The effect of Tai Chi exercise on motor function and sleep quality in patients with stroke:A meta-analysis

Objective:The meta-analysis is to objectively evaluate the efficacy of Tai Chi exercise for motor function and sleep quality in patients with stroke.Methods:Randomized controlled trials(RCTs)about the effects of Tai Chi versus a non-exercise or conventional rehabilitation exercise control group on motor function and sleep quality in patients with stroke were searched from multiple electronic databases(PubMed,Web of Science,the Cochrane Library,EMBASE,AMED,CBM,CNKI,Wanfang and VIP)until August 2016.Two investigators independently screened eligible studies,extracted data,and assessed the methodological quality by using the quality evaluation criteria for RCTs recommended by Cochrane Handbook.Then meta-analysis was performed by RevMan5.3 software.Results:A total of 17 RCTs with 1209 participants were included.The meta-analysis indicated that there was a significant difference on improving the balance function(P<0.001)and ability of daily activity(P=0.0003)of patients with stroke between Tai Chi group and control group.However,no significant effect was found on Tai Chi for walking function and sleep quality(P>0.05).Conclusion:Tai Chi exercise can significantly improve the balance function and ability of daily activities of patients with stroke,and there are no significant differences in walking function and sleep quality.Therefore,lots of multicenter,large-sample,higher quality randomized controlled trials are needed to verify the effects of Tai Chi exercise in improving walking function and sleep quality for patients with stroke.

Prevention of osteoporotic fracture:from skeletal and non-skeletal perspectives

With the global population aging,especially in China,the prevention and management of osteoporotic fragility fractures has become increasingly important.Bone mineral density(BMD)is an important index of osteoporotic fracture risk,which has become aroutine measurement inclinical practice and thus formed the cornerstone in monitoring treatment efficacy of osteoporosis.In the past 30 years,several pharmacologic therapies have been developed to increase BMD and reduce osteoporotic fractures,especially vertebral fractures.However,the management of nonvertebral fractures and hip fractures remains challenging as low BMD is only one of the multi-factors for these conditions.Hip fractures mainly result from a fall and its incidence is higher in the frigid zone due to low temperature affecting neuromuscular function and high latitude with less sunlight,the conditions rendering less active vitamin D conversion,apart from increased falling.In this paper,we focus on two therapeutic strategies targeting both skeletal and non-skeletal factors,that is,Tai Chi(TC)exercise for improving balance and"kidney-tonifying"traditional Chinese medicine(TCM)against muscle atrophy.TC is a mind-body exercise that has the potential as an effective and safe intervention for preventing fall-related fractures in the elderly.This makes it a promising and feasible physical activity for the elderly in frigid zone to prevent osteoporotic fractures.Several TCM formula popular in northeast of China within frigid zone are also introduced.They are reportedly effective in maintaining or improving BMD and muscle strength with the potential of reducing osteoporotic fracture.However,more rationally designed vigorous basic investigations and prospective clinical trials are highly desired to validate and consolidate the preliminary observations in the future.