Paul Lam

Tai chi exercise for treatment of pain and disability in people with persistent low back pain: A randomized controlled trial

To determine the effect of tai chi exercise on persistent low back pain.

Effectiveness of tai chi for Parkinson's disease: A critical review

The objective of this review is to assess the effectiveness of tai chi as a treatment option for Parkinsons disease (PD). We have searched the literature using 21 databases from their inceptions to January 2008, without language restrictions. We included all types of clinical studies regardless of their design. Their methodological quality was assessed using the modified Jadad score. Of the seven studies included, one randomised clinical trial (RCT) found tai chi to be superior to conventional exercise in terms of the Unified PD Rating Scale (UPDRS) and prevention of falls. Another RCT found no effects of tai chi on locomotor ability compared with qigong. The third RCT failed to show effects of tai chi on the UPDRS and the PD Questionnaires compared with wait list control. The remaining studies were either non-randomised (n=1) or uncontrolled clinical trials (n=3). Collectively these data show that RCTs of the tai chi for PD are feasible but scarce. Most investigations suffer from methodological flaws such as inadequate study design, poor reporting of results, small sample size, and publication without appropriate peer review process. In conclusion, the evidence is insufficient to suggest tai chi is an effective intervention for PD. Further research is required to investigate whether there are specific benefits of tai chi for people with PD, such as its potential effect on balance and on the frequency of falls.

Feasibility and Effects of a Tai Chi Self-Help Education Program for Korean Gastric Cancer Survivors

PURPOSE/OBJECTIVES To determine the feasibility of conducting a study of a tai chi self-help education program in Korean adults with gastric cancer and to describe the effects of a six-month tai chi self-help education program on depression, health-related quality of life (HRQOL), and immune markers. DESIGN One-group, pre- and post-test design. SETTING Outpatient clinics of two large hospitals in the Republic of Korea. SAMPLE Convenience sample of 33 Korean adults with gastric cancer diagnoses after gastrectomy. METHODS The Korean gastric cancer survivors participated in a 24-week tai chi self-help education program. The participants completed the Center for Epidemiologic Studies-Depression (Korean version) and the Functional Assessment of Cancer Therapy-General (Korean version) for HRQOL and provided blood samples for immune markers. All measurements were conducted at baseline and at one week following the 24-week intervention. MAIN RESEARCH VARIABLES Feasibility was determined as the percentage of participants completing the 24-week protocol. Preliminary data on depression, HRQOL, and immune markers were obtained. FINDINGS The dropout rate was 36.4%; 21 of 33 survivors participated in the tai chi self-help education program for 24 weeks. No complications or injuries occurred to the participants during the program. No significant differences were noted in depression, HRQOL, and immune markers before and after the intervention. CONCLUSIONS Tai chi exercise, in combination with a self-help program, can be safe and feasible for Korean gastric cancer survivors. This feasibility study did not show that the tai chi self-help education program improves depression, HRQOL, and immune markers in Korean gastric cancer survivors. IMPLICATIONS FOR NURSING Additional studies are needed to determine the long-term impact relative to usual care.

A randomized controlled trial of tai chi for long-term low back pain (TAI CHI): Study rationale, design, and methods

BackgroundLow back pain persisting for longer than 3 months is a common and costly condition for which many current treatments have low-moderate success rates at best. Exercise is among the more successful treatments for this condition, however, the type and dosage of exercise that elicits the best results is not clearly defined. Tai chi is a gentle form of low intensity exercise that uses controlled movements in combination with relaxation techniques and is currently used as a safe form of exercise for people suffering from other chronic pain conditions such as arthritis. To date, there has been no scientific evaluation of tai chi as an intervention for people with back pain. Thus the aim of this study will be to examine the effects of a tai chi exercise program on pain and disability in people with long-term low back pain.Methods and designThe study will recruit 160 healthy individuals from the community setting to be randomised to either a tai chi intervention group or a wait-list control group. Individuals in the tai chi group will attend 2 tai chi sessions (40 minutes)/week for 8 weeks followed by 1 tai chi session/week for 2 weeks. The wait-list control will continue their usual health care practices and have the opportunity to participate in the tai chi program once they have completed the follow-up assessments. The primary outcome will be bothersomeness of back symptoms measured with a 0–10 numerical rating scale. Secondary outcomes include, self-reports of pain-related disability, health-related quality of life and global perceived effect of treatment. Statistical analysis of primary and secondary outcomes will be based on the intention to treat principle. Linear mixed models will be used to test for the effect of treatment on outcome at 10 weeks follow up. This trial has received ethics approval from The University of Sydney Human Research Ethics Committee. HREC Approval No.10452DiscussionThis study will be the first trial in this area and the information on its effectiveness will allow patients, clinicians and treatment funders to make informed choices regarding this treatment.Trial RegistrationThis trial has been registered with Australian New Zealand Clinical Trials Registry. ACTRN12608000270314

Epigenetic Changes in Response to Tai Chi Practice: A Pilot Investigation of DNA Methylation Marks

Tai chi exercise has been shown to improve physiological and psychosocial functions, well-being, quality of life, and disease conditions. The biological mechanisms by which tai chi exerts its holistic effects remain unknown. We investigated whether tai chi practice results in positive epigenetic changes at the molecular level. Design. The DNA methylation profiles of sixty CpG-dinucleotide marks in female tai chi practitioners (N = 237; 45–88 years old) who have been practising tai chi for three or more years were compared with those of age-matched control females (N = 263) who have never practised tai chi. Results. Six CpG marks originating from three different chromosomes reveal a significant difference (P < 0.05) between the two cohorts. Four marks show losses while two marks show gains in DNA methylation with age in the controls. In the tai chi cohort all six marks demonstrate significant slowing (by 5–70%) of the age-related methylation losses or gains observed in the controls, suggesting that tai chi practice may be associated with measurable beneficial epigenetic changes. Conclusions. The results implicate the potential use of DNA methylation as an epigenetic biomarker to better understand the biological mechanisms and the health and therapeutic efficacies of tai chi.

The Effects of Tai Chi Exercise on Elders with Osteoarthritis: A Longitudinal Study

PURPOSE Tai Chi exercise has been proven to be beneficial among elders with osteoarthritis (OA). The long-term effects of this exercise remain unclear. The purpose of this study was to evaluate the effects of the Tai Chi exercise for Arthritis (TCEA) program on the physical status and quality of life of OA elders. METHODS This was a time series study with one group design. Subjects diagnosed with OA of the lower extremities, aged 60 years or over, were recruited from an outpatient clinic at a community teaching hospital. Thirteen participants joined a TCEA exercise class three times per week for 2 years. Physical status including body mass index (BMI), lean body mass, hand grasp strength, flexibility, and equilibrium were measured four times-at baseline, 3 months, 1 year, and 2 years of the TCEA exercise class. Quality of life was also measured at these time points. RESULTS Lean body mass was significantly decreased within the study period (p < .05). Participants experienced significant improvements in physical functioning, role limitations, and social functioning on the dimensions of quality of life (SF-36) (p < .05). CONCLUSION Elderly people with OA should be encouraged to exercise using Tai Chi for maintaining physical function and improving quality of life.

위장암 환자의 삶의 질에 영향을 미치는 요인

PURPOSE The purpose of this study was to identify the factors influencing quality of life after analyzing the relationship between depression, health promotion and quality of life in patients with gastrointestinal neoplasms. METHODS The subjects of this study were 63 people who underwent treatments from 2 general hospitals in Seoul and Daejeon and had no recurrence in stages I & II of gastrointestinal neoplasms. Data was collected from March 1 to April 30, 2006. A questionnaire consisting of Center for Epidemiologic Studies Depression (CES-D), Health Promoting Lifestyle Profile II (HPLP II) and Functional Assessment of Cancer Therapy-Colorectal (FACT-C) was given. The collected data was analyzed with the SPSS program which was used for descriptive statistics, Pearson correlation coefficients and hierarchical multiple regression. RESULTS The major findings of this study were as follows: 1) There was a significant relationship between depression (r=-.639, p=.000), health promotion (r=.407, p=.001) and quality of life. 2) Significant factors were depression (F=-4.091, p=.000) and health promotion (F=2.375, p=.021) that explained 46% of quality of life (F=10.022, p=.000). CONCLUSION Cancer patients experienced extreme depression which led to a negative effect on quality of life. Health promotion was an important variable to the quality of life and it gave the patients motivation for having a will and belief for better health.