Effect of Tai Chi on Physical Function, Fall Rates and Quality of Life Among Older Stroke Survivors

Background: Poor physical function and quality of life are ubiquitous post-stroke. Effective interventions to improve physical function and quality of life for stroke survivors are critically needed. Objective: Examine the effect of a Tai Chi (TC) intervention on physical function and quality of life. Methods: In a single-blind randomized clinical trial community-dwelling stroke survivors, aged ≥ 50 years and ≥ 3 months post-stroke, were assigned to: Yang style 24-posture TC (n=53), SilverSneakers® (SS, n=44) strength and range of movement exercise, or Usual Care (UC, n=48) for 12 weeks. TC and SS attended a 1-hour class 3 times/week, while UC had weekly phone calls. Standardized measures for Physical Function were the Short Physical Performance Battery (SPPB), Fall Rates and 2-Minute StepTest; and for Quality of Life were the Medical Outcomes Study SF-36, Center for Epidemiological Studies Depression and Pittsburgh Sleep Quality Index. Results: A total of 145 stroke survivors (47% women, mean age=70 years, time post-stroke=3 years, ischemic stroke=66%, hemiparesis=73%) enrolled. During the intervention, TC participants had 2/3 fewer falls (n=5 falls), than the SS (n=14 falls) and UC (n=15 falls) groups (χ2=5.60, p=0.06). All groups had improvements in the SPPB score (F 1,142 =85.29, p<0.01), after the 12-week intervention. Post-hoc tests following a significant interaction for the 2-Minute StepTest (F 2,142 =4.69, p<0.01) indicated TC (t 53 =2.45, p=0.02) and SS (t 44 =4.63, p<0.01) groups had significantly better aerobic endurance over time, though the UC group did not (t 48 =1.58, p=0.12). All groups reported better perceived physical (SF-36 PCS, F 1,142 =4.15, p=0.04) and mental health (SF-36 MCS, F 1,142 =15.60, p<0.01), after the intervention. There were no significant within group changes in perceived physical health (p>0.05), while significant improvements in perceived mental health (p < 0.05) were observed within all groups. No significant changes in depressive symptoms or sleep quality were observed (p>0.05). Attrition was 10% (n=14), and intervention adherence rates were 85%. Conclusions: Goals of stroke rehabilitation are to prevent disability, improve physical function and quality of life. TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention may be more effective in reducing fall rates than SS or UC. Future studies examining the effectiveness of TC to reduce fall rates; and improve physical function and quality of life for community-dwelling stroke survivors are recommended.

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Prevalence and correlates of depression among black and Latino stroke survivors with uncontrolled hypertension: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-040461 ◽

2020 ◽

Vol 10 (12) ◽

pp. e040461

Author(s):

Adebayo O Ogunlade ◽

Stephen K Williams ◽

Jennifer Joseph ◽

Deborah O Onakomaiya ◽

Joseph P Eimicke ◽

...

Keyword(s):

Quality Of Life ◽

Physical Function ◽

Functional Independence ◽

Uncontrolled Hypertension ◽

Stroke Survivors ◽

Foreign Born ◽

Poststroke Depression ◽

Link Type ◽

Patient Reported

ObjectiveTo examine the prevalence and correlates of depression in a cohort of black and Hispanic stroke survivors with uncontrolled hypertension.SettingBaseline survey data from 10 stroke centres across New York City.ParticipantsBlack and Hispanic stroke survivors with uncontrolled hypertension (n=450).Outcome measuresDepressive symptoms were assessed with the 8-item Patient Reported Outcomes Measurement Information System (PROMIS) measure. Depression was defined as a PROMIS score ≥55. Other data collected included clinical factors, health-related quality of life (EuroQoL five dimensions (EQ-5D)), functional independence (Barthel Index, BI), stroke-related disability (Modified Rankin Score), physical function (PROMIS Physical Function) and executive functioning (Frontal Assessment Battery).ResultsThe mean age was 61.7±11.1 years, 44% of participants were women and 51% were black. Poststroke depression was noted in 32% of the cohort. Examining bivariate relationships, patients with depression were observed to have poorer function and quality of life as evidenced by significantly lower PROMIS physical function scores (36.9±8.32 vs 43.4±10.19, p<0.001); BI scores (79.9±19.2 vs 88.1±15.1, p<0.001); EQ-5D scores (0.66±0.24 vs 0.83±0.17, p<0.001) and higher Rankin scores (2.10±1.00 vs 1.46±1.01, p<0.001) compared with those without depression. Multivariate (model adjusted) significant correlates of depression included lower self-reported quality of life (OR=0.02 (CI 0.004 to 0.12) being younger (OR=0.94; 95% CI 0.91 to 0.97); not married (OR=0.46; CI 0.24 to 0.89)); and foreign-born (OR=3.34, 95% CI 1.4 to 7.97). There was a trend for higher comorbidity to be uniquely associated with depression (≥3 comorbid conditions, OR=1.49, 95% CI 1.00 to 2.23).ConclusionsPoststroke depression is common among black and Hispanic stroke survivors with higher rates noted among foreign-born patients and those with high comorbidity. These findings highlight the importance of screening for depression in minority stroke survivors.Trial registration numberhttp://www.clinicaltrials.gov. Unique identifier: NCT01070056.

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The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs

Clinical Rehabilitation ◽

10.1177/0269215517691083 ◽

2017 ◽

Vol 31 (5) ◽

pp. 582-595 ◽

Cited By ~ 29

Author(s):

Lucie Brosseau ◽

Jade Taki ◽

Brigit Desjardins ◽

Odette Thevenot ◽

Marlene Fransen ◽

...

Keyword(s):

Quality Of Life ◽

Pain Relief ◽

Knee Osteoarthritis ◽

Physical Function ◽

Tai Chi ◽

Statistical Significance ◽

Clinical Importance ◽

Exercise Programs ◽

High Quality

Objective: To identify effective mind-body exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning non-traditional land-based exercises for knee osteoarthritis. Methods: A systematic search and adapted selection criteria included comparative controlled trials with mind-body exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement). Results: The four high-quality studies identified demonstrated that various mind-body exercise programs are promising for improving the management of knee osteoarthritis. Hatha Yoga demonstrated significant improvement for pain relief (Grade B) and physical function (Grade C+). Tai Chi Qigong demonstrated significant improvement for quality of life (Grade B), pain relief (Grade C+) and physical function (Grade C+). Sun style Tai Chi gave significant improvement for pain relief (Grade B) and physical function (Grade B). Conclusion: Mind-body exercises are promising approaches to reduce pain, as well as to improve physical function and quality of life for individuals with knee osteoarthritis.

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Effects of tai chi exercise on posturography, gait, physical function and quality of life in postmenopausal women with osteopaenia: a randomized clinical study

Clinical Rehabilitation ◽

10.1177/0269215510375902 ◽

2010 ◽

Vol 24 (12) ◽

pp. 1080-1090 ◽

Cited By ~ 29

Author(s):

Ming-Chien Chyu ◽

C. Roger James ◽

Steven F Sawyer ◽

Jean-Michel Brismée ◽

Ke T Xu ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Study ◽

Physical Function ◽

Postmenopausal Women ◽

Tai Chi ◽

Randomized Clinical Study ◽

Tai Chi Exercise

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Determinants of caregiving burden and quality of life of informal caregivers of African stroke survivors: literature review

International Journal on Disability and Human Development ◽

10.1515/ijdhd-2016-0041 ◽

2017 ◽

Vol 16 (3) ◽

Cited By ~ 2

Author(s):

Umaru M. Badaru ◽

Omoyemi O. Ogwumike ◽

Ade F. Adeniyi ◽

Ekechukwu E. Nelson

Keyword(s):

Quality Of Life ◽

Functional Status ◽

Physical Function ◽

Informal Caregivers ◽

Stroke Survivors ◽

Inclusion Criteria ◽

Caregiving Burden ◽

Provision Of Care ◽

And Training

AbstractBackground:The involvement of informal caregivers (CGs) in the provision of care for stroke survivors always ensures the success of stroke rehabilitation.Aims:The aim of this review was to find the determinants of caregiving burden and quality of life (QOL) of CGs of African stroke survivors.Methods:The literature was searched in Google Scholar and PUBMED, AJOL and Cochrane Databases using selected search strategies without date restriction.Results:A total of eight African studies met the inclusion criteria. There were more female stroke CGs (55.6%) than their male counterparts. The determinants of CG QOL were duration and burden of caregiving, the CG’s age and functional status of the stroke survivors. The determinants of caregiving burden were functional status of stroke survivors and having intimate relationship with them.Conclusion:Impairment of physical function in African stroke survivors was the consistent determinant of increased caregiving burden and deterioration of CG QOL. CG education and training is needed in order to enhance their ability to cope effectively with the burden of providing care to stroke survivors who have impairment of physical function and this may help to improve CG QOL.

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Effects of a Tai Chi-Based Stroke Rehabilitation Program on Symptom Clusters, Physical and Cognitive Functions, and Quality of Life: A Randomized Feasibility Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105453 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5453

Author(s):

Rhayun Song ◽

Moonkyoung Park ◽

Taejung Jang ◽

Jiwon Oh ◽

Min Kyun Sohn

Keyword(s):

Quality Of Life ◽

Cognitive Function ◽

Cognitive Functions ◽

Stroke Rehabilitation ◽

Tai Chi ◽

Self Care ◽

Rehabilitation Program ◽

Symptom Clusters ◽

Stroke Survivors

Stroke survivors suffer from disease-associated symptoms. Tai Chi can be a beneficial approach to provide an adapted form of intervention to manage their symptoms. The study aimed to determine the effects of a Tai Chi-based stroke rehabilitation program on symptom clusters, physical and cognitive functions, and stroke-specific quality of life among stroke survivors in Korea. Thirty-four stroke survivors were randomly assigned to receive either the Tai Chi-based program or the stroke-symptom management program. The feasibility of the program and its effects on the outcomes were assessed at baseline, 3 months, and 6 months. Repeated measures ANOVA showed that most symptoms improved in both groups during the 6-month period, but swallowing-related symptoms improved significantly in the Tai Chi group. Based on the interaction effect, Tai Chi was more effective on flexor muscle strength, ambulation, and activities of daily living and cognitive function over 6 months than their counterparts. Among SS-QOL dimensions, the Tai Chi group showed significant improvements in the thinking and self-care dimensions. The Tai Chi-based stroke rehabilitation program was feasible and safely applicable to stroke survivors in the community settings. This program could improve symptoms, physical and cognitive function, leading to improvements in the self-care dimension of the SS-QOL among stroke survivors.

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