Tai Chi and Parkinson’s disease (PD): A systematic overview of the scientific quality of the past systematic reviews

Background: Recurrent falls are a common phenomenon in Parkinson’s disease (PD) patients which leads to increased healthcare costs, poor quality of life, and caregiver burden. Through suitable exercise training fall in PD patients can be prevented or minimized. Aim of this review was to provide recent information of different intervention strategies to prevent falls in PD. Methodology: Electronic data base such as PubMed and Scopus indexed journals were searched from the past five year to retrieve recent evidence. Keywords such as Parkinson’s disease, fall prevention and rehabilitation were used. Only Systematic review and RCT were added for the higher-level evidence data extraction. Conclusion: Eexercise-based program and Tai chi were found to have positive evidences for preventing falls in PD patients. However, various mechanism behind the fall in PD as well as worsening of the symptoms as the result of disease progression may be the reason behind the negative results of some of the intervention.

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The effect of Tai Chi and Qigong on health-related quality of life in Parkinson’s disease

International Journal of Rehabilitation Research ◽

10.1097/mrr.0000000000000358 ◽

2019 ◽

Vol 42 (3) ◽

pp. 196-204 ◽

Cited By ~ 3

Author(s):

Oznur Fidan ◽

Gulce Kallem Seyyar ◽

Bahar Aras ◽

Ertugrul Colak ◽

Ozgen Aras

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Tai Chi ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Effectiveness of non-pharmacological falls prevention interventions for people with Multiple Sclerosis, Parkinson’s Disease and stroke: protocol for an umbrella review

HRB Open Research ◽

10.12688/hrbopenres.13023.1 ◽

2020 ◽

Vol 3 ◽

pp. 17

Author(s):

Nicola O'Malley ◽

Amanda M. Clifford ◽

Laura Comber ◽

Susan Coote

Keyword(s):

Multiple Sclerosis ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Systematic Reviews ◽

Neurological Diseases ◽

Evaluation Framework ◽

Falls Prevention ◽

Umbrella Review ◽

Prevention Interventions

Background: Falls are common among people with neurological diseases and are associated with many negative physical, psychosocial and economic consequences. Implementation of single diagnosis falls prevention interventions is currently problematic due to lack of participants and resources. Given the similarities in falls risk factors across stroke, Parkinson’s Disease (PD) and Multiple Sclerosis (MS), the development of an intervention designed for mixed neurological populations seems plausible and may provide a solution to current implementation challenges. This umbrella review aims to summarise the totality of evidence regarding the effectiveness of non-pharmacological falls prevention interventions for people with MS, PD and stroke and to identify the commonalities and differences between interventions that are effective for each disease to inform the development of an intervention for mixed diagnoses. Methods: This umbrella review will be conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Electronic databases and grey literature will be searched. Systematic reviews of randomised controlled trials (RCTS) and studies investigating the effects of non-pharmacological falls prevention interventions on falls outcomes among people with MS, PD and stroke will be included. Methodological quality of included reviews will be assessed using the Assessment of Multiple Systematic Reviews 2 tool. The Grading of Recommendations Assessments, Development and Evaluation framework will be used to rate the quality of evidence. A summary of evidence table and narrative synthesis will be utilised to clearly indicate the findings. Discussion: This umbrella review presents a novel and timely approach to synthesise existing falls literature to identify effective non-pharmacological interventions for people with MS, PD and stroke. Of importance, this umbrella review will use a robust methodology to explore the key differences and similarities in effective interventions for individuals with these neurological diseases to facilitate the development of an intervention for mixed neurological groups.

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The Efficacy of Tai Chi and Stretching Exercises Based on a Smartphone Application for Patients With Parkinson's Disease: A Protocol for a Randomized Controlled Trial

Frontiers in Neurology ◽

10.3389/fneur.2021.731606 ◽

2021 ◽

Vol 12 ◽

Author(s):

Renyan Ma ◽

Yuning Hou ◽

Yiyin Zhang ◽

Muyang He ◽

Song Gao ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Daily Living ◽

Tai Chi ◽

Smartphone Application ◽

Exercise Session ◽

Informed Consent Form ◽

Stretching Exercises

Introduction: Parkinson's disease (PD) is a common neurodegenerative disease that seriously impairs patients' quality of life, and increases the burden of patients and caregivers. Both drugs and exercise can alleviate its motor and non-motor symptoms, improving the quality of life for PD patients. Telehealth, an increasingly popular tool, makes rehabilitation accessible at home, overcoming the inconvenience of traffic and scheduling. Care-PD is a phone application designed for rehabilitation training, which provides Tai Chi and stretching exercises through tutorial videos as well as an online evaluation system. In this protocol, we will explore the efficacy of Tai Chi and stretching exercises as a PD rehabilitation therapy based on the smartphone application Care-PD.Methods and Analysis: A double-blind, parallel randomized controlled trial will be conducted in this study. The recruitment, intervention, and evaluation processes will be implemented through the Care-PD application. Persons with PD will fill out questionnaires on Activities of Daily Living (ADL), upload the latest case report, and sign the informed consent form in the application. Afterward, doctors and researchers will screen and enroll 180 participants who will be randomly (1:1:1) assigned to Tai Chi group, stretching exercises group, or control group. The subjects will participate in a 1-h exercise session three times per week for 12 weeks, ending with another 4 weeks of follow-up study. Each exercise session includes 10 min of warm-up, 45 min of exercise, and 5 min of cool-down. The primary outcomes are Motor Aspects of Experiences of Daily Living and the 39-item Parkinson's disease Questionnaire. The secondary outcomes include the 9-item Wearing-Off Questionnaire, the Freezing of Gait Questionnaire, the Caregiver Strain Index, Non-motor Experiences of Daily Living, ADL, and Morse Fall Scale. All assessments will be performed at baseline, week 12 and 16.Discussion: Care-PD integrates subject recruitment, intervention, and evaluation, providing a new perspective on clinical rehabilitation for persons with PD. This study will evaluate the efficacy of Tai Chi and stretching exercises on patients' quality of life and disease progression based on a smartphone application. We aim to provide a new rehabilitation training platform for persons with PD.Ethics and Dissemination: This study was approved by the Scientific Research Ethics Committee (102772020RT132) of Shanghai University of Sport. Data collection begins after the approval of the ethics committee. The participants must sign an informed consent form before enrollment. The results will be published in relevant journals, seminars, and be disseminated among rehabilitation practitioners and patients with PD.Clinical Trial Registration: Chinese Clinical Trial Registry, identifier [ChiCTR2100042096]. Registered on January 13, 2021.

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Doença de Parkinson: Revisão Clínica e Atualização

Acta Médica Portuguesa ◽

10.20344/amp.11978 ◽

2019 ◽

Vol 32 (10) ◽

pp. 661

Author(s):

Verónica Cabreira ◽

João Massano

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Neurodegenerative Disorder ◽

Clinical Findings ◽

Disease Biomarkers ◽

The Past ◽

Non Motor Symptoms ◽

Deep Brain

Parkinson’s disease is the second most common neurodegenerative disorder, and a significant increase in its prevalence in the past three decades has been documented. Environmental and genetic factors contribute to the pathophysiology of this disease, and 5% – 10% of cases have a monogenic cause. The diagnosis relies on clinical findings, supported by adequate testing. There is no absolute method to diagnose Parkinson’s disease in vivo, except for genetic testing in specific circumstances, whose usefulness is limited to a minority of cases. New diagnostic criteria have been recently proposed with the aim of improving diagnostic accuracy, emphasizing findings that might point to other causes of parkinsonism. The available therapeutic options are clinically useful, as they improve the symptoms as well as the quality of life of patients. After the introduction of levodopa, deep brain stimulation emerged as the second therapy with an important symptomatic impact in the treatment of Parkinson’s disease. Non-motor symptoms and motor complications are responsible for a large proportion of disability, so these should be identified and treated. Current scientific research is focused on the identification of disease biomarkers allowing correct and timely diagnosis, and on creating more effective therapies, thus fulfilling current clinical unmet needs. This paper presents an updated review on Parkinson’s disease, guiding the readership through current concepts, and allowing their application to daily clinical practice.

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A Meta-Analysis on the Efficacy of Tai Chi in Patients with Parkinson’s Disease between 2008 and 2014

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/593263 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 15

Author(s):

Ji Zhou ◽

Tao Yin ◽

Qian Gao ◽

Xiao Cun Yang

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Function ◽

Tai Chi ◽

Meta Analysis ◽

Sufficient Evidence ◽

Gait Velocity ◽

Valid Evidence

Objective. The purpose of this systematic review is to evaluate the evidence on the effect of Tai Chi for Parkinson’s disease (PD).Methods. Six electronic databases up to June 2014 were searched. The methodological quality was assessed with PEDro scale. Standardised mean difference and 95% confidence intervals of random-effects model were calculated.Results. Nine studies were included in our review. The aggregated results are in favor of Tai Chi on improving motor function (P=0.002) and balance (P<0.00001) in patients with PD. However, there is no sufficient evidence to support or refute the value of Tai Chi on improving gait velocity (P=0.11), stride length (P=0.21), or quality of life (P=0.40). And there is no valid evidence in follow-up effects of Tai Chi for PD. Conclusion. The current results suggest that Tai Chi can significantly improve the motor function and balance in patients with PD, but there is indeed not enough evidence to conclude that Tai Chi is effective for PD because of the small treatment effect, methodological flaws of eligible studies, and insufficient follow-up. Consequently, high-quality studies with long follow-up are warranted to confirm current beneficial findings.

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Non-motor signs in Parkinson’s disease: a review

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20150029 ◽

2015 ◽

Vol 73 (5) ◽

pp. 454-462 ◽

Cited By ~ 41

Author(s):

Renato P. Munhoz ◽

Adriana Moro ◽

Laura Silveira-Moriyama ◽

Helio A. Teive

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Current Knowledge ◽

Early Recognition ◽

The Other ◽

Motor Disorder ◽

The Past ◽

Sensory Disturbances

During the past decade the view of Parkinson’s disease (PD) as a motor disorder has changed significantly and currently it is recognized as a multisystem process with diverse non-motor signs (NMS). In addition to been extremely common, these NMS play a major role in undermining functionality and quality of life. On the other hand, NMS are under recognized by physicians and neglected by patients. Here, we review the most common NMS in PD, including cognitive, psychiatric, sleep, metabolic, and sensory disturbances, discuss the current knowledge from biological, epidemiological, clinical, and prognostic standpoints, highlighting the need for early recognition and management.

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The Impact of Tai Chi on Motor Function, Balance, and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/6637612 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Xing Yu ◽

Xinze Wu ◽

Guozhen Hou ◽

Peipei Han ◽

Liying Jiang ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Function ◽

Methodological Quality ◽

Tai Chi ◽

Meta Analysis ◽

Gait Velocity

Objective. Parkinson’s disease adversely affects function and quality of life, leading to increased mortality. The practice of Tai Chi has been associated with multifaceted improvements in health-related fitness. Considering the limited number of clinical studies included in previous reviews, inconsistent methodological quality, and inconclusive results, this meta-analysis aims to assess the effects of Tai Chi in patients with Parkinson’s disease. Method. Four English language databases and four Chinese databases were systematically searched for existing randomized controlled trials (RCTs) of Tai Chi in Parkinson’s disease from database inception through August 1, 2020. Methodological quality was appraised with the Cochrane Risk of Bias tool. A meta-analysis of comparative effects was performed using the Review Manager v.5.3 software. Results. Seventeen published RCTs totaling 951 subjects were included. Results showed that Tai Chi has a statistically significant effect on the outcomes of gait velocity, unified Parkinson’s disease rating scale (UPDRS) motor score, activities-specific balance confidence (ABC) score, and Berg Balance Scale (BBS). The effects on the Timed Up and Go Test (TUGT) and Parkinson’s Disease Questionnaire-39 (PDQ-39) were not statistically significant. Conclusions. This systematic review and meta-analysis of Parkinson’s disease and Tai Chi suggests Tai Chi is a relatively safe activity that can result in gains in general motor function and improve bradykinesia and balance. It has no statistically significant advantage for quality of life and functional mobility. Further randomized trials with larger sample sizes and of higher methodological quality are needed to confirm these results and to assess the feasibility of Tai Chi intervention for potential different clinical applications.

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A Mobile Phone App-Based Tai Chi Training in Parkinson's Disease: Protocol for a Randomized Controlled Study

Frontiers in Neurology ◽

10.3389/fneur.2020.615861 ◽

2021 ◽

Vol 11 ◽

Author(s):

Song Gao ◽

Keneilwe Kenny Kaudimba ◽

Jiaxin Cai ◽

Yao Tong ◽

Qianqian Tian ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Clinical Trial ◽

Parkinson's Disease ◽

Mobile Phone ◽

Tai Chi ◽

Secondary Outcome ◽

Controlled Study ◽

Experimental Group

Introduction: With an increasing number of China's aging population, Parkinson's disease (PD) increases year by year. Persons with PD exhibit abnormal balance functions, leading to motor skills difficulties, such as unstable walking or even falling. Therefore, activities of daily living and quality of life are affected. This study aims to explore the effectiveness of Tai Chi training based on the mobile phone app in improving the balance ability of persons with PD.Methods and Analysis: A randomized, single-blind, parallel controlled trial will be conducted in this study. One hundred forty-four persons with PD who meet the inclusion criteria will be randomly divided into a 1:1:1 ratio: (1) control group, (2) basic experimental group (basic app with no Tai Chi training features), and (3) balanced-enhanced experimental group (basic app with Tai Chi training features). Individuals with PD will be evaluated on balance and motor function outcomes. The primary outcome measure is the limits of stability (including the maximum excursion and direction control); the secondary outcome measures include the Unified Parkinson's Disease Rating Scale III (UPDRS-III), Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up & Go (TUG), 6-Minute Walk Test (6MWT), and 39-item Parkinson's Disease Questionnaire (PDQ-39). Each group of patients will go through an assessment at baseline, 17 and 33 weeks.Discussion: This study will evaluate the effectiveness of the mobile phone app Tai Chi training on the balance function of persons with PD. We assume that a challenging Tai Chi project based on a mobile phone app will improve balance in the short and long term. As walking stability progresses, it is expected that daily activities and quality of life improve. These findings will be used to improve the effectiveness of future home management measures for persons with PD.Ethics and Dissemination: This study has been approved by the ethical review committee of the Shanghai University of Sport (approval number: 102772019RT056). Informed consent will be obtained from all participants or their guardians. The authors intend to submit the study findings to peer-reviewed journals or academic conferences to be published.Clinical Trial Registration: Chinese Clinical Trial Registry (ChiCTR2000029135).

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