health!” – Paul Lam

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly.

 

Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of falls in the elderly.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Indeed, Tai Chi training has been shown to reduce the frequency of falls in the elderly. It is not known, however, how effective  Tai Chi training is in preventing falls relative to other exercises. The evidence is accumulating. So, it is important to review and summarize what has been learned.

 

In today’s Research News article “Exercise for preventing falls in older people living in the community.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360922/), Sherrington and colleagues review, summarize, and perform a meta-analysis of the relative effectiveness of various exercises, including Tai Chi in improving balance and reducing falls in the elderly. They identified 108 randomized controlled trials including a total of 23,407 participants averaging 77 years of age employing any form of exercise and measuring falls before and after treatment.

 

They report that the published research found that all forms of exercise combined significantly reduced falls by 23% and reduced the number of people experiencing falls by 15% with larger effects when the program was delivered by a health care professional. With respect to specific forms of exercise they found that balance and functional exercises significantly reduced falls by 24% and reduced the number of people experiencing falls by 13% while Tai Chi significantly reduced falls by 19% and reduced the number of people experiencing falls by 20%. There were too few studies with mixed resultsmof other forms of exercise such as walking, dance, strength exercises to evaluate their effectiveness.

 

These findings support the use of exercise to reduce falls in the elderly including the use of Tai Chi. Some advantages of Tai Chi include the facts that it is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to reduce falls in elderly individuals.

 

So, reduce falls in the elderly with exercise and Tai Chi.

 

based on current available evidence, suggest that Tai Chi exercise is an effective intervention to prevent the risk of falls among older adults.” – Yu-Ning Hu

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. The Cochrane database of systematic reviews, 1(1), CD012424. https://doi.org/10.1002/14651858.CD012424.pub2

 

Abstract

Background

At least one‐third of community‐dwelling people over 65 years of age fall each year. Exercises that target balance, gait and muscle strength have been found to prevent falls in these people. An up‐to‐date synthesis of the evidence is important given the major long‐term consequences associated with falls and fall‐related injuries

Objectives

To assess the effects (benefits and harms) of exercise interventions for preventing falls in older people living in the community.

Search methods

We searched CENTRAL, MEDLINE, Embase, three other databases and two trial registers up to 2 May 2018, together with reference checking and contact with study authors to identify additional studies.

Selection criteria

We included randomised controlled trials (RCTs) evaluating the effects of any form of exercise as a single intervention on falls in people aged 60+ years living in the community. We excluded trials focused on particular conditions, such as stroke.

Data collection and analysis

We used standard methodological procedures expected by Cochrane. Our primary outcome was rate of falls.

Main results

We included 108 RCTs with 23,407 participants living in the community in 25 countries. There were nine cluster‐RCTs. On average, participants were 76 years old and 77% were women. Most trials had unclear or high risk of bias for one or more items. Results from four trials focusing on people who had been recently discharged from hospital and from comparisons of different exercises are not described here.

Exercise (all types) versus control

Eighty‐one trials (19,684 participants) compared exercise (all types) with control intervention (one not thought to reduce falls). Exercise reduces the rate of falls by 23% (rate ratio (RaR) 0.77, 95% confidence interval (CI) 0.71 to 0.83; 12,981 participants, 59 studies; high‐certainty evidence). Based on an illustrative risk of 850 falls in 1000 people followed over one year (data based on control group risk data from the 59 studies), this equates to 195 (95% CI 144 to 246) fewer falls in the exercise group. Exercise also reduces the number of people experiencing one or more falls by 15% (risk ratio (RR) 0.85, 95% CI 0.81 to 0.89; 13,518 participants, 63 studies; high‐certainty evidence). Based on an illustrative risk of 480 fallers in 1000 people followed over one year (data based on control group risk data from the 63 studies), this equates to 72 (95% CI 52 to 91) fewer fallers in the exercise group. Subgroup analyses showed no evidence of a difference in effect on both falls outcomes according to whether trials selected participants at increased risk of falling or not.

The findings for other outcomes are less certain, reflecting in part the relatively low number of studies and participants. Exercise may reduce the number of people experiencing one or more fall‐related fractures (RR 0.73, 95% CI 0.56 to 0.95; 4047 participants, 10 studies; low‐certainty evidence) and the number of people experiencing one or more falls requiring medical attention (RR 0.61, 95% CI 0.47 to 0.79; 1019 participants, 5 studies; low‐certainty evidence). The effect of exercise on the number of people who experience one or more falls requiring hospital admission is unclear (RR 0.78, 95% CI 0.51 to 1.18; 1705 participants, 2 studies, very low‐certainty evidence). Exercise may make little important difference to health‐related quality of life: conversion of the pooled result (standardised mean difference (SMD) ‐0.03, 95% CI ‐0.10 to 0.04; 3172 participants, 15 studies; low‐certainty evidence) to the EQ‐5D and SF‐36 scores showed the respective 95% CIs were much smaller than minimally important differences for both scales.

Adverse events were reported to some degree in 27 trials (6019 participants) but were monitored closely in both exercise and control groups in only one trial. Fourteen trials reported no adverse events. Aside from two serious adverse events (one pelvic stress fracture and one inguinal hernia surgery) reported in one trial, the remainder were non‐serious adverse events, primarily of a musculoskeletal nature. There was a median of three events (range 1 to 26) in the exercise groups.

Different exercise types versus control

Different forms of exercise had different impacts on falls (test for subgroup differences, rate of falls: P = 0.004, I² = 71%). Compared with control, balance and functional exercises reduce the rate of falls by 24% (RaR 0.76, 95% CI 0.70 to 0.81; 7920 participants, 39 studies; high‐certainty evidence) and the number of people experiencing one or more falls by 13% (RR 0.87, 95% CI 0.82 to 0.91; 8288 participants, 37 studies; high‐certainty evidence). Multiple types of exercise (most commonly balance and functional exercises plus resistance exercises) probably reduce the rate of falls by 34% (RaR 0.66, 95% CI 0.50 to 0.88; 1374 participants, 11 studies; moderate‐certainty evidence) and the number of people experiencing one or more falls by 22% (RR 0.78, 95% CI 0.64 to 0.96; 1623 participants, 17 studies; moderate‐certainty evidence). Tai Chi may reduce the rate of falls by 19% (RaR 0.81, 95% CI 0.67 to 0.99; 2655 participants, 7 studies; low‐certainty evidence) as well as reducing the number of people who experience falls by 20% (RR 0.80, 95% CI 0.70 to 0.91; 2677 participants, 8 studies; high‐certainty evidence). We are uncertain of the effects of programmes that are primarily resistance training, or dance or walking programmes on the rate of falls and the number of people who experience falls. No trials compared flexibility or endurance exercise versus control.

Authors’ conclusions

Exercise programmes reduce the rate of falls and the number of people experiencing falls in older people living in the community (high‐certainty evidence). The effects of such exercise programmes are uncertain for other non‐falls outcomes. Where reported, adverse events were predominantly non‐serious.

Exercise programmes that reduce falls primarily involve balance and functional exercises, while programmes that probably reduce falls include multiple exercise categories (typically balance and functional exercises plus resistance exercises). Tai Chi may also prevent falls but we are uncertain of the effect of resistance exercise (without balance and functional exercises), dance, or walking on the rate of falls.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360922/