Improve Cardiopulmonary Health Over the Long Haul in Obese Elderly with Tai Chi

February 6, 2020 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Research has found that seniors who regularly practice tai chi are steadier on their feet, less likely to suffer high blood pressure, and physically stronger. Tai chi has been known to improve hand/eye coordination, increase circulation, and can even promote a better night’s sleep.” – Chris Corregall

Obesity is a major risk factor for cardiovascular and pulmonary diseases and diabetes. Overweight and abdominal obesity are associated with high blood pressure, insulin resistance and elevation of plasma cholesterol and triglycerides. It is highly associated with pulmonary problems and type-2 diabetes. Obesity incidence has been rising rapidly and it currently affects over a third of U.S. adults. The simplest treatment is simply exercise and weight loss. Also, mindfulness techniques have been shown to be effective in treating Metabolic Syndrome.

Obviously, there is a need for effective treatments to prevent or treat the health consequences of obesity. But, despite copious research and a myriad of dietary and exercise programs, there still is no safe and effective treatment. Tai Chi practice is both an exercise and a mindfulness practice. It has been found to be effective for an array of physical and psychological issues. It appears to strengthen the immune system, reduce inflammation, and improve cardiovascular function. Tai Chi training has also been shown to improve lung function. These findings are encouraging. But little is known about the ability of Tai Chi practice to improve cardiopulmonary function over the long-term.

In today’s Research News article “Tai Chi can prevent cardiovascular disease and improve cardiopulmonary function of adults with obesity aged 50 years and older: A long-term follow-up study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824704/), Sun and colleagues recruited healthy obese adults over 50 years of age (average 66 years) and provided them with a health education training. In addition, half the participants received training in Tai Chi 3 times per week for 30-40 minutes. They were measured before and after training and then every 3 to 6 months over 6 years for blood pressure, body size, cardiac function, and lung function.

They found that in comparison to baseline and the health education only group, the Tai Chi group had significantly lower systolic and diastolic blood pressure, waist and hip circumference, weight, and body mass index, and significant improvements in cardiac and lung function that were maintained for 6 years. In addition, the Tai Chi group had lower incidences of health complications, lower mortality, and lower rates of cardiovascular and cerebrovascular disease.

These results are exciting and remarkable. It is exceedingly rare to have such long-term follow-up of the effectiveness of an intervention. The results demonstrate that Tai Chi practice can be safely maintained over very long periods of time and produce sustained benefits for the health of the elderly. It’s important to note that Tai Chi is gentle and safe, appropriate for all ages, 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.

So, improve cardiopulmonary health over the long haul in obese elderly with Tai Chi.

“Practising the ancient martial art of Tai Chi is so beneficial to elderly people’s health that it should be “the preferred mode of training”” – The Telegraph

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

Sun, L., Zhuang, L. P., Li, X. Z., Zheng, J., & Wu, W. F. (2019). Tai Chi can prevent cardiovascular disease and improve cardiopulmonary function of adults with obesity aged 50 years and older: A long-term follow-up study. Medicine, 98(42), e17509. doi:10.1097/MD.0000000000017509

Abstract

To research the possible role of Tai Chi in preventing cardiovascular disease and improving cardiopulmonary function in adults with obesity aged 50 years and older.

Between 2007 and 2012, 120 adults with obesity, aged 50 years and older, were divided into a Tai Chi group and a control group, with 60 participants in each group. The 2 groups were evaluated for weight, waist circumference, hip circumference, blood pressure (BP), body mass index, and incidence of chronic disease during follow-up monitoring.

Two- and 6-year follow-up showed that the average BP in the Tai Chi group along with either the systolic or diastolic pressure decreased significantly compared to those in the control group (P < .001). Waist and hip circumference, weight, and body mass index in the Tai Chi group were significantly reduced compared to those in the control group (P < .001). The cardiopulmonary function of the control group and the Tai Chi group changed, with the cardiac index significantly higher in the Tai Chi group than in the control group (P < .05). The Tai Chi group had significantly higher levels of lung function, including vital capacity, maximal oxygen uptake, and total expiratory time, than the control group. The total incidence of complications and mortality in the Tai Chi group were much lower than those in the control group (P < .001). The incidence of cardiovascular and cerebrovascular disease in the Tai Chi group (16.67%) was lower than that in the control group (38.33%).

Tai Chi is not only a suitable exercise for elderly people with obesity, but it can also help to regulate BP, improve heart and lung function in these individuals, as well as reduce the incidence of cardiovascular disease and other chronic diseases, helping to improve their quality of life.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824704/

Slow Cellular Aging with Mindfulness

January 27, 2020April 28, 2022 psyjdc Leave a comment

Slow Cellular Aging with Mindfulness

By John M. de Castro, Ph.D.

“those with more years of meditation practice had longer telomere length overall, and that women meditators had significantly longer telomeres as compared to women non-meditators. These findings further support meditation’s positive effect on healthy cellular aging.” – Sonima Wellness

One of the most exciting findings in molecular biology in recent years was the discovery of the telomere. This is a component of the DNA molecule that is attached to the ends of the strands. Recent genetic research has suggested that the telomere and its regulation is the biological mechanism that produces aging. It has been found that the genes, coded on the DNA molecule, govern cellular processes in our bodies. One of the most fundamental of these processes is cell replication. Cells are constantly turning over. Dying cells or damaged are replaced by new cells. The cells turn over at different rates but most cells in the body are lost and replaced between every few days to every few months. Needless to say, we’re constantly renewing ourselves.

As we age the tail of the DNA molecule called the telomere shortens. When it gets very short cells have a more and more difficult time reproducing and become more likely to produce defective cells. On a cellular basis, this is what produces aging. As we get older the new cells produced are more and more likely to be defective. The shortening of the telomere occurs each time the cell is replaced. So, slowly as we age it gets shorter and shorter. This has been called a “mitotic clock.” This is normal. But telomere shortening can also be produced by oxidative stress, which can be produced by psychological and physiological stress. This is mediated by stress hormones and the inflammatory response. So, chronic stress can accelerate the aging process. In other words, when we’re chronically stressed, we get older faster.

Fortunately, there is a mechanism to protect the telomere. There is an enzyme in the body called telomerase that helps to prevent shortening of the telomere. It also promotes cell survival and enhances stress-resistance. Research suggests that processes that increase telomerase activity tend to slow the aging process by protecting the telomere. One activity that seems to increase telomerase activity and protect telomere length is mindfulness practice. Hence, engaging in mindfulness practices may protect the telomere and thereby slow the aging process.

In today’s Research News article “Association among dispositional mindfulness, self-compassion, and leukocyte telomere length in Chinese adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647116/), Keng and colleagues recruited adults, aged 18 to 55 years of age, with no regular meditation or mindfulness practice. Blood samples were drawn and leukocyte telomere length measured. In addition, they were measured for mindfulness, self-compassion, anxiety, depression, and stress.

They found that, as expected, the older the participant the shorter the telomere length and the higher the levels of perceived stress, the shorter the telomere length. When controlling for age they found that the higher the levels of overall mindfulness and the nonreactivity facet of mindfulness the longer the length of the telomeres. Also, when controlling for age the higher the levels of overall self-compassion and the common humanity and de-identification from one’s thoughts and emotions facets of self-compassion the longer the length of the telomeres.

It needs to be kept in mind that these results are correlational and as such causation cannot be determined. However, previous research has demonstrated a causal link by training mindfulness and finding increased telomere lengths. This suggests that the present associations were due to a causal connection between mindfulness and telomere length.

In addition, these were young and middle-aged adults who did not display high levels of mindfulness, stress or psychological distress. Mindfulness is thought to affect telomere length as a result of reducing stress which is responsible for shortening the telomers. So, only mild association would be expected. Clearer larger association may require older more distressed participants. The fact that it was the nonreactivity facet of mindfulness that was most strongly associated with longer telomeres supports the contention that stress reduction is the critical effect of mindfulness. By reducing the reaction to events, stress is lowered which, in turn, decreases cellular aging.

These results suggest that mindfulness, particularly the nonreactivity facet of mindfulness and self-compassion common humanity and de-identification from one’s thoughts and emotions facets of self-compassion reduces cellular aging. Mindfulness increases self-compassion. So, although not tested here, mindfulness may decrease cellular aging both directly and indirectly via self-compassion. By protecting the telomeres from shortening and mindfulness reduces cellular aging. In this way mindfulness may lead to happier and longer lives.

So, slow cellular aging with mindfulness.

“one of the most effective interventions, apparently capable of slowing the erosion of telomeres – and perhaps even lengthening them again – is meditation.” – Jo Marchant

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

Keng, S. L., Yim, O. S., Lai, P. S., Chew, S. H., & Ebstein, R. P. (2019). Association among dispositional mindfulness, self-compassion, and leukocyte telomere length in Chinese adults. BMC psychology, 7(1), 47. doi:10.1186/s40359-019-0323-y

Abstract

Background

Whereas meditation training has been purported to support slower cellular aging, little work has explored the association among different facets of dispositional mindfulness, self-compassion, and cellular aging. The present study aimed to examine the relationship between leukocyte telomere length (LTL), an index of cellular aging, dispositional mindfulness, and self-compassion in a sample of Singaporean Chinese adults.

Methods

One hundred and fifty-eight Chinese adults (mean age = 27.24 years; 63.3% female) were recruited from the community and completed self-report measures assessing dispositional mindfulness, self-compassion, and psychological symptoms, as well as provided blood samples for analyses of LTL. Multiple regression analyses were conducted to examine the role of trait mindfulness and self-compassion in predicting LTL, taking into consideration potential covariates such as chronological age and psychological symptoms.

Results

Results showed that nonreactivity, one of the five facets of dispositional mindfulness, was significantly associated with LTL, after controlling for chronological age. There was also a trend for dispositional mindfulness, self-compassion, and their selected facets (i.e., nonjudging, common humanity, and de-identification) to each be associated with longer LTL.

Conclusions

Overall, the findings provide preliminary support for the association among aspects of dispositional mindfulness, self-compassion, and aging. In particular, individuals high on nonreactivity experience slower aging at the cellular level, likely through engaging in more adaptive coping mechanisms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647116/

Improve Quality of Life and Reduce Falls in Dementia Patients with Tai Chi

January 24, 2020 psyjdc Leave a comment

Improve Quality of Life and Reduce Falls in Dementia Patients with Tai Chi

By John M. de Castro, Ph.D.

“The number of people living with Alzheimer’s disease and other dementia-related conditions is exploding in the United States. But while scientists struggle to find a new medical treatment, tai chi, the ancient Chinese martial art, has emerged as a potentially potent way to help stem the tide.” – David-Dorian Ross

Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. These are progressive disorders with no cures. Alzheimer’s disease is the most common form of dementia. It is estimated that 5 million Americans have Alzheimer’s disease. It involves an irreversible progressive loss of mental function associated with brain degeneration. The early stages are typified by memory loss but as the disease progresses patients can lose the ability to carry on a conversation or carry on normal life functions, and eventually leads to death.

Mindfulness training has been found to help protect aging individuals from physical and cognitive declines. Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Tai Chi practice has been found to be effective for an array of physical and psychological issues. Tai Chi has been shown to help the elderly improve attention, balance, reducing falls, arthritis, cognitive function, memory, and reduce age related deterioration of the brain. So, it makes sense to investigate the effects of Tai Chi practice in patients with dementia.

In today’s Research News article “Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875562/),Nyman and colleagues recruited community dwelling elderly (aged 78 to 97 years) adults with dementia and randomly assigned them to either usual care or usual care plus 20 weeks of once a week for 90 minutes Tai Chi practice and home practice. They were measured before and after training for dynamic balance, functional balance, falls, fall efficacy, fear of falls, quality of life, and cognitive function.

They found that in comparison to baseline and the usual care group, the Tai Chi group had a significantly greater quality of life and significantly fewer falls (44% fewer) during the 6-month follow-up period. There were no serious adverse events due to Tai Chi practice recorded.

Since Tai Chi is practiced in groups, the fact that it produced an increase in quality of life may have been due to the enhanced social contacts occurring in the course of practice. This can have quite an impact as community dwelling elderly, and particularly those with dementia, are often isolated from social contacts. The reduced falls has been previous documented in the elderly. The present study, though, documents this in dementia patients. This is very important as falls in the elderly are particularly dangerous and can be major contributors to mortality.

Tai Chi is not strenuous, involving 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 the quality of life and prevent falls in elderly dementia patients.

So, improve quality of life and reduce falls in dementia patients with Tai Chi.

“Researchers have shown that regular practice of Tai Chi increases brain volume, augments memory and thinking skills, and may combat dementia.” – Explore

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

Samuel R Nyman, Wendy Ingram, Jeanette Sanders, Peter W Thomas, Sarah Thomas, Michael Vassallo, James Raftery, Iram Bibi, Yolanda Barrado-Martín. Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia. Clin Interv Aging. 2019; 14: 2017–2029. Published online 2019 Nov 19. doi: 10.2147/CIA.S228931

Abstract

Purpose

To investigate the effect of Tai Chi exercise on postural balance among people with dementia (PWD) and the feasibility of a definitive trial on falls prevention.

Patients and methods

Dyads, comprising community-dwelling PWD and their informal carer (N=85), were randomised to usual care (n=43) or usual care plus weekly Tai Chi classes and home practice for 20 weeks (n=42). The primary outcome was the timed up and go test. All outcomes for PWD and their carers were assessed six months post-baseline, except for falls, which were collected prospectively over the six-month follow-up period.

Results

For PWD, there was no significant difference at follow-up on the timed up and go test (mean difference [MD] = 0.82, 95% confidence interval [CI] = −2.17, 3.81). At follow-up, PWD in the Tai Chi group had significantly higher quality of life (MD = 0.051, 95% CI = 0.002, 0.100, standardised effect size [ES] = 0.51) and a significantly lower rate of falls (rate ratio = 0.35, 95% CI =0.15, 0.81), which was no longer significant when an outlier was removed. Carers in the Tai Chi group at follow-up were significantly worse on the timed up and go test (MD = 1.83, 95% CI = 0.12, 3.53, ES = 0.61). The remaining secondary outcomes were not significant. No serious adverse events were related to participation in Tai Chi.

Conclusion

With refinement, this Tai Chi intervention has potential to reduce the incidence of falls and improve quality of life among community-dwelling PWD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875562/

Reduce Pain and Falls and Improve Mobility in the Elderly with Tai Chi

December 18, 2019 psyjdc Leave a comment

Reduce Pain and Falls and Improve Mobility in the Elderly with Tai Chi

By John M. de Castro, Ph.D.

“Solid research shows that tai chi can benefit people with osteoarthritis, rheumatoid arthritis, fibromyalgia, tension headache, and other ongoing, painful conditions.” – Harvard Health

Pain involves both physical and psychological issues. Physically, exercise can be helpful in strengthening the body to prevent or relieve pain. Psychologically, the stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Tai Chi, Qigong, and yoga are all exercises and mindfulness practices that have been found to be effective for pain.

In today’s Research News article “Tai Chi for older adults with chronic multisite pain: a randomized controlled pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126990/), You and colleagues examine the ability of Tai Chi practice to reduce chronic pain in the elderly. They recruited elderly (>65 years of age) with multisite (2 or more) musculoskeletal pain who either had 1 or more falls in the last year or used a cane or walker. They were randomly assigned to receive 12 weeks, 2 hours, twice a week of either Tai Chi or light physical exercise. They were measured before and after training for acceptability of the exercises, chronic health conditions, pain, attention, executive function, physical function, gait, falls, and fear of falling. 83% of the elderly completed the study.

They found that in comparison to baseline the elderly who engaged in Tai Chi had significantly lower pain and pain interference with activities, improvements in gait, including stride and swing time, and decreased gait asymmetry, and decreased fear of falling, and fewer falls over the subsequent 9 months, while the light exercise group did not.

These are encouraging pilot results that are similar to other findings with Tai Chi with other types of patients. Unfortunately, because this was a small pilot study there were no statistically significant differences between the Tai Chi group and the light exercise group even though the Tai Chi groups was significantly improved relative to baseline whereas the light exercise group was not. But these results provide justification for performing a future large scale randomized controlled trial.

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.

So, reduce pain and falls and improve mobility in the elderly with Tai Chi.

“Improved flexibility will reduce stiffness and help keep joints mobile. Stiffness causes pain; increase flexibility will relieve pain. Tai Chi for Arthritis gently moves all joints, muscles and tendons throughout the body.” – Paul Lam

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

You, T., Ogawa, E. F., Thapa, S., Cai, Y., Zhang, H., Nagae, S., … Leveille, S. G. (2018). Tai Chi for older adults with chronic multisite pain: a randomized controlled pilot study. Aging clinical and experimental research, 30(11), 1335–1343. doi:10.1007/s40520-018-0922-0

Abstract

Background

Chronic pain is associated with poorer cognition and mobility, and fall risk in older adults.

Aims

To investigate the feasibility of a randomized trial of mind-body exercise (Tai Chi) versus light physical exercise in older adults with multisite pain.

Methods

Adults aged ≥ 65y with multisite pain who reported falling in the past year or current use of an assistive device were recruited from Boston area communities. Participants were randomized to either a Tai Chi or a light physical exercise program, offered twice weekly for 12 weeks. The primary outcomes were feasibility and acceptability. Secondary outcomes included pain characteristics, cognition, physical function, gait mobility, fear of falling, and fall frequency.

Results

Of 176 adults screened, 85 were eligible, and 54 consented and enrolled (average age 75±8y; 96.30% white; 75.93% female). The dropout rate was 18% for Tai Chi and 12% for light physical exercise. For those completing the study, exercise class attendance was 76% for Tai Chi and 82% for light physical exercise. There were no significant group differences in most secondary outcomes. Tai Chi significantly lowered pain severity (4.58±1.73 to 3.73±1.79, p<0.01) and pain interference (4.20±2.53 to 3.16±2.28, p<0.05), reduced fear of falling (90.82±9.59 to 96.84±10.67, p<0.05), and improved several single-task and dual-task gait variables, while light physical exercise did not change these measures

Discussion and Conclusions

This study demonstrated the feasibility and acceptability of conducting a larger randomized controlled trial in older adults with multisite pain. Study findings and challenges encountered will inform future research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126990/

Tai Chi Practice is a Cost-Effective Treatment to Reduce Falls in Older Adults

October 24, 2019 psyjdc Leave a comment

Tai Chi Practice is a Cost-Effective Treatment to Reduce Falls in Older Adults

By John M. de Castro, Ph.D.

“Across multiple studies, Tai chi appears to reduce risk of falling by 20 to 45 percent and is considered one of the best exercises available for ambulatory older adults with balance concerns.” – Peter Wayne

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, if Tai Chi training is more or less cost-effective than other exercises for reducing falls in the elderly.

In today’s Research News article “Cost-Effectiveness of a Therapeutic Tai Ji Quan Fall Prevention Intervention for Older Adults at High Risk of Falling.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696718/), Li and colleagues recruited community-based elderly individuals (over 70 years of age) who had experienced at least one fall in the last year and randomly assigned them to one of three conditions; Tai Chi practice, multimodal (mixed) exercises, or stretching. The exercises occurred in twice weekly, 60-minute sessions, for 24 weeks. They were measured before and after training for falls, health related quality of life, health index, quality-adjusted life-years (QALYs), and health-related service utilization expenses.

They found that Tai Chi practice resulted in significantly greater reduction in falls and increase in quality-adjusted life-years (QALYs) than either the multimodal or stretching exercises. The costs of implementing the 3 programs were equivalent. The total health-related utilization cost was $1,958 per participant for Tai Chi, compared with $2,583 for multimodal and $2,131 for stretching. Tai Chi produced greater reductions in falls at a lower cost and resulted in lower health care costs results in in incremental costs of $850 per additional fall prevented and $27,614 per additional QALY gained.

These results suggest that Tai Chi practice is a safe, effective, and cost-effective means of reducing falls in the elderly. Falls when they occur in the elderly can be quite devastating and can produce major injuries that can even lead to death. So, their prevention is very important not just for reducing health care costs but for the longevity and quality of life of the individual.

So, Tai Chi practice is a cost-effective treatment to reduce falls in older adults.

“Falling in adults age 65 and older is significantly associated with loss of independence, premature mortality and big health care costs.” – Peter Harmer

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, F., Harmer, P., Eckstrom, E., Fitzgerald, K., Akers, L., Chou, L. S., … Winters-Stone, K. (2019). Cost-Effectiveness of a Therapeutic Tai Ji Quan Fall Prevention Intervention for Older Adults at High Risk of Falling. The journals of gerontology. Series A, Biological sciences and medical sciences, 74(9), 1504–1510. doi:10.1093/gerona/glz008

Abstract

Background

Data on the cost-effectiveness of proven fall prevention exercise interventions are limited. We aimed to establish the cost-effectiveness of Tai Ji Quan: Moving for Better Balance (TJQMBB) compared with a conventional exercise intervention for older adults at high risk of falling.

Methods

We conducted a trial-based cost-effectiveness analysis involving 670 older adults who had a history of falling or impaired mobility. Participants received one of three interventions—TJQMBB, multimodal exercise, or stretching exercise (control)—each of which was implemented twice weekly for 24 weeks. The primary cost-effectiveness measure was the incremental cost per additional fall prevented, comparing TJQMBB and multimodal exercise to Stretching and TJQMBB to multimodal exercise, with a secondary measure of incremental cost per additional quality-adjusted life-year (QALY) gained. The intervention was conducted between February 2015 and January 2018, and cost-effectiveness was estimated from a health care system perspective over a 6-month time horizon.

Results

The total cost to deliver the TJQMBB intervention was $202,949 (an average of $906 per participant); for multimodal exercise, it was $223,849 ($1,004 per participant); and for Stretching, it was $210,468 ($903 per participant). Incremental cost-effectiveness ratios showed that the multimodal exercise was cost-effective ($850 per additional fall prevented; $27,614 per additional QALY gained) relative to Stretching; however, TJQMBB was the most economically dominant strategy (ie, having lower cost and being clinically more efficacious) compared with multimodal and stretching exercises with regard to cost per additional fall prevented and per additional QALY gained. TJQMBB had a 100% probability of being cost-effective, relative to Stretching, at a threshold of $500 per each additional fall prevented and $10,000 per additional QALY gained. Sensitivity analyses showed the robustness of the results when extreme cases, medical costs only, and missing data were considered.

Conclusions

Among community-dwelling older adults at high risk for falls, TJQMBB is a cost-effective means of reducing falls compared with conventional exercise approaches.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696718/

Relieve Chronic Low Back Pain with Tai Chi

September 14, 2019 psyjdc Leave a comment

Relieve Chronic Low Back Pain with Tai Chi

By John M. de Castro, Ph.D.

“Tai Chi has demonstrated usefulness in the prevention and treatment of certain problems such as back pain. Importantly, Tai Chi is non-invasive, relatively inexpensive, and gentle on the spine, so many people with back pain are starting to try it as an adjunct to (or sometimes instead of) traditional medical approaches to manage back pain. Furthermore, Tai Chi does not require any expensive equipment and can be practiced anywhere.” – Robert Humphreys

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses.

Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Tai Chi is a mindfulness practice that is safe and gentle and has been shown to improve spinal health and reduce pain. So, it would seem reasonable to examine the ability of Tai Chi practice to treat chronic low back pain.

In today’s Research News article “Chen-Style Tai Chi for Individuals (Aged 50 Years Old or Above) with Chronic Non-Specific Low Back Pain: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388249/), Liu and colleagues recruited older adults (aged 50 and over) who were diagnosed with chronic low back pain and randomly assigned them to receive Chen Style Tai Chi training, deep core stabilization exercise, or a no-treatment control condition. Tai Chi and core stabilization exercise practice occurred for 60 minutes three times per week for 12 weeks. They were measured before and after training for lower back pain intensity and for knee and ankle joint position matching ability (proprioception).

They found that in comparison to baseline and the control group both Tai Chi training and core stabilization exercise produced a significant decrease in lower back pain, with Tai Chi training producing the greatest relief of the pain. There were, however, no significant effects of training on knee and ankle joint proprioception.

The study is significant in that it demonstrates that Tai Chi practice is a safe and effective treatment to relieve chronic low back pain in older adults. This pain is a major problem decreasing their ability to fully engage in daily and work activities. So the relief of the pain by Tai Chi practice should contribute to a marked increase in their quality of life.

So, relieve chronic low back pain with Tai Chi.

“Some solid research shows that tai chi can benefit people with osteoarthritis, rheumatoid arthritis, fibromyalgia, tension headache, and other ongoing, painful conditions.” – 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

Liu, J., Yeung, A., Xiao, T., Tian, X., Kong, Z., Zou, L., & Wang, X. (2019). Chen-Style Tai Chi for Individuals (Aged 50 Years Old or Above) with Chronic Non-Specific Low Back Pain: A Randomized Controlled Trial. International journal of environmental research and public health, 16(3), 517. doi:10.3390/ijerph16030517

Abstract

Tai Chi (TC) can be considered safe and effective intervention to improve pain and pain-related functional disability. However, it is unclear that whether aging individuals with Chronic Non-Specific Low Back Pain (CNS-LBP) can achieve positive results. This study, therefore, attempted to explore the effects of TC on pain and functional disability in CNS-LBP patients aged 50 years old or above. Forty-three individuals (aged 50 years old or above) with CNS-LBP were randomly assigned into three groups: Chen-Style TC group (n = 15), Core Stabilization training (CST) group (n = 15), and control group (n = 13). Participants in the TC group participated in Chen-style TC training program (three 60-min sessions per week for 12 weeks), individuals in CST group received 12-week Core Stabilization exercise on the Swiss ball, whereas individuals in the control group maintained their unaltered lifestyle. Pain intensity as primary outcome was measured using the Visual Analogue Scale (VAS), A BiodexSystem 3 isokinetic dynamometer was used to measure knee and ankle joint position sense (JPS) as secondary outcomes at baseline and after the 12-week intervention. TC and CST have significant effects in VAS for CNS-LBP patients (p< 0.01, TC group OR CST group versus control group in mean of the post-minus-pre assessment). However, the feature of joint position sense (JPS) of ankle inversion, ankle eversion and knee flexion did not occur, it showed no significant effects with TC and CST. TC was found to reduce pain, but not improve lower limb proprioception in patients with CNS-LBP. Future research with larger sample sizes will be needed to achieve more definitive findings on the effects of TC on both pain and lower limb proprioception in this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388249/

Improve Depression by Modulating the Autonomic Nervous System in the Elderly with Tai Chi

August 19, 2019May 11, 2020 psyjdc Leave a comment

Improve Depression by Modulating the Autonomic Nervous System in the Elderly with Tai Chi

By John M. de Castro, Ph.D.

“The ancient Chinese practice of tai chi appears to relieve symptoms of depression in older people.” – Tara Parker-Pope

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decreases during aging. The aging process involves a systematic progressive decline in every system in the body. It is inevitable and cannot be avoided. This includes our mental abilities which decline with age including impairments in memory, attention, and problem-solving ability, and in emotion regulation. Depression is very common in the elderly. The elderly cope with increasing loss of friends and family, deteriorating health, as well as concerns regarding finances on fixed incomes. In addition, many elderly experience withdrawal and isolation from social interactions producing increased loneliness, worry and anxiety.

There is some hope for age related decline, however, as there is evidence that it can be slowed. There are some indications that physical and mental exercise can reduce the rate of decline. For example, contemplative practices such as meditation, yoga, and Tai Chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging and with improving depression. There is, however, been very little research on the mechanisms by which Tai Chi practice improves depression in the elderly.

In today’s Research News article “The Effects of Tai Chi on Heart Rate Variability in Older Chinese Individuals with Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313592/), Liu and colleagues recruited elderly (aged 60 and older) who were not taking antidepressant medications or drinking alcohol, but who scored as having mild depression on an elderly depression scale. They were randomly assigned to either receive Tai Chi training for 60 minutes, 3 times per week for 24 weeks, or to a no-treatment control condition. The elderly were measured before and after treatment for depression, and heart rate variability, a measure of autonomic nervous system activity.

They found that in comparison to baseline and the control group the Tai Chi participants had significantly decreased levels of depression and significant decreases in low frequency heart rate variability and significant increases in high frequency heart rate variability. The higher the levels of high frequency heart rate variability the lower the levels of depression and the lower the levels of low frequency heart rate variability the lower the levels of depression.

These findings are interesting and suggest that Tai Chi training reduces depression in the elderly. The results further suggest that Tai Chi training may do so by creating balance between the sympathetic and parasympathetic nervous systems. High frequency heart rate variability is suggestive of parasympathetic (relaxation) activity and this was increased by Tai Chi training while low frequency heart rate variability is suggestive of sympathetic (activation) activity and this was decreased by Tai Chi training. Hence, the results suggest that Tai Chi training may lead to less activation and greater relaxation and this may counter depression.

So, improve depression by modulating the autonomic nervous system in the elderly with Tai Chi

“Tai chi has many physical and emotional benefits. Some of the benefits of tai chi include decreased anxiety and depression and improvements in cognition. It may also help you manage symptoms of some chronic diseases.” – Healthline

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., Xie, H., Liu, M., Wang, Z., Zou, L., Yeung, A. S., … Yang, Q. (2018). The Effects of Tai Chi on Heart Rate Variability in Older Chinese Individuals with Depression. International journal of environmental research and public health, 15(12), 2771. doi:10.3390/ijerph15122771

Abstract

Background Very little research has been done to simultaneously investigate the effects of Tai Chi (TC) on depression and heart rate variability (HRV). This study, therefore, attempted to explore the effects of TC on depression and on HRV parameters. Methods Sixty older individuals with depression score of 10 or above (the Geriatric Depression Scale, GDS) were randomly assigned into two groups: TC (n = 30) and control group (n = 30). Participants in the experimental group participated in a 24-week TC training program (three 60-min sessions per week), whereas individuals in the control group maintained their unaltered lifestyle. Depression and HRV were measured using the GDS and digital electrocardiogram at baseline and after the 24-week intervention. Results The TC had produced significant positive chances in depression and some HRV parameters (mean heart rate, RMSSD, HF, LFnorm, and HFnorm) (p < 0.05), whereas these positive results were not observed in the control group. Conclusions The results of this study indicated that TC may alleviate depression of the elderly through modulating autonomous nervous system or HRV parameters. This study adds to a growing body of research showing that TC may be effective in treating depression of the elderly. Tai Chi as a mild to moderate mind-body exercise is suitable for older individuals who suffer from depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313592/

Improve Cognitive Function in Early Dementia Patients with Tai Chi

August 7, 2019 psyjdc Leave a comment

Improve Cognitive Function in Early Dementia Patients with Tai Chi

By John M. de Castro, Ph.D.

“The number of people living with Alzheimer’s disease and other dementia-related conditions is exploding in the United States. But while scientists struggle to find a new medical treatment, tai chi, the ancient Chinese martial art, has emerged as a potentially potent way to help stem the tide.” – David-Dorian Ross

In today’s Research News article “The effectiveness of Tai Chi for short-term cognitive function improvement in the early stages of dementia in the elderly: a systematic literature review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6512568/), Lim and colleagues reviewed and summarized the published research literature examining the effectiveness of Tai Chi practice for the treatment of cognitive problems in patients in the early stages of dementia. They identified 9 published research studies.

There were differing results in different studies that varied in rigor, but in general, the studies reported that Tai Chi practice resulted in improved cognitive function, working memory, verbal learning and memory, fewer complaints about memory loss, semantic memory, and visuospatial ability. Hence, the review concluded that Tai Chi practice produces small but clinically significant improvements in cognitive functions and memory in patients in the early stages of dementia.

These are potentially important findings as there is no cure for dementia and deterioration is inevitable. Slowing the progression of the disease is the only current hope there is for the patients. Tai Chi practice appears to be a safe and effective method to slow down the inevitable cognitive decline in dementia patients.

Tai Chi is not strenuous, involving 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 treat patients in the early stages of dementia, slowing the progression of the disease.

So, improve cognitive function in early dementia patients with Tai Chi.

“Those with the best balance and walking abilities at the start of the study were three times less likely to have developed dementia as those with lower physical abilities. The good news is that practicing can dramatically improve your balance within months or even weeks.”

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

Lim, K. H., Pysklywec, A., Plante, M., & Demers, L. (2019). The effectiveness of Tai Chi for short-term cognitive function improvement in the early stages of dementia in the elderly: a systematic literature review. Clinical interventions in aging, 14, 827–839. doi:10.2147/CIA.S202055

Abstract

Purpose: This systematic review examines intervention studies using Tai Chi in the early stages of dementia to determine the effectiveness of Tai Chi for the short-term improvement of cognitive functions for elderly persons with the disease.

Methods: A keyword search was done in PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), and Cochrane Library databases using keywords such as Tai Chi, Dementia*, and cognition. A secondary search strategy consisting of a manual search in the reference lists of selected articles was also used.

Results: A total of nine studies were reviewed including six randomized controlled trials, two non-randomized controlled trials, and one non-randomized prospective study. The studies suggest Tai Chi has impacts on global cognitive functions, visuospatial skills, semantic memory, verbal learning/memory, and self-perception of memory. The effects of Tai Chi on overall cognition for people with mild cognitive impairment are comparable to those in control groups which engaged in exercise.

Conclusion: The studies reviewed affirm the potential of Tai Chi to improve short-term cognitive function in the elderly at the onset of dementia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6512568/

Reduce Stress and Improve Emotion Regulation with Mindfulness

July 25, 2019 psyjdc Leave a comment

Reduce Stress and Improve Emotion Regulation with Mindfulness

By John M. de Castro, Ph.D.

“By recognizing and identifying emotions as they arise, you are able to see how your thoughts can spiral you into agitated emotional states. . . Being mindful of your emotions will help you accept them and also stay in control of them. It’s from that place you will be able to refocus, rebalance, and recalibrate.” – Tris Thorpe

Mindfulness practice has been shown to improve emotion regulation. Practitioners demonstrate the ability to fully sense and experience emotions, but respond to them in more appropriate and adaptive ways. In other words, mindful people are better able to experience yet control their responses to emotions. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders.

Mindfulness has also been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. It is not known if stress reduction my be part of the mechanism by which mindfulness improves the control of emotions.

In today’s Research News article “Perceived stress mediates the relationship between mindfulness and negative affect variability: A randomized controlled trial among middle-aged to older adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534144/), Colgan and colleagues recruited mildly stressed older adults aged 50 – 85 years and randomly assigned them to either receive a 6-week mindfulness meditation program or to a wait-list control condition. Meditation training occurred one-on-one for 1.5 hours weekly for 6 weeks and involved home practice. The participants were measured before and after training for perceived stress, positive and negative emotions, variability of negative emotions, and expectancies about the effects of meditation.

They found that in comparison to baseline and the wait-list control group the meditation group had significant decreases in perceived stress and negative emotion variability. In addition, the greater the change in perceived stress the greater the change in negative emotion variability. A mediation analysis revealed that meditation practice was reduced negative emotion variability directly and indirectly by reducing perceived stress which, in turn, reduced negative emotion variability.

It should be pointed out that there wasn’t an active control condition which opens up the possibility that placebo (subject expectancy) effects could be responsible for the results. But, the participants reported expectancies regarding the effects of meditation that were no different than the expectancies of control participants. This suggests that placebo effects were not responsible for the results.

Negative emotion variability can be viewed as an indicator of emotion regulation. If indeed an individual has better ability to deal with emotions then it would be expected that emotions would not build upon themselves and thereby be less variable. So, the present results are in line with previous research that meditation practice improves emotion regulation. They also suggest that it does so, in part, by its ability to reduce perceived stress.

So, reduce stress and improve emotion regulation with mindfulness.

“Through mindfulness you can learn to turn your negative emotions into your greatest teachers and sources of strength. Instead of ‘turning away’ from pain in avoidance we can learn to gently ‘turn towards’ what we’re experiencing. We can bring a caring open attention towards the wounded parts of ourselves and make wise choices about how to respond to ourselves and to life. It’s a paradox that we all must understand: It is by turning towards negative emotions that we find relief from them – not by turning away.” – Melli O’Brien

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

Colgan, D. D., Klee, D., Memmott, T., Proulx, J., & Oken, B. (2019). Perceived stress mediates the relationship between mindfulness and negative affect variability: A randomized controlled trial among middle-aged to older adults. Stress and health : journal of the International Society for the Investigation of Stress, 35(1), 89–97. doi:10.1002/smi.2845

Abstract

Despite the interest in mindfulness over the past 20 years, studies have only recently begun to examine mindfulness in older adults. The primary aim of this study was to evaluate pretreatment to post-treatment change in negative affect variability (NAV) following a mindfulness training among 134 mildly stressed, middle-aged to older adults. The secondary aim was to assess if the effects of mindfulness training on NAV would be partially explained by pretreatment to post-treatment reductions in perceived stress, a trend that would be congruent with several stress models. In this randomized control trial, participants were assigned to either a 6-week mindfulness meditation training programme or to a wait list control. Ecological momentary assessment, a data capturing technique that queries about present moment experiences in real time, captured NAV. Mixed-model ANOVAs and a path analysis were conducted. Participants in the mindfulness meditation training significantly reduced NAV when compared with wait list control participants. Further, there was a significant indirect group effect on reductions in NAV through change in perceived stress. Few studies have tested mechanisms of action, which connect changes that occur during mindfulness training with psychological outcomes in older adults. Understanding the mechanisms by which mindfulness enhances well-being may optimize interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534144/

Improve Physical and Mental Health in the Homebound Elderly with Qigong and Cognitive Behavioral Therapy

July 13, 2019 psyjdc Leave a comment

Improve Physical and Mental Health in the Homebound Elderly with Qigong and Cognitive Behavioral Therapy

By John M. de Castro, Ph.D.

“tai chi provides plenty of health benefits at any age, but it is especially appropriate for seniors. It doesn’t require special equipment, it’s easy on the muscles and joints and it’s one of the best low-impact exercise programs out there.” – Perry Alleva

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our mental abilities which decline with age including impairments in memory, attention, and problem-solving ability. It is inevitable and cannot be avoided. They’ve found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners. Tai Chi and Qigong have also been shown to be beneficial in slowing or delaying physical and mental decline with aging and to increase brain matter in the elderly.

Cognitive Behavioral Therapy (CBT) attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. This would also seem an appropriate therapy for the psychological and mental decline in the elderly. In today’s Research News article “The effect of Baduanjin qigong combined with CBT on physical fitness and psychological health of elderly housebound.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320153/), Jing and colleagues compare the effectiveness of Qigong practice and Cognitive Behavioral Therapy (CBT) and their combination for the treatment of physical and mental problems of the housebound elderly.

They recruited elderly (over 60 years of age) who were housebound (left the house once per week or fewer over a period of at least 6 months) and randomly assigned them to receive either Qigong practice, Cognitive Behavioral Therapy (CBT), or their combination. They received the intervention at home for 1 to 1.5 hours per visit twice a month for the first 3 months and once a month for the next three months. They were encouraged to practice at home daily. They were measured before, at 3 months, and after the intervention for pulmonary function, activities of daily living, subjective health, loneliness, depression, quality of life and the housebound scale.

They found at the end of the intervention that all groups had significant improvements in their lung function, their daily activities, subjective health, loneliness, depression, and quality of life. They also found that the combined Qigong and CBT group was significantly less housebound (lest the house more often), lonely, and depressed, and had significantly greater subjective health than either of the treatments separately.

The results are very positive but the lack of an active control condition leaves open the possibility of attention effects, placebo effects, and experimenter bias. Indeed. the housebound elderly would be expected to react very positively to home visits and this by itself could improve their mental state. But the results suggest that although Qigong practice and Cognitive Behavioral Therapy (CBT) are effective treatments to improve the physical and psychological state of the housebound elderly, the combination of the two produces even greater benefits. The fact that their benefits are additive suggests the Qigong practice and CBT work by differing mechanisms.

Qigong is gentle and safe, 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 alone, at home, and can be quickly learned. So, Qigong practices would appear to be an excellent gentle practice to treat housebound elderly individuals and its effectiveness can be significantly increased by combining it with and Cognitive Behavioral Therapy (CBT).

So, improve physical and mental health in the homebound elderly with Qigong and cognitive behavioral therapy.

“research into the benefits of tai chi for seniors indicates that with regular practice, individuals may relieve the symptoms of chronic pain, anxiety, and depression, improve coordination, reducing the number of falls, improve everyday physical functioning, which promotes independent living, reduce arthritis pain, joint stiffness, and high blood pressure, maintain a healthy bone density level to reduce breakage, improve overall fitness.” – Tracey Kelly

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

Jing, L., Jin, Y., Zhang, X., Wang, F., Song, Y., & Xing, F. (2018). The effect of Baduanjin qigong combined with CBT on physical fitness and psychological health of elderly housebound. Medicine, 97(51), e13654. doi:10.1097/MD.0000000000013654

Abstract

Background:

To investigate the effectiveness of Baduanjin qigong combined with cognitive-behavior therapy (CBT) on the physical fitness and psychological health of elderly housebound.

Materials and methods:

The 120 elderly housebound were randomly divided into 3 intervention groups: Baduanjin training, Baduanjin training combined with CBT, and CBT. The interventions were conducted by means of home visits over 6 months. Spirometry, SF-36 health survey of quality of life, and Lawton and Brody Instrumental Activities of Daily Living Scale (IADL) were used to collect physical health data, and self-evaluation of overall health status, self-evaluation of loneliness, and short-form geriatric depression scale (GDS-15) were used to collect mental health data at baseline, 3 months, and 6 months after intervention. Data was analyzed by repeated measures analysis of variance (rANOVA) and chi-squared test (χ2 test).

Results:

Forced vital capacity (FVC), maximum voluntary ventilation (MVV), quality of life (QOL), and self-reported health status were significantly increased (P < .05) in the group receiving joint Baduanjin and CBT intervention at 3 months and 6 months, as compared to the Baduanjin only group or the CBT only group. Activities of daily living (ADL), self-evaluated loneliness, and level of depression were significantly lowered (P < .05) in the group receiving joint Baduanjin and CBT intervention at 3 months and 6 months, as compared to the Baduanjin only group or the CBT only group.

Conclusions:

Physical and psychological statuses of elderly housebound were significantly improved by Baduanjin training combined with CBT. The effect of the combined intervention exceeded that of CBT or Baduanjin alone.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320153/