Effectiveness of Messenger Plants (Peperomia Pellucida L.) and Tai Chi Exercise as Modality Therapy for Gout Sufferers: Literature review

Hyperuricemia correlated with an increase in monosodium urate crystals, which was a precipitating factor for gout arthritis. In Indonesia, this disease was more common in individuals over 34 years of age. The elderly who had gout can be associated with metabolic syndrome and increase the risk of cardiovascular disease. Pharmacological therapy of gout, such as allopurinol, had a greater potential to cause side effects in patients than complementary therapy. This article aimed to determine the effectiveness of the messenger plant (Peperomia pellucida) and Tai Chi exercise in overcoming hyperuricemia. The writing method used was a literature review. Articles were obtained through search sites: Google Scholar, Science-Direct, and NCBI, and the criteria used in the search were Indonesian and English with a range of publication years 2014-2020. Eight main journals were used as references; from these journals, it was concluded that Peperomia pellucida could inhibit the formation of uric acid with xanthine oxidase activity through its quercetin-type flavonoid content, while Tai Chi exercise could increase joint flexibility and blood circulation in patients with gout. Therefore, these therapies can be used as a reference for complementary therapy for individuals with hyperuricemia to help manage uric acid levels and reduce the risk of developing gouty arthritis.

Meta-Analysis of Elderly Lower Body Strength: Different Effects of Tai Chi Exercise on the Knee Joint-Related Muscle Groups

Importance. Tai Chi exercise mostly involves muscle fitness with biological, biomechanical, and psychosomatic medicine in elderly rehabilitation. Increased incidents related to elderly muscle fitness deficiency tend to be an urgent public health issue. However, there is a controversy on the effects of Tai Chi exercise on muscle fitness, especially the lower body strength of the elderly. Objective. To determine whether lower body strength such as keen extension and flexion strength may be improved by Tai Chi exercise in older adults from the perspective of evidence-based medicine. Methods. Databases of PubMed, Embase, and Cochrane Library were searched up to July 1, 2021. Randomized clinical trials are adopted to compare Tai Chi exercise with sedentary behavior or other low intensity exercise in terms of influence on lower body strength rehabilitation, especially keen extension and flexion strength in people aged over 60. A meta-analysis was performed to discuss outcomes of lower body strength, knee muscle strength, and knee extension/flexion strength. Results. A total of 25 randomized trials involving 1995 participants fulfilled the inclusion criteria. (1) Tai Chi exercise significantly improved elderly lower body strength (−0.54, [−0.81, −0.28], p < 0.00001 , I2 = 74%), but there was no differential improvement in the strength of the knee joints (0.10, [−0.02, 0.23], p = 0.11 , I2 = 34%). (2) Elderly individual lower body strength declined with age, while this trend was suppressed by Tai Chi exercise (−0.35, [0.14, 0.56], p = 0.001 , I2 = 70%). (3) Although Tai Chi exercise did no significantly improve the large muscle group of knee joint extensor like quadriceps femoris (3.15, [−0.69, 6.99], p = 0.24 , I2 = 26%), it showed marked enhancement to the strength of deep small muscle group of knee joint flexor (10.25, [6.90, 13.61], p < 0.00001 , I2 = 0%). The heterogeneity might be caused by distinguished measurements of muscle strength. Therefore, Tai Chi exercise specifically enhanced some certain muscle strength of knee joints and improved muscle fitness rehabilitation as well as function activity for elderly. Conclusions. In this RCT meta-analysis, Tai Chi exercise has positive effects on lower body strength of elderly. Although no obvious improvement on the knee extensor is observed, it may be used as a rehabilitation treatment for training stable deep muscle groups to improve the knee flexion strength significantly.

Stroke Survivors’ Personal Efficacy Beliefs and Outcome Expectations of Tai Chi Exercise: A Qualitative Descriptive Study

Prior qualitative research conducted among stroke survivors to explore the potential benefits and challenges of participating in tai chi exercise during stroke recovery is limited to those without depression. A qualitative descriptive approach was used. Social Cognitive Theory and Complex Systems Biology provided the theoretical framework, with focus group interview data collected from stroke survivors after participation in a tai chi intervention. Due to COVID-19, the focus group interview was conducted via online video conferencing. Content analysis of the de-identified transcript was conducted with a-priori codes based on the theoretical framework and inductive codes that were added during the analysis process. Lincoln and Guba’s criteria were followed to ensure trustworthiness of the data. Community-dwelling stroke survivors (n = 7) participating in the focus group interviews were on average 68 years old, mainly retired (71%, n = 5), married women (57%, n = 4) with >13 years education (86%, n = 6). The three major themes were: personal efficacy beliefs, tai chi intervention active ingredients, and outcome expectations. Social Cognitive Theory underscored stroke survivors’ personal efficacy beliefs, behavior, and outcome expectations, while Complex Systems Biology highlighted the active ingredients of the tai chi intervention they experienced. Participation in the 8-week tai chi intervention led to perceived physical, mental, and social benefits post stroke.

A community-centric multi-disciplinary education program with the 8-section brocade Tai Chi therapy for patients with osteoarthritis of the knee – a pilot study

Background Osteoarthritis (OA) of the knee is one of the most common chronic degenerative joint diseases, and a multi-disciplinary approach to educating patients with OA knee are effective in symptoms management. Tai Chi exercise is a novel approach to relieving knee OA symptoms. Combining both educational program and Tai Chi has not yet been explored. Methods Multi-disciplinary education program included a total of 4-week 2-h weekly talks delivered by different health professionals with live demonstrations. This was then followed by a 1-h Tai Chi class (Baduanjin). Results from IPAQ (Physical activity level), WOMAC (evaluate knee OA conditions), and SF-36v2 (quality of life) were collected at the first class of education program, 3 and 6 months after the end of Tai Chi class. CSQ-8 (program effectiveness) was administered on the last day of Tai Chi class. Results One hundred and twelve patients joined the program. The overall attendance was over 90% with close-to-zero dropout rate. Satisfaction scored high in 85% of patients. WOMAC pain scores (p = 0.04) and SF-36v2 emotional role (p = 0.02) were statistically decreasing (improving) at 6 months after the program. SF-36v2 physical role and mental health tended to improve with time. Conclusions Combining both multidisciplinary education program program and Tai Chi exercise for knee OA patients was proven feasible. This program received high satisfaction, high attendance and very low dropout rates without any adverse event. Patients’ pain and emotion were significantly improved. A large-scale randomized trial introducing a control group is recommended. Trial registration Registry: ClinicalTrials.gov Registration number: NCT04204213 Date of registration: 18/12/2019 (Retrospectively registered)

Tai Chi as a Therapy of Traditional Chinese Medicine on Reducing Blood Pressure: A Systematic Review of Randomized Controlled Trials

Objective. This study systematically evaluated the effects of Tai Chi exercise on blood pressure, body mass index (BMI), and quality of life (QOL) in patients with hypertension. A meta-analysis was performed to provide a reliable reference for clinical practice. Methods. We searched for randomized controlled trials (RCTs) in five English databases and two Chinese databases, with the earliest data dated December 5, 2020. A quality assessment of the methods and a meta-analysis were also conducted. Results. The meta-analysis of 24 studies showed that the intervention group showed better outcomes in terms of systolic blood pressure (SBP) (SMD −1.05, 95% CI −1.44 to −0.67, P ≤ 0.001 ; I2 = 93.7%), diastolic blood pressure (DBP) (SMD −0.91, 95% CI −1.24 to −0.58, P ≤ 0.001 ; I2 = 91.9%), and QOL (physical functioning (SMD 0.86, 95% CI 0.36 to 1.37, P = 0.001 ; I2 = 91.3%), role-physical (SMD 0.86, 95% CI 0.61 to 1.11, P ≤ 0.001 ; I2 = 65%), general health (SMD 0.75, 95% CI 0.32 to 1.17, P = 0.001 ; I2 = 88.1%), bodily pain (SMD 0.65, 95% CI 0.29 to 1.00, P ≤ 0.001 ; I2 = 83.1%), vitality (SMD 0.71, 95% CI 0.34 to 1.07, P ≤ 0.001 ; I2 = 84.3%), social functioning (SMD 0.63, 95% CI 0.07 to 1.19, P = 0.027 ; I2 = 93.1%), role-emotional (SMD 0.64, 95% CI 0.22 to 1.06, P = 0.003 ; I2 = 88.1%), and mental health (SMD 0.73, 95% CI 0.31 to 1.16, P = 0.001 ; I2 = 88.2%)) compared to those of the control group. However, no significant improvements were seen in BMI of the intervention group (SMD −0.08, 95% CI −0.35 to −0.19, P = 0.554 ; I2 = 69.4%) compared to that of the control group. Conclusion. Tai Chi is an effective intervention to improve SBP and DBP in patients with essential hypertension.

Impacts of tai chi exercise on functional fitness in community-dwelling older adults with mild degenerative knee osteoarthritis: a randomized controlled clinical trial

Background Degenerative osteoarthritis (OA) often leads to pain and stiffness of the affected joints, which may affect the physical performance and decrease the quality of life of people with degenerative knee OA. Compared to traditional exercise, tai chi is a safe exercise with slow movements which can facilitate physical functioning and psychological well being, and might be suitable for improving the physical activities of older adults with knee OA. Therefore, this study investigated the impacts of tai chi exercise on the functional fitness of community-dwelling older adults with degenerative knee OA. Methods Sixty-eight community-dwelling older adults with knee OA were recruited from the local community to participate in this randomized controlled clinical trial. All subjects were randomly assigned to either an TCE group that practiced tai chi exercise (TCE) (n = 36) or a control group (CON) (n = 32) that received regular health education programs twice per week for 12 weeks. Outcome measurements were determined using functional fitness tests before and after the intervention, including a 30-s chair stand (number of repeats), 30-s arm-curl (number of repeats), 2-min step (number of steps), chair sit-and-reach (reaching distance, cm), back-scratch flexibility (distance between hands, cm), single-leg stand (time, s), functional reach (reaching distance, cm), 8-foot up-and-go (time, s), and 10-m walk tests (time, s). Pre-post comparisons of functional fitness were analyzed using the ANCOVA test with SPSS software version 18.0. Results Results revealed that participants’ functional fitness in the TCE group had significantly higher adjusted mean post-tests scores than that in the CON group after the intervention, including the 8-foot up-and-go (s) (mean difference [MD]=-2.92 [-3.93, -1.91], p = 2.39*10− 7), 30-s arm curl (MD = 4.75 (2.76, 6.73), p = 1.11*10− 5), 2-min step (MD = 36.94 [23.53, 50.36], p = 7.08*10− 7), 30-s chair stand (MD = 4.66 [2.97, 6.36], p = 6.96*10− 7), functional-reach (MD = 5.86 [3.52, 8.20], p = 4.72*10− 6), single-leg stand with eyes closed (MD = 3.44 [1.92, 4.97], p = 2.74*10− 5), chair sit-and-reach (MD = 3.93 [1.72, 6.15], p = 0.001), and single-leg stand with eyes opened (MD = 17.07 [6.29, 27.85], p = 0.002), with large effect sizes (η²=0.14 ~ 0.34). Conclusions Community-dwelling older adults with knee OA in the TCE group had better functional fitness performances after the 12-week tai chi intervention than those receiving only health education.

Changes in symptoms, sleep, oxidative stress, and inflammatory markers among community-dwelling stroke survivors after a tai chi exercise intervention

Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Laurence B. Emmons Research Award Background Depression is prevalent among one-third to two-thirds of stroke survivors. Despite the availability of pharmacotherapies and/or psychotherapies, depression persists, even 5-10 years post-stroke, reflecting limited treatment responses and/or adherence to this conventional care. Mind-body interventions are commonly used among adults to ameliorate depressive symptoms, thus we investigated the feasibility of Tai Chi, alongside conventional care, to manage post-stroke depression. Purpose Describe changes in symptoms of depression, anxiety and stress, sleep, oxidative stress, and inflammatory markers post-intervention among community-dwelling stroke survivors with depressive symptoms. Methods In this feasibility study, a single-group pre-post intervention design was used. Due to COVID-19, participants attended a 1-hour Tai Chi exercise class three times per week for 8 weeks, instead of the planned 12-weeks. Symptoms of depression, anxiety and stress were assessed using standardized questionnaires (Center for Epidemiological Studies Depression scale, CESD; Generalized Anxiety Disorder Assessment; Perceived Stress Scale), objective sleep was assessed via a research-grade triaxial accelerometer (ActiGraph GT9X), and blood samples were taken to assess oxidative stress (plasma superoxide dismutase, SOD) and inflammatory markers (serum tumor necrosis factor-alpha, interleukin-6, interleukin-10). Pre-post intervention changes were assessed using paired t-tests. Results Community-dwelling stroke survivors (N = 11) on average 69.7 ± 9.3 years old, mainly retired (73%, n = 8), married men (55%, n = 6) with &gt;13 years education (91%, n = 10), reporting depression symptoms (CESD = 17.3 ± 11.4) and 55% taking anti-depressant medications, enrolled. The majority of participants reported having an ischemic stroke (82%, n = 9) with hemiparesis (55%, n = 6), but were able to walk 15 feet without assistance (91%, n = 10). After the Tai Chi intervention, we observed significant reductions in symptoms of depression (-5.3 ± 5.9, p = 0.01), anxiety (-2.2 ± 2.4, p = 0.01) and stress (-4.6 ± 4.8, p = 0.01); along with better sleep efficiency (+1.8 ± 1.8, p = 0.01), less wakefulness after sleep onset (-9.3 ± 11.6, p = 0.04), and less time awake (-9.3 ± 11.6, p = 0.04). In addition, there was a 36% decrease in SOD activity (p = 0.02) indicative of a decreased oxidative environment post-intervention; though no significant changes in any of the inflammatory markers were found (all p-values &gt;0.05). Conclusion Symptoms of depression, anxiety and stress were observed in these community-dwelling stroke survivors along with sub-optimal sleep. Among community-dwelling stroke survivors, Tai Chi exercise is a feasible intervention that can be used alongside conventional care to manage post-stroke depression and may also aid in reducing symptoms of anxiety and stress, and improve sleep. Further research is needed with rigorous study designs and larger samples, before widespread recommendations can be made.

Stroke survivors personal efficacy beliefs and outcomes expectations of tai chi exercise: a qualitative descriptive study

Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Laurence B. Emmons Research Award Background Strokes are a leading cause of serious long-term disability, often compounded by post-stroke depression. Prior Tai Chi research conducted among stroke survivors has focused mainly on physical functioning yet understanding the potential benefits and challenges of participating in Tai Chi exercise during stroke recovery is limited. Social Cognitive Theory and Complex Systems Biology provided the theoretical framework to examine stroke survivors’ personal efficacy beliefs, behaviour (Tai Chi intervention), and outcome expectations (Figure 1). Purpose To describe community-dwelling stroke survivors’ experiences of being in an 8-week Tai Chi intervention, including any benefits or challenges they had, and allow the participants to offer any suggestions for improving how the Tai Chi classes were structured. Methods A qualitative descriptive approach was used, with focus group interview data collected from stroke survivors after participation in a Tai Chi intervention. Due to COVID-19, the focus group interview was conducted via on-line video conferencing. The interview was audio-recorded, then transcribed using an online transcription service. Content analysis of the de-identified transcript was conducted using online analysis software with a priori codes based on the theoretical framework, and inductive codes that were added during the analysis process. The transcript was coded independently by two researchers and discussed until consensus was reached. Lincoln and Guba’s criteria were followed to ensure trustworthiness of the data. Results Community-dwelling stroke survivors (n = 7) participating in the focus group interviews were on average 68 years old, mainly retired (71%, n = 5), married women (57%, n = 4) with &gt;13 years education (86%, n = 6), reporting depression symptoms (Center for Epidemiological Studies-Depression = 15.9 ± 9.6) with 43% (n = 3) taking anti-depressant medications. The major findings are summarized according to three major themes: Personal Efficacy Beliefs, Tai Chi Intervention Active Ingredients and Outcome Expectations. Personal Efficacy Beliefs centered on the participants’ ability to do the Tai Chi movements. The Tai Chi Intervention Active Ingredients experienced during the classes were evident, apart from ‘natural freer breathing’ which was not discussed or described. Outcome Expectations centered on the physical, mental, and social benefits experienced, challenges encountered, and suggestions for improving the Tai Chi classes. Conclusion Social Cognitive Theory underscored stroke survivors’ personal efficacy beliefs, behaviour, and outcome expectations. While Complex Systems Biology highlighted the active ingredients of Tai Chi intervention they experienced. Participation in the 8-week Tai Chi intervention led to perceived holistic (physical, mental, social) benefits post-stroke.