OBJECTIVE: To explore the effects of Tai Chi on body mass index (BMI), exercise capacity, and mental health of overweight/obese adults, and investigate factors influencing adherence to enhance adherence of Tai Chi as a sustainable exercise method. METHODS: A randomized, controlled, exploratory clinical trial was conducted paired with a qualitative study of adherence management. A total of 20 overweight/obese participants were randomly assigned to a standard Tai Chi group (experimental) and a simplified Tai Chi group (control) for an 8-week intervention, 10 patients in each group, with a 12-month follow-up. BMI was calculated and exercise capacity including an isokinetic muscle strength and balance ability test were evaluated. Mental health was assessed using the General Well-Being Schedule (GWB), Pittsburgh Sleep Quality Index (PSQI), and Coping Self Efficacy Scale (CSES) at baseline, 4th week, and 8th week, respectively. The qualitative research included open-interviews with Tai Chi practitioners and semi-structured interviews with subjects. RESULTS: The intervention was conducted in Haidian Park, Beijing, China from October 6, 2022, to January 1, 2023, without dropouts. After an 8-week intervention, the participants in the experimental group exhibited a significant decrease in BMI (P<0.05). Both groups demonstrated significant improvements in exercise capacity (P<0.05). The experimental group exhibited a significant enhancement in the GWB, PSQI and CSES (P<0.05). Only GWB had significant difference in the control group (P<0.05). The experimental group surpassed the control group in GWB and CSES (P<0.05). The adherence rate was 87.5% in the experimental group and 57.9% in the control group after 8 weeks intervention. Analysis on adherence identified 15 themes, the top 3 themes mentioned were as follows: mind-body effects, online and on-site guidance, training schedule (for subjects); mind-body effects, difficulties in practicing, and understanding of Tai Chi (for practitioners). CONCLUSIONS Both interventions were effective in improving exercise capacity. Tai Chi, integrating both physical and mental conditioning, reduced weight, improved exercise capacity and mental happiness, and increased adherence, providing a sustainable exercise program (ChiCTR2200063599).
Humans ; Tai Ji ; Mental Health ; Female ; Male ; Obesity/physiopathology* ; Overweight/physiopathology* ; Middle Aged ; Patient Compliance ; Exercise/psychology* ; Adult ; Body Mass Index ; Exercise Tolerance/physiology*

Lower limb osteoarthritis (OA) is a chronic, multifactorial disease characterized by impaired physical function, chronic pain, compromised psychological health and decreased social functioning. Chronic inflammation plays a critical role in the pathophysiology of OA. Tai Chi is a type of classical mind-body exercise derived from ancient Chinese martial arts. Evidence supports that Tai Chi has significant benefits for relieving lower limb OA symptoms. Using a biopsychosocial framework, this review aims to elucidate the beneficial effects of Tai Chi in lower limb OA and disentangle its potential mechanisms from the perspective of biology, psychology, and social factors. Complex biomechanical, biochemical, neurological, psychological, and social mechanisms, including strengthening of muscles, proprioception improvement, joint mechanical stress reduction, change of brain activation and sensitization, attenuation of inflammation, emotion modulation and social support, are discussed.
Humans ; Tai Ji ; Osteoarthritis/therapy* ; Exercise Therapy ; Lower Extremity ; Chronic Disease ; Inflammation

With the increasing prominence of population aging, the cognitive decline of the elderly has gradually become a hotspot of clinical research. As a traditional rehabilitation exercise, Tai Chi has been proved to have a positive effect on improving cognitive function and delaying cognitive decline in the elderly. However, the related brain function mechanism is still unclear. In this paper, we collected studies which observed the changes of Tai Chi on brain regions related to cognitive function in the elderly using magnetic resonance imaging (MRI), electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS). We summarized relevant studies from perspective of structural and functional changes in the brain. The results showed that Tai Chi may delay and improve cognitive decline in the elderly by reshaping the structure and function of brain regions related to cognitive function such as memory, attention and execution. The effect of Tai Chi for cognitive function may be associated with positive regulation of cardiovascular function, emotion and meditation level of the elderly. In addition, the improvement of cognitive function further enhances the balance of the elderly. We also found that practice time, frequency and intensity of Tai Chi could be factors influencing the improvement of cognitive function and brain function in the elderly.
Aged ; Attention ; Brain/physiology* ; Cognition ; Humans ; Neuroimaging ; Tai Ji/psychology*

Aged ; Blood Pressure ; Exercise ; Humans ; Hypertension/therapy* ; Middle Aged ; Nitric Oxide Synthase ; Tai Ji

BACKGROUND: Sleep disorders are common in older adults and have a negative influence on their physical and mental health. General aerobic exercises (GAEs) have long been used in the treatment of sleep disorders as a non-pharmacological measure. However, there is no consensus on the efficacy of traditional Chinese exercises (TCEs) for treating sleep disorders in older adults and the difference between TCEs and GAEs. OBJECTIVE: This study assessed the effects of TCEs and GAEs on the sleep quality of older adults and the differences between these two interventions. SEARCH STRATEGY: PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, China Science Journal Database and Wanfang Data were searched from their inception to August 2020. INCLUSION CRITERIA: Randomized controlled trials (RCTs) that evaluated the effects of TCEs and GAEs on older adults with sleep disorders were included. DATA EXTRACTION AND ANALYSIS: Data were extracted by two researchers working independently. The risk bias of included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and the quality of evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. The Pittsburgh Sleep Quality Index (PSQI) was used to estimate sleep quality. Meta-analyses were performed to assess the total PSQI score of the exercise intervention as the primary outcome, and the scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication and daytime dysfunction were assessed as secondary outcomes. Subgroup, sensitivity, and meta-regression analyses were conducted to assess the contribution of covariables to heterogeneity. RESULTS: A total of 22 RCTs (including 1747 participants) were included in the meta-analysis. The results indicated that TCEs (weighted mean difference [WMD] = -2.14, 95% confidence interval [CI] [-2.82, -1.46], P < 0.001; heterogeneity: P < 0.001, I CONCLUSION Current evidence shows that both TCEs and GAEs, as complementary and non-pharmacological approaches, help to improve the sleep quality in older adults with potentially clinical implications; however, there was not enough evidence to conclude the difference between them. More rigorous and high-quality RCTs are needed to arrive at reliable conclusions.
Aged ; China ; Exercise ; Exercise Therapy ; Female ; Humans ; Sleep Wake Disorders/therapy* ; Tai Ji

The purpose of this study is to analyze the biomechanics of ankle cartilage and ligaments during a typical Tai Chi movement-Brush Knee and Twist Step (BKTS). The kinematic and kinetic data were acquired in one experienced male Tai Chi practitioner while performing BKTS and in normal walking. The measured parameters were used as loading and boundary conditions for further finite element analysis. This study showed that the contact stress of the ankle joint during BKTS was generally less than that during walking. However, the maximum tensile force of the anterior talofibular ligament, the calcaneofibular ligament and the posterior talofibular ligament during BKTS was 130 N, 169 N and 89 N, respectively, while it was only 57 N, 119 N and 48 N during walking. Therefore, patients with arthritis of the ankle can properly practice Tai Chi. Practitioners with sprained lateral ligaments of the ankle joint were suggested to properly reduce the ankle movement range during BKTS.
Ankle ; Ankle Joint ; Biomechanical Phenomena ; Humans ; Knee Joint ; Lateral Ligament, Ankle ; Male ; Tai Ji

With the increasing number of cardiovascular patients, more and more people are living with diseases. Cardiac rehabilitation (CR) is an effective treatment and prevention measure for cardiovascular disease (CVD), which aims to relieve both psychological and physiological stress of CVD, reduce risk of death from CVD, improve cardiovascular function and patients' quality of life. Tai Chi is popular in China and mainly used as a daily leisure activity for the elderly to strengthen their bodies. This review discusses whether Tai Chi could be taken as a positive intervention in CR and what is the exact role and its mechanisms as exercise therapy for CVD. The authors detail the role of Tai Chi on CR from the aspects of exercise capacity, risk factors of CVD and psychological factors, etc., as well as highlight the limitation of Tai Chi research at present.
Cardiac Rehabilitation ; methods ; Cardiovascular Diseases ; therapy ; Exercise Therapy ; methods ; Humans ; Tai Ji

OBJECTIVETo observe the effect of Tai Ji Quan (TJQ) training on strength and function of lower limbs in the aged.

METHODSSixty senile subjects were recruited and assigned to the TJQ group and the control group (imparting health knowledge)by random digit table. Patients in the TJQ group received 24-style TJQ training for 18 months (60 min each time, 5 times per week), while those in the control group were imparted with sarcopenia related causes, pathogeneses, prevention and control measures. The maximum isometric strength of bilateral iliopsoas, quadriceps femoris, tibialis anterior muscle, hamstrings; the time for 5 sitting-up tests and Time Up and Go Test (TUGT), one-leg standing time with closed eyes test; and the score of Berg balance scale were compared between the two groups.

RESULTSCompared with before treatment, muscle strength increased in the TJQ group with an average increased capacity (rate) as follows, bilateral iliopsoas 5.5 kg (16.9%), quadriceps femoris 5.5 kg (26.2%), and tibialis anterior muscle 8.5 kg (36.2%) (all P < 0.05). The time for TUGT and 5 sitting-up tests was shortened by 1.3 s (16.7%) and 0.9 s (14.5%) respectively in the TJQ group. The time for one-leg standing time with closed eyes test was increased by 8.4 s (left) and 9.1 s (right) respectively. The score of Berg balance scale increased by 4.3% (P < 0.05). Compared with the control group, bilateral quadriceps femoris and tibialis anterior muscle strength increased significantly (P < 0.01); the time for TUGT and 5 sitting-up tests, the time for one-leg standing time with closed eyes test, scores of Berg balance scale were all improved in the TJQ group after intervention (P < 0.05).

CONCLUSIONTJQ training could improve strength of iliopsoas, quadriceps femoris, tibialis anterior muscle in the aged, elevate their balance and locomotor activities, and possibly prevent and treat sarcopenia.

Exercise Therapy ; Humans ; Lower Extremity ; Muscle Strength ; Muscle, Skeletal ; Postural Balance ; Tai Ji

OBJECTIVEAging is associated with a progressive decline in muscle strength, muscle mass and impaired physical function, which reduces mobility and impairs quality of life in the elderly population. The 6-12 months of exercise can enhance the muscle strength, but these improvements can only be maintained for a short period. In this study, we investigated the effects of long-term Tai Chi (TC) exercise on muscle strength of lower extremities.

METHODSA cross-sectional study was conducted in 205 long-term TC practitioners (age: 60-89 years) and 205 age and gentle matched controls who did not practice TC. Each of the activity group was further divided into three distinct age groups: G1, 60-69 years; G2, 70-79 years; and G3, 80-89 years. Hand-held dynamometery was used to measure the maximum isometric strength of iliopsoas, quadriceps femoris, tibialis anterior and hamstrings in both sides of the participants. Unpaired t tests were performed to compare the difference of strength between the TC and non-Tai Chi (NTC) groups. Multivariate analysis of variance (MANOVA) was used to compare the lower muscle strengths among the different age groups in the TC and NTC groups. Pearson's correlations were used to quantify the linear relationship between the months of TC practice and lower limbs muscle strength.

RESULTSThe inter-rater reliabilities of iliopsoas, quadriceps femoris, tibialis anterior and hamstrings were intraclass correlation coeffificient (ICC) (1,1) = 0.895 (0.862-0.920), ICC (2,2) = 0.905 (0.874-0.928), ICC (3,3) = 0.922 (0.898-0.941) and ICC (4,4) = 0.930 (0.908-0.947). The strength of the muscles in the TC group did not differ among different age groups (P>0.05). The strength of iliopsoas, quadriceps femoris, tibialis anterior and hamstrings in TC group was higher than that in the NTC group (P<0.05). A correlation between muscle strength and extension of the exercise period was positive (P<0.05).

CONCLUSIONSResults shed light on the orientation and magnitude of long-term TC in preventing muscle strength loss with aging. TC might be a good form to slow down the trend of age-related decline in muscle strength in community-dwelling population.

Aged ; Aged, 80 and over ; Aging ; physiology ; Female ; Humans ; Lower Extremity ; physiology ; Male ; Muscle Strength ; physiology ; Reproducibility of Results ; Tai Ji

PURPOSE: This study was done to investigate the motivational, physical and affective benefits of exergaming in community dwelling older adult women. METHODS: The research design was a nonequivalent control group pre-test and post-test design. Sixty-one older adult women over the age of 65 were recruited from 6 community senior centers to participate in the 8 week exercise intervention or control group. Six centers were divided into one of three groups: exergame, qigong exercise, or control. The exergame and the qigong exercise group received 16 sessions, scheduled twice a week, with each session lasting 50 minutes. Test measures were completed before and after the 8 week intervention period for all participants. Measures included: Grip strength, chair stand, 6 m walking, balance, geriatric depression scale, vitality and intrinsic motivation. RESULTS: There were significant improvements in the exergame and qigong exercise group for grip strength, chair stand, 6m walking, balance, vitality and intrinsic motivation at the end the 8-week program compared with the control group. CONCLUSION: The exergame could be an effective alternative for older adult women to group exercise classes.
Aged ; Aged, 80 and over ; Depression/physiopathology ; *Exercise ; Female ; Gait ; Hand Strength ; Humans ; Postural Balance ; *Program Evaluation ; Self Report ; Senior Centers ; *Tai Ji