Effects of traditional Chinese exercises on blood glucose and hemoglobin A1c levels in patients with prediabetes: A systematic review and meta-analysis

Background:Traditional Chinese exercises(TCEs)have a positive effect on glycemic control and hemoglobin A1 c(HbA1 c),but there is no consensus on the benefits of TCEs for patients with prediabetes.Objective:The objective of this study was to systematically investigate the effects of TCEs on blood glucose control in patients with prediabetes.Search strategy:Comprehensive retrieval of randomized controlled trials(RCTs)was carried out using PubMed,Cochrane Library,Embase,China National Knowledge Infrastructure,VIP Database for Chinese Technical Periodicals,Wanfang Data Knowledge Service Platform,China Biology Medicine disc,Google Scholar and Baidu academic databases.The retrieval window ranged from the establishment of the database to December 2018,and references related to the included trials were searched without language restrictions.Inclusion criteria:The study included RCTs with a clinical diagnosis of prediabetes that was also treated with TCEs.Data extraction and analysis:Literature screening,data extraction and literature quality assessment were performed independently by two researchers.In the case of disagreement,a third party was invited to negotiate and make a decision.Standardized mean difference(SMD)was used to estimate the therapeutic effect.Meta-analysis was performed using Review Manager 5.3.5 and Stata 15.0.Heterogeneity was assessed using Q test and I2,and the source of heterogeneity was determined using Galbraith diagram and sensitivity analysis.A Q test resulting in P<0.1 and I2>50%indicated significant difference and random effect model analysis was performed.Otherwise,a fixed effect model was applied.Begg’s and Egger’s tests were used to assess publication bias.Results:Nine RCTs involving 485 participants were included in this study.The results showed that TCEs could reduce fasting blood glucose(FBG),2 h blood glucose(2 hPBG)and HbA1 c in patients with prediabetes.The treatment subgroup showed that an intervention of 6 months had better results,while the Gongfa subgroup showed that the TCE Baduanjin yielded better results.(1)FBG:SMD=à0.73,95%confidence interval(CI)[à0.97,à0.50],P<0.00001;Baduanjin:SMD=à0.83,95%CI[à1.13,à0.53],P<0.00001;6-month treatment:SMD=à0.73,95%CI[à1.20,à0.26],P=0.002.(2)2 hPBG:SMD=à0.75,95%CI[à0.94,à0.57],P<0.00001;Baduanjin:SMD=à0.62,95%CI[à0.91,à0.32],P<0.00001;6-month treatment:SMD=à0.91,95%CI[à1.39,à0.44],P=0.0002.(3)HbA1 c:SMD=à0.56,95%CI[à0.89,à0.23],P=0.00008;Baduanjin:SMD=à0.46,95%CI[à0.83,à0.08],P=0.02;6-month treatment:SMD=à0.77,95%CI[à1.24,à0.29],P=0.002.Conclusion:TCEs had positive effects in improving blood glucose levels in patients with prediabetes.Hence,TCEs may be of potential therapeutic value for patients with prediabetes,as an adjuvant therapy along with other treatments.Although the evidence suggests that the intervention is effective for6 months,the mechanism of TCEs on glycemic control,the minimum exercise dose and their safety remain to be further studied.

Effects of traditional Chinese exercises and general aerobic exercises on older adults with sleep disorders: A systematic review and meta-analysis

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:Pub Med,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,I2=82%;15 studies,n=1063)and GAEs(WMD=-2.88,95%CI[-5.22,-0.55],P<0.001;heterogeneity:P<0.001,I2=98%;5 studies,n=500)significantly improved total sleep quality,having favorable effects on subjective sleep quality,sleep latency,sleep duration,habitual sleep efficiency,sleep disturbance,use of sleep medication and daytime dysfunction.Subgroup analysis showed that TCEs demonstrated superiority after 12 weeks(WMD=-2.77,95%CI[-4.26,-1.28],P<0.001;heterogeneity:P<0.001,I2=85%;5 studies,n=420)and Qigong had a greater intervention effect for improving the sleep quality of older adults than Tai Chi(WMD=-3.37,95%CI[-4.38,-2.35],P<0.001;heterogeneity:P=0.04,I2=63%;4 studies,n=321).Meta-regression revealed that the year of publication,sample size,mean age of participants,and percentage of females in the primary studies did not account for the overall heterogeneity.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 highquality RCTs are needed to arrive at reliable conclusions.

Effects of Tai Chi in diabetes patients: Insights from recent research

Tai Chi,a practice that combines elements of both exercise and mindfulness,offers a wide range of health benefits.The body of evidence concerning the impact of Tai Chi on diabetes has recently been growing.This editorial aims to provide a concise summary of the current state of evidence for Tai Chi's effects on individuals with type 2 diabetes(T2D).The review includes 3 randomized controlled trials(RCTs)and 5 systematic reviews and meta-analyses,all of which investigate the effectiveness of Tai Chi on various health outcomes in individuals with T2D.Tai Chi demonstrates a significant effect to enhance glycemic control,lower blood pressure,improve serum lipid profiles,reduce insulin resistance,positively influence obesity-related indices,and improve overall quality of life in individuals with T2D.However,it is noteworthy that recent RCTs have reported inconsistent findings regarding the effects of Tai Chi on glycemic control and insulin resistance.The author also delves into potential mechanisms by which Tai Chi may exert its influence on the human body.Finally,the editorial highlights the critical issues that warrant further exploration in the future.

Effect of Chinese Traditional Healthcare Exercises on 136 Junior School Students

Objective： To observe the physiological and psychological effects of Chinese traditional healthcare exercises （CTHE） on the adolescents. Methods： A total of 136 healthy students of junior school were recruited and randomly divided into the test group （68 cases） and the control group （68 cases）. The subjects in the test group practiced CTHE, while those in the control group did ＂the 8th radio calisthenics＂, an official recommended calisthenics for promoting healthcare in China, 3 times a week, and 7 weeks practicing overall. The general body function examination and the meridian energy detection system were used to determine the effects of the two groups. Results： （1） After exercise, the chest circumference and heart rate were increased significantly （P〈0.01）, and both the systolic pressure （SP） and diastolic pressure （DP） were decreased significantly （P〈0.01）, while the weight had no significant change （P〉0.05） in the test group. In the control group, the chest circumference, the SP and DP had no significant improvement （P〉0.05）, while the heart rate was significantly increased and the weight was significantly decreased （P〈0.01）. （2） The test group achieved significant positive changes in the performance status, state of mind and fatigue index （P〈0.01 or P〈0.05）, while the control group only achieved a significant positive change in performance status （P〈0.01）, and a negative significant decrease in the autonomic nerve function （P〈0.05）. Conclusion： Junior school students would get physiological and psychological benefit from practicing CTHE, and which is suitable for them to practice.