Background: Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis(OA), little is known about its potential benefits on gait characteristics among older ...Background: Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis(OA), little is known about its potential benefits on gait characteristics among older Chinese women who have a high prevalence of both radiographic and symptomatic knee OA. This study aims to assess the efficacy of a tailored Tai Ji Quan intervention on gait kinematics for older Chinese women with knee OA.Methods: A randomized controlled trial involving 46 older women in Shanghai, China, with clinically diagnosed knee OA. Randomized(1:1)participants received either a 60 min Tai Ji Quan session(n = 23) 3 times weekly or a 60 min bi-weekly educational session(n = 23) for 24 weeks.Primary outcomes were changes in gait kinematic measures from baseline to 24 weeks. Secondary outcomes included changes in scores on the Western Ontario and Mc Master University Osteoarthritis Index(WOMAC) and Short Physical Performance Battery(SPPB).Results: After 24 weeks the Tai Ji Quan group demonstrated better performance in gait velocity(mean difference, 8.40 cm/s, p = 0.01), step length(mean difference, 3.52 cm, p = 0.004), initial contact angle(mean difference, 2.19°, p = 0.01), and maximal angle(mean difference, 2.61°,p = 0.003) of flexed knees during stance phase compared to the control group. In addition, the Tai Ji Quan group showed significant improvement in WOMAC scores(p < 0.01)(mean difference,-4.22 points in pain, p = 0.002;-2.41 points in stiffness, p < 0.001;-11.04 points in physical function, p = 0.006) and SPPB scores(mean difference, 1.22 points, p < 0.001).Conclusion: Among older Chinese women with knee OA, a tailored Tai Ji Quan intervention improved gait outcomes. The intervention also improved overall function as indexed by the WOMAC and SPPB. These results support the use of Tai Ji Quan for older Chinese adults with knee OA to both improve their functional mobility and reduce pain symptomatology.展开更多
目的通过对比太极拳初学者和太极拳运动员白鹤亮翅动作关节角度活动变化、压力中心(center of pres-sure,COP)变化和肌肉活动特点,分析运动员是如何通过肌肉活动控制其白鹤亮翅的姿势平衡。方法太极拳运动员和初学者分两组各10人。记录...目的通过对比太极拳初学者和太极拳运动员白鹤亮翅动作关节角度活动变化、压力中心(center of pres-sure,COP)变化和肌肉活动特点,分析运动员是如何通过肌肉活动控制其白鹤亮翅的姿势平衡。方法太极拳运动员和初学者分两组各10人。记录太极白鹤亮翅动作时双下肢10块骨骼肌表面肌电图、双下肢3大关节的二维角运动和COP在侧方和前后的移位。每次试验8 s完成,重复5次。统计处理后,做肌电运动和平衡分析;其中肌电数据做标准化处理,并比较太极拳运动员和初学者的异同。结果运动员组支撑腿胫骨前肌、股二头肌、臀中肌)的肌电活动表现为显著高于初学者同侧腿骨骼肌的肌电活动;运动员组虚步腿的腓肠肌和股直肌的肌电活动显著高于初学组同侧同名肌。运动员组下肢3大关节最大平均活动角度比初学组大,支撑腿髋关节显著高于初学组同侧同关节。运动员组COP前后方向位移显著小于初学组。结论运动员可以通过肌肉活动的增强对抗COP的移位,保持姿势平衡稳定,而初学者COP前后移位失控时并没表现出积极的肌肉活动。初步解释了太极拳练习能提高人体下肢肌肉力量和平衡控制能力的原因。展开更多
背景:当前针对患者骨健康/骨密度相关疾患结局指标的影响,传统太极功法干预仍然存在较大的争议,亟待作进一步探讨。目的:系统评价传统太极功法干预对改善骨密度流失的临床疗效与安全性。方法:通过计算机对中国知网CNKI、万方、维普VIP...背景:当前针对患者骨健康/骨密度相关疾患结局指标的影响,传统太极功法干预仍然存在较大的争议,亟待作进一步探讨。目的:系统评价传统太极功法干预对改善骨密度流失的临床疗效与安全性。方法:通过计算机对中国知网CNKI、万方、维普VIP和中国生物医学文献数据库、以及国外数据库PubMed、MEDLINE、EMbase、CochraneLibrary等进行全面检索;配合对大学图书馆的馆藏期刊进行手工检索,检索时间截于2019年1月;系统搜集传统太极功法(包括太极拳、太极推手、太极柔力球等)干预对骨健康/骨密度相关疾患结局指标影响的随机对照研究(RCT)文献。参考Cochrane系统评价方法进行文献筛选、资料提取以及方法学质量评价;并采用Rev Man 5.3软件进行Meta分析。结果与结论:共纳入14篇文献(16个RCT研究),Meta分析结果表明:接受传统太极功法干预后,脊柱腰椎L2-4骨密度(SMD=0.40,95%CI[0.16,0.65],P=0.001)、以及股骨颈骨密度(SMD=0.75,95%CI [0.27,1.24],P=0.002)改善方面均优于对照组;然而在Ward’s三角骨密度(SMD=0.50,95%CI[-0.10,1.10],P=0.10)、股骨干骨密度(SMD=0.16,95%CI[-0.11,0.44],P=0.25)、股骨近端转子骨密度(SMD=0.54,95%CI[-0.01,1.09],P=0.05)、以及桡骨远端1/3处骨密度(SMD=0.20,95%CI[-0.26,0.66],P=0.040)与对照组比较,组间差异无统计学意义;且传统太极功法干预尚未发现严重不良事件。当前证据发现,传统太极功法干预在特定人群(例如老年人、骨质疏松人群、围绝经期与绝经后妇女)脊柱腰椎、股骨颈等部位的骨密度流失改善方面疗效明确,不良反应较少。鉴于纳入文献数量偏少以及研究本身局限性,有待开展高质量的、设计严谨的临床试验予以进一步验证。展开更多
基金funded by the Shanghai City Committee of Science and Technology Key Project (No. 12490503200)the National Science Foundation for Distinguished Young Scholars of China (No. 81025022)
文摘Background: Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis(OA), little is known about its potential benefits on gait characteristics among older Chinese women who have a high prevalence of both radiographic and symptomatic knee OA. This study aims to assess the efficacy of a tailored Tai Ji Quan intervention on gait kinematics for older Chinese women with knee OA.Methods: A randomized controlled trial involving 46 older women in Shanghai, China, with clinically diagnosed knee OA. Randomized(1:1)participants received either a 60 min Tai Ji Quan session(n = 23) 3 times weekly or a 60 min bi-weekly educational session(n = 23) for 24 weeks.Primary outcomes were changes in gait kinematic measures from baseline to 24 weeks. Secondary outcomes included changes in scores on the Western Ontario and Mc Master University Osteoarthritis Index(WOMAC) and Short Physical Performance Battery(SPPB).Results: After 24 weeks the Tai Ji Quan group demonstrated better performance in gait velocity(mean difference, 8.40 cm/s, p = 0.01), step length(mean difference, 3.52 cm, p = 0.004), initial contact angle(mean difference, 2.19°, p = 0.01), and maximal angle(mean difference, 2.61°,p = 0.003) of flexed knees during stance phase compared to the control group. In addition, the Tai Ji Quan group showed significant improvement in WOMAC scores(p < 0.01)(mean difference,-4.22 points in pain, p = 0.002;-2.41 points in stiffness, p < 0.001;-11.04 points in physical function, p = 0.006) and SPPB scores(mean difference, 1.22 points, p < 0.001).Conclusion: Among older Chinese women with knee OA, a tailored Tai Ji Quan intervention improved gait outcomes. The intervention also improved overall function as indexed by the WOMAC and SPPB. These results support the use of Tai Ji Quan for older Chinese adults with knee OA to both improve their functional mobility and reduce pain symptomatology.
文摘目的通过对比太极拳初学者和太极拳运动员白鹤亮翅动作关节角度活动变化、压力中心(center of pres-sure,COP)变化和肌肉活动特点,分析运动员是如何通过肌肉活动控制其白鹤亮翅的姿势平衡。方法太极拳运动员和初学者分两组各10人。记录太极白鹤亮翅动作时双下肢10块骨骼肌表面肌电图、双下肢3大关节的二维角运动和COP在侧方和前后的移位。每次试验8 s完成,重复5次。统计处理后,做肌电运动和平衡分析;其中肌电数据做标准化处理,并比较太极拳运动员和初学者的异同。结果运动员组支撑腿胫骨前肌、股二头肌、臀中肌)的肌电活动表现为显著高于初学者同侧腿骨骼肌的肌电活动;运动员组虚步腿的腓肠肌和股直肌的肌电活动显著高于初学组同侧同名肌。运动员组下肢3大关节最大平均活动角度比初学组大,支撑腿髋关节显著高于初学组同侧同关节。运动员组COP前后方向位移显著小于初学组。结论运动员可以通过肌肉活动的增强对抗COP的移位,保持姿势平衡稳定,而初学者COP前后移位失控时并没表现出积极的肌肉活动。初步解释了太极拳练习能提高人体下肢肌肉力量和平衡控制能力的原因。
文摘背景:当前针对患者骨健康/骨密度相关疾患结局指标的影响,传统太极功法干预仍然存在较大的争议,亟待作进一步探讨。目的:系统评价传统太极功法干预对改善骨密度流失的临床疗效与安全性。方法:通过计算机对中国知网CNKI、万方、维普VIP和中国生物医学文献数据库、以及国外数据库PubMed、MEDLINE、EMbase、CochraneLibrary等进行全面检索;配合对大学图书馆的馆藏期刊进行手工检索,检索时间截于2019年1月;系统搜集传统太极功法(包括太极拳、太极推手、太极柔力球等)干预对骨健康/骨密度相关疾患结局指标影响的随机对照研究(RCT)文献。参考Cochrane系统评价方法进行文献筛选、资料提取以及方法学质量评价;并采用Rev Man 5.3软件进行Meta分析。结果与结论:共纳入14篇文献(16个RCT研究),Meta分析结果表明:接受传统太极功法干预后,脊柱腰椎L2-4骨密度(SMD=0.40,95%CI[0.16,0.65],P=0.001)、以及股骨颈骨密度(SMD=0.75,95%CI [0.27,1.24],P=0.002)改善方面均优于对照组;然而在Ward’s三角骨密度(SMD=0.50,95%CI[-0.10,1.10],P=0.10)、股骨干骨密度(SMD=0.16,95%CI[-0.11,0.44],P=0.25)、股骨近端转子骨密度(SMD=0.54,95%CI[-0.01,1.09],P=0.05)、以及桡骨远端1/3处骨密度(SMD=0.20,95%CI[-0.26,0.66],P=0.040)与对照组比较,组间差异无统计学意义;且传统太极功法干预尚未发现严重不良事件。当前证据发现,传统太极功法干预在特定人群(例如老年人、骨质疏松人群、围绝经期与绝经后妇女)脊柱腰椎、股骨颈等部位的骨密度流失改善方面疗效明确,不良反应较少。鉴于纳入文献数量偏少以及研究本身局限性,有待开展高质量的、设计严谨的临床试验予以进一步验证。
