OBJECTIVE:This pilot, randomized clinical trial investigates the effectiveness of tai chi as the primary treatment for Chinese Americans with major depressive disorder (MDD).

METHODS:67 Chinese Americans with DSM-IV MDD and no treatment for depression were recruited between March 2012 and April 2013 and randomized (1:1:1) into a tai chi intervention, an education program, or a waitlisted group for 12 weeks. The primary outcome measure was the 17-item Hamilton Depression Rating Scale (HDRS₁₇); positive response for this outcome was defined as a decrease in total score of 50% or more, and remission was defined as HDRS₁₇ ≤ 7.

RESULTS:Participants (N = 67) were 72% female with a mean age of 54± 13 years. No serious adverse events were reported. After the end of the 12-week intervention, response rates were 25%, 21%, and 56%, and remission rates were 10%, 21%, and 50% for the waitlisted, education, and tai chi intervention groups, respectively. The tai chi group showed improved treatmentresponse when compared to both the waitlisted group (odds ratio [OR] = 2.11; 95% CI, 1.01-4.46) and to the education group (OR = 8.90; 95% CI, 1.17-67.70). Tai chi intervention showed significantly improved remission rate over the waitlisted group (OR = 3.01; 95% CI, 1.25-7.10), and a trend of improved remission compared to the education group (OR = 4.40; 95% CI, 0.78-24.17).

CONCLUSIONS:As the primary treatment, tai chi improved treatment outcomes for Chinese Americans with MDD over both passive and active control groups.

TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT01619631.

PURPOSE:To compare 2 mild-to-moderate group exercises and treatment as usual (TAU) for improvements in physical function and depressive symptoms.

METHODS:Patients with heart failure (n = 70, mean age = 66 yr, range = 45-89 yr) were randomized to 16 wk of tai chi (TC), resistance band (RB) exercise, or TAU.

RESULTS:Physical function differed by group from baseline to follow-up, measured by distance walked in the 6-min walk test (F = 3.19, P = .03). Tai chi participants demonstrated a nonsignificant decrease of 162 ft (95% confidence interval [CI], 21 to -345, P = .08) while distance walked by RB participants remained stable with a nonsignificant increase of 70 ft (95% CI, 267 to -127, P = .48). Treatment as usual group significantly decreased by 205 ft (95% CI, -35 to -374, P = .02) and no group differences occurred over time in end-systolic volume (P = .43) and left ventricular function (LVEF) (P = .67). However, groups differed over time in the Beck Depression Inventory (F = 9.2, P<.01). Both TC and RB groups improved (decreased) by 3.5 points (95% CI, 2-5, P<.01). Treatment as usual group decreased insignificantly 1 point (95% CI, -1 to 3, P = .27).

CONCLUSIONS:Tai chi and RB participants avoided a decrease in physical function decrements as seen with TAU. No groups changed in cardiac function. Both TC and RB groups saw reduced depression symptoms compared with TAU. Thus, both TC and RB groups avoided a decrease in physical function and improved their psychological function when compared with TAU.

PURPOSE:Individuals with osteoarthritis can experience difficulty walking and poor strength, possibly leading to falls and fractures. Exercise has been found to increase strength and bone mineral density. The purpose of this study was to determine the effects of 6 months of t'ai chi on knee muscle strength, bone mineral density, and fear of falling in older women with osteoarthritis.

METHODS:Eighty-two (82) women with osteoarthritis, recruited from outpatient clinics and community health centers, were randomly assigned to either a t'ai chi group and took part in a t'ai chi program, or a control group. Of these, 30 subjects (mean age = 63 years) in the t'ai chi group and 35 (mean age = 61 years) in the control group completed post-test measures at 6 months.

RESULTS:After the 6-month study period, subjects in the t'ai chi program had significantly greater knee extensor endurance (pre- to post-test mean increase = 36.4 W/kg, versus 1.1 W/kg for the controls), and significantly greater bone mineral density in the neck of the proximal femur (mean change = 0.09, versus -0.10 for the controls), Ward's triangle (mean change = 0.04, versus -0.04 for the controls), and trochanter (mean change = 0.07, versus -0.05 for the controls) than the controls. However, knee extensor and flexor strength did not differ significantly between the groups. The fear of falling during daily activities reduced significantly more in the t'ai chi group (mean change = -2.40, versus 0.66 for the controls).

CONCLUSIONS:T'ai chi increased knee extensor muscle endurance and bone mineral density in older women with osteoarthritis, and decreased their fear of falling during daily activities. Further study with long-term follow-up is needed to substantiate the role of t'ai chi exercise in the prevention of fall and its related fracture.

OBJECTIVES: To determine the effectiveness of a 16-week community-based tai chi program in reducing falls and improving balance in people aged 60 and older. DESIGN: Randomized, controlled trial with waiting list control group. SETTING: Community in Sydney, Australia. PARTICIPANTS: Seven hundred two relatively healthy community-dwelling people aged 60 and older (mean age 69). INTERVENTION: Sixteen-week program of community-based tai chi classes of 1 hour duration per week. MEASUREMENTS: Falls during 16 and 24 weeks of follow-up were assessed using a calendar method. Balance was measured at baseline and 16-week follow-up using six balance tests. RESULTS: Falls were less frequent in the tai chi group than in the control group. Using Cox regression and time to first fall, the hazard ratio after 16 weeks was 0.72 (95% confidence interval (CI)=0.51-1.01, P=.06), and after 24 weeks it was 0.67 (95% CI=0.49-0.93, P=.02). There was no difference in the percentage of participants who had one or more falls. There were statistically significant differences in changes in balance favoring the tai chi group on five of six balance tests. CONCLUSION: Participation in once per week tai chi classes for 16 weeks can prevent falls in relatively healthy community-dwelling older people.

OBJECTIVE: To evaluate the potential benefits of programmed Tai Chi Chun (TCC) exercise on the weight-bearing bones of early postmenopausal women. DESIGN: Age-matched and randomized prospective intervention. SETTING: University medical school. PARTICIPANTS: One hundred thirty-two healthy postmenopausal women (mean age, 54.0+/-3.5y) within 10 years of menopause onset were recruited and randomized into the TCC exercise group (n=67) or the sedentary control group (n=65). INTERVENTION: Supervised TCC exercise was performed by the TCC group for 45 minutes a day, 5 days a week, for 12 months; control subjects retained a sedentary life style.Main outcome measures Bone mineral density (BMD) was measured in the lumbar spine and proximal femur by using dual-energy x-ray absorptiometry and in the distal tibia by using multislice peripheral quantitative computed tomography (pQCT). All BMD measurements were repeated after 12 months in both groups. Fracture rate was also documented. RESULTS: Baseline measurements showed homogeneity in age, anthropometric variables, and menstruation status between the TCC and control groups. Exactly 81.6% of the subjects in the TCC group and 83.1% of subjects in the control group completed the 12-month follow-up study. BMD measurements revealed a general bone loss in both TCC and sedentary control subjects at all measured skeletal sites, but with a reportedly slower rate in the TCC group. A significant 2.6- to 3.6-fold retardation of bone loss (P<.01) was found in both trabecular and cortical compartments of the distal tibia in the TCC group as compared with the controls, as measured by pQCT. A total of 4 fracture cases were documented during follow-up, including 3 subjects in the control group and 1 in the TCC group. CONCLUSIONS: This is the first prospective and randomized study to show that a programmed TCC exercise intervention is beneficial for retarding bone loss in weight-bearing bones in early postmenopausal women. Long-term follow-up is needed to substantiate the role of TCC exercise in the prevention of osteoporosis and its related fracture.

OBJECTIVE:This was a secondary data analysis of a cluster-randomized clinical trial that tested the efficacy of a 20-week Sun-style Tai Chi (TC) program in reducing pain in community-dwelling elders with cognitive impairment and knee osteoarthritis (OA). The study also examined whether elders' level of cognitive function was related to the outcomes of the TC program.

METHOD:Elders (N=55) were recruited from 8 study sites. Each site was randomly assigned to participate in either a 20-week TC or an education program. Verbal report of pain was measured by a Verbal Descriptor Scale (VDS) at weeks 1, 5, 9, 13, 17 and 21 (designated as times 1-6). Pain behaviors and analgesic intake were also recorded at times 1-6.

RESULTS:At post-test, scores on the VDS and observed pain behaviors were significantly better in the TC group than in the control group (p=0.008-0.048). The beneficial effects of TC were not associated with cognitive ability.

CONCLUSION:These results suggest that TC can be used as an adjunct to pharmacological intervention to relieve OA pain in elders with cognitive impairment.

TRIAL REGISTRATION:Clinical Trial.gov NCT01528566.

OBJECTIVE:This was a secondary data analysis of a cluster-randomized clinical trial that tested the efficacy of a 20-week Sun-style Tai Chi (TC) program in reducing pain in community-dwelling elders with cognitive impairment and knee osteoarthritis (OA). The study also examined whether elders' level of cognitive function was related to the outcomes of the TC program.

METHOD:Elders (N=55) were recruited from 8 study sites. Each site was randomly assigned to participate in either a 20-week TC or an education program. Verbal report of pain was measured by a Verbal Descriptor Scale (VDS) at weeks 1, 5, 9, 13, 17 and 21 (designated as times 1-6). Pain behaviors and analgesic intake were also recorded at times 1-6.

RESULTS:At post-test, scores on the VDS and observed pain behaviors were significantly better in the TC group than in the control group (p=0.008-0.048). The beneficial effects of TC were not associated with cognitive ability.

CONCLUSION:These results suggest that TC can be used as an adjunct to pharmacological intervention to relieve OA pain in elders with cognitive impairment.

TRIAL REGISTRATION:Clinical Trial.gov NCT01528566.

PURPOSE:This study was to examine the effects of adherence to a 6-month t'ai chi exercise program on glucose control, diabetic self-care activities, and quality of life among individuals with type 2 diabetes.

METHOD:The data from a quasi-experimental study at multisite health-promotion centers in Korea with pretest and 3- and 6-month post-test measures were used. Ninety-nine (99) adults diagnosed with type 2 diabetes and HbA1c 6.0 or higher were included in the analysis. The t'ai chi intervention consisted of 19 movements from Yang and Sun styles provided twice a week for 6 months. Sixty-two (62) subjects completed both pretest and post-test measures. To achieve the desired outcomes, subjects needed to complete 80% of the sessions of the t'ai chi program, and 31 subjects who met this criteria were compared to those who did not (n = 31). Outcome measures included glucose control (fasting blood sugar, HbA1c), diabetic self-care activities, and quality of life (36-Item Short Form Health Survey, version 2).

RESULTS:Using repeated measure analysis of variance for baseline, 3 months, and 6 months, the adherent group had greater decline in fasting glucose (interaction effect F = 5.60, df = 2, p<0.05) and HbA1c (interaction effect F = 4.15, df = 2, p<0.05) than the nonadherers. The adherent group performed significantly more diabetic self-care activities (interaction effect F = 5.13, df = 2, p<0.05), and had better quality of life in mental component summary, social functioning, mental health, and vitality as compared to the nonadherent group. The significant differences in quality of life remained after adjusting for self-care activities except for mental health, which was no longer significant.

CONCLUSION:For those with type 2 diabetes, t'ai chi could be an alternative exercise intervention to increase glucose control, diabetic self-care activities, and quality of life. Whether t'ai chi can reduce or prevent diabetic complications requires further study.

OBJECTIVE: To study the effect of Tai Chi on exercise tolerance in patients with moderate heart failure. DESIGN: Randomised parallel group study balanced for baseline variables. SETTING: Cardiology Department, Royal Hallamshire Hospital. PATIENTS AND METHODS: 52 patients (42 men, mean age (68.9 years), range (46-90 years), and 10 women, mean age (70.0 years), range (58-82)) with chronic heart failure (New York Heart Association symptom class II-III) were studied. Patients were randomised to Tai Chi Chuan twice a week for 16 weeks or to standard medical care without exercise rehabilitation. MAIN OUTCOME MEASURES: The primary outcome measure was the change in the distance walked in the shuttle walk test. Secondary outcome measures were changes in symptom scores and quality of life indices. RESULTS: Objective measures of exercise tolerance did not improve significantly with Tai Chi, but patients having Tai Chi exercise had an improvement in symptom scores of heart failure measured by the Minnesota Living with Heart Failure Questionnaire (comparison of deltas, -2.4 control vs -14.9; p = 0.01), and depression scores measured by the SCL-90-R questionnaire (-2.9 vs -6.8; p = 0.12) compared with those patients in the control group. CONCLUSION: In patients with chronic heart failure, 16 weeks of Tai Chi training was safe, with no adverse exercise related problems. It was enjoyed by all taking part and led to significant improvements in symptoms and quality of life.

BACKGROUND:There is increasing evidence showing the health benefits of various forms of traditional Chinese exercises (TCEs) on the glycemic profile in people with type 2 diabetes. However, relatively little is known about the combined clinical effectiveness of these traditional exercises. This study was designed to perform a systematic review and meta-analysis of the overall effect of 3 common TCEs (Tai Ji Quan, Qigong, Ba Duan Jin) on glycemic control in adults with type 2 diabetes.

METHODS:We conducted an extensive database search in Cochrane Library, EMBASE, PubMed, Web of Science, EBSCO, and China National Knowledge Infrastructure on randomized controlled trials published between April 1967 and September 2017 that compared any of the 3 TCEs with a control or comparison group on glycemic control. Data extraction was performed by 2 independent reviewers. Study quality was evaluated using the, which assessed the risk of bias, including sequence generation, allocation concealment, blinding, completeness of outcome data, and selective outcome reporting. The resulting quality of the reviewed studies was characterized in 3 grades representing the level of bias: low, unclear, and high. All analyses were performed using random effects models and heterogeneity was quantified. Wespecified changes in biomarkers of hemoglobin A1c (in percentage) and fasting blood glucose (mmol/L) as the main outcomes and triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein-cholesterol, 2-h plasma glucose, and fasting plasma glucose as secondary outcomes.

RESULTS:A total of 39 randomized, controlled trials (Tai Ji Quan = 11; Qigong = 6; Ba Duan Jin = 22) with 2917 type 2 diabetic patients (aged 41-80 years) were identified. Compared with a control or comparison group, pooled meta-analyses of TCEs showed a significant decrease in hemoglobin A1c (mean difference (MD) = -0.67%; 95% confidence interval (CI): -0.86% to -0.48%;<0.00001) and fasting blood glucose (MD = -0.66 mmol/L; 95%CI: -0.95 to -0.37 mmol/L;<0.0001). The observed effect was more pronounced for interventions that were medium range in duration (i.e.,>3-<12 months). TCE interventions also showed improvements in the secondary outcome measures. A high risk of bias was observed in the areas of blinding (i.e., study participants and personnel, and outcome assessment).

CONCLUSION:Among patients with type 2 diabetes, TCEs were associated with significantly lower hemoglobin A1c and fasting blood glucose. Further studies to better understand the dose and duration of exposure to TCEs are warranted.

OBJECTIVES: To evaluate the effects of a behavioral intervention, Tai Chi, on resting and vaccine-stimulated levels of cell-mediated immunity (CMI) to varicella zoster virus (VZV) and on health functioning in older adults. DESIGN: A prospective, randomized, controlled trial with allocation to two arms (Tai Chi and health education) for 25 weeks. After 16 weeks of intervention, subjects were vaccinated with VARIVAX, the live attenuated Oka/Merck VZV vaccine licensed to prevent varicella. SETTING: Two urban U.S. communities between 2001 and 2005. PARTICIPANTS: A total of 112 healthy older adults aged 59 to 86. MEASUREMENTS: The primary endpoint was a quantitative measure of VZV-CMI. Secondary outcomes were scores on the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). RESULTS: The Tai Chi group showed higher levels of VZV-CMI than the health education group (P<.05), with a significant rate of increase (P<.001) that was nearly twice that found in the health education group. Tai Chi alone induced an increase in VZV-CMI that was comparable in magnitude with that induced by varicella vaccine, and the two were additive; Tai Chi, together with vaccine, produced a substantially higher level of VZV-CMI than vaccine alone. The Tai Chi group also showed significant improvements in SF-36 scores for physical functioning, bodily pain, vitality, and mental health (P<.05). CONCLUSION: Tai Chi augments resting levels of VZV-specific CMI and boosts VZV-CMI of the varicella vaccine.

Obesity, metabolic syndrome, dyslipidemia, and poor quality of life are common conditions associated with hypertension, and incidence of hypertension is age dependent. However, an effective program to prevent hypertension and to improve biomedical factors and quality of life has not been adequately examined or evaluated in Chinese older adults. This study aims to examine the effectiveness of a Tai Chi program to improve health status in participants with hypertension and its related risk factors such as dyslipidemia, hyperglycemia, and quality of life in older adults in China. A randomized study design was used. At the conclusion of the intervention, 266 patients remained in the study. Blood pressure and biomedical factors were measured according to the World Diabetes Association standard 2002. A standardized quality-of-life measure was used to measure health-related quality of life. It was found that a Tai Chi program to improve hypertension in older adults is effective in reducing blood pressure and body mass index, maintaining normal renal function, and improving physical health of health-related quality of life. It did not improve existing metabolic syndrome levels, lipid level (dyslipidemia) or fasting glucose level (hyperglycemia), to prevent further deterioration of the biomedical risk factors. In conclusion, Tai Chi is effective in managing a number of risk factors associated with hypertension in Chinese older adults. Future research should examine a combination of Tai Chi and nutritional intervention to further reduce the level of biomedical risks.

BACKGROUND: Both athletes with intensive exercise and aged people may have weakened immunity against virus infection. This study aimed to evaluate whether people undergoing aerobic exercises including competitive cyclists with moderate training (CMT) and middle-aged people practicing Tai Chi Chuan (TCC) exercise have higher immunity against hepatitis B virus than age-matched sedentary controls including college students (CSC) and middle-aged people (MSC). METHODS: Human peripheral blood mononuclear cells from competitive cyclists and sedentary controls were stimulated by phytohemagglutinin (PHA) to prepare conditioned medium (MNC-CM) for the assessment of inhibitory effects on hepatitis B surface antigen (HBsAg) expression in human hepatoma Hep3B cells. RESULTS: The inhibitory effects on the relative HBsAg expression of CMT's and TCC's MNC-CM were greater than those of the controls. The CMT's MNC-CM prepared from 5 microg/ml PHA decreased HBsAg expression to 61.5%, whereas that of CSC remained at 83.8%. Similarly, this expression by treatment of TCC group' MNC-CM was 68.4% whereas that of MSC group was 84.3%. The levels of cytokines such as interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), IFN-alpha and interleukin-1beta (IL-1beta) in the MNC-CM from the CMT and TCC groups were greater than those in the controls. Antibody neutralization of CMT's MNC-CM and addition of recombinant cytokines into CSC's MNC-CM indicated that IFN-gamma, TNF-alpha and IFN-alpha had synergistic effects against HBsAg expression. Similar blocking effect was noted in TCC versus MSC groups. CONCLUSION: These results suggest that the immunomodulatory response to suppress HBsAg expression in CMT and TCC with moderate aerobic exercise is greater than that in age-matched sedentary controls.

BACKGROUND: Both athletes with intensive exercise and aged people may have weakened immunity against virus infection. This study aimed to evaluate whether people undergoing aerobic exercises including competitive cyclists with moderate training (CMT) and middle-aged people practicing Tai Chi Chuan (TCC) exercise have higher immunity against hepatitis B virus than age-matched sedentary controls including college students (CSC) and middle-aged people (MSC). METHODS: Human peripheral blood mononuclear cells from competitive cyclists and sedentary controls were stimulated by phytohemagglutinin (PHA) to prepare conditioned medium (MNC-CM) for the assessment of inhibitory effects on hepatitis B surface antigen (HBsAg) expression in human hepatoma Hep3B cells. RESULTS: The inhibitory effects on the relative HBsAg expression of CMT's and TCC's MNC-CM were greater than those of the controls. The CMT's MNC-CM prepared from 5 microg/ml PHA decreased HBsAg expression to 61.5%, whereas that of CSC remained at 83.8%. Similarly, this expression by treatment of TCC group' MNC-CM was 68.4% whereas that of MSC group was 84.3%. The levels of cytokines such as interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), IFN-alpha and interleukin-1beta (IL-1beta) in the MNC-CM from the CMT and TCC groups were greater than those in the controls. Antibody neutralization of CMT's MNC-CM and addition of recombinant cytokines into CSC's MNC-CM indicated that IFN-gamma, TNF-alpha and IFN-alpha had synergistic effects against HBsAg expression. Similar blocking effect was noted in TCC versus MSC groups. CONCLUSION: These results suggest that the immunomodulatory response to suppress HBsAg expression in CMT and TCC with moderate aerobic exercise is greater than that in age-matched sedentary controls.

Many people with depression or anxiety turn to nonpharmacologic and nonconventional interventions, including exercise, yoga, meditation, tai chi, or qi gong. Meta-analyses and systematic reviews have shown that these interventions can improve symptoms of depression and anxiety disorders. As an adjunctive treatment, exercise seems most helpful for treatment-resistant depression, unipolar depression, and posttraumatic stress disorder. Yoga as monotherapy or adjunctive therapy shows positive effects, particularly for depression. As an adjunctive therapy, it facilitates treatment of anxiety disorders, particularly panic disorder. Tai chi and qi gong may be helpful as adjunctive therapies for depression, but effects are inconsistent. As monotherapy or an adjunctive therapy, mindfulness-based meditation has positive effects on depression, and its effects can last for six months or more. Although positive findings are less common in people with anxiety disorders, the evidence supports adjunctive use. There are no apparent negative effects of mindfulness-based interventions, and their general health benefits justify their use as adjunctive therapy for patients with depression and anxiety disorders.

BACKGROUND:Antipsychotic drugs are limited in their ability to improve negative symptoms, quality of life, and medication adherence in patients with schizophrenia. The addition of nonpharmacological interventions like social skills training has a positive effect on medication adherence and decreases rehospitalization rates but is limited in improving patients' symptoms, aggressive behaviors, and quality of life. Aerobic exercise, especially Tai-chi, can potentially reduce psychopathological and negative symptoms, decrease aggressive behaviors, and improve quality of life. It is an ideal rehabilitation intervention for patients with schizophrenia. However, no study has investigated the effects of social skills training plus Tai-chi on outcomes among outpatients with schizophrenia. This study analyzes the effect of antipsychotics combined with community-based integrated interventions on outcomes of schizophrenia.

METHODS:In this study, a 24-session social skills training plus Tai-chi was used in community settings among patients with schizophrenia. A total of 244 patients were randomly assigned to medication treatment alone (MTA group) or community-based integrated intervention (CBII group), which accepted social skills training plus Tai-chi in addition to medication treatment. Generalized linear mixed models were used to evaluate the intervention effect (group effect), intervention effect over time (time effect), and interaction effect (group× time effect). t tests were used to evaluate between-group differences on clinical variables. Multiple linear regression analysis was used to analyze the differences between the intervention at 12 months and baseline for the Positive and Negative Syndrome Scale (PANSS) negative symptoms and quality of life-social domain.

RESULTS:Compared with the MTA group, the CBII group had lower scores on PANSS (F = 17.312, p<0.001) and negative symptoms (F = 44.909, p<0.001), a lower risk for aggressive behavior (F = 12.382, p<0.001), and a greater improvement in adherence to medication (F = 12.391, p<0.001) after 1 year of intervention. The changes in PANSS total scores, negative scores, and social domain of the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF) from baseline to 12 months were significant between the two groups (PANSS total score: t = 4.839, p<0.001; negative symptoms: t = 8.250, p<0.001, and quality of life-social domain: t = -2.171, p = 0.031). Multiple linear regression analysis also showed that the intervention was significantly effective for changes from baseline to 12 months on PANSS total score (B = 0.804, p<0.001), negative score (B = 0.709, p<0.001), and social domain of quality of life (B = -0.673, p = 0.044).

CONCLUSIONS:This study suggested that the community-based integrated intervention such as social skills training plus Tai-chi should be part of a rehabilitation effort for patients with schizophrenia in order to improve clinical symptoms, quality of life, and medication adherence.

Methods of exercise such as Pilates and taiji quan, which have been shown to have beneficial effects on physical and mental characteristics, have been studied more often in samples of older participants. The purpose of this investigation was to examine the effects of a semester of either Pilates or taiji quan training on perceived self-efficacy, sleep quality and mood, as well as strength and balance in college-age individuals. Self-efficacy was found to be improved in the Pilates and taiji quan groups and there was a trend towards improvement in sleep quality. Mood was found to be improved significantly in the Pilates group while the taiji group showed a trend towards improvement. There were no changes or group differences in the strength or balance measures. Pilates and taiji quan are effective exercise modes to improve mental parameters in college-age individuals.

Methods of exercise such as Pilates and taiji quan, which have been shown to have beneficial effects on physical and mental characteristics, have been studied more often in samples of older participants. The purpose of this investigation was to examine the effects of a semester of either Pilates or taiji quan training on perceived self-efficacy, sleep quality and mood, as well as strength and balance in college-age individuals. Self-efficacy was found to be improved in the Pilates and taiji quan groups and there was a trend towards improvement in sleep quality. Mood was found to be improved significantly in the Pilates group while the taiji group showed a trend towards improvement. There were no changes or group differences in the strength or balance measures. Pilates and taiji quan are effective exercise modes to improve mental parameters in college-age individuals.

OBJECTIVE:Studies have demonstrated that Tai Chi exercise improves blood lipid level with inconsistent results. A meta-analysis was conducted to quantify the effects of Tai Chi on blood lipid profiles in humans.

METHODS:We screened the databases of PubMed, EMBASE, Cochrane Library (Central), Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang data, and Clinicaltrials.gov for randomized controlled trials with Physiotherapy Evidence Database (PEDro) score more than 3 points up to June 2015. Six studies involving 445 subjects were included. Most trials applied 12-week Tai Chi intervention courses.

RESULTS:In comparison with the control group, blood triglyceride (TG) level difference between follow-up and baseline was statistically significantly lower in the Tai Chi practicing group (weighted mean difference (WMD) -16.81 mg/dl; 95% confidence intervals (CI) -31.27 to -2.35 mg/dl; P=0.02). A trend to improving total cholesterol (TC) reduction was found with Tai Chi (WMD -7.96 mg/dl; 95% CI -17.30 to 1.39 mg/dl; P=0.10). However, no difference was found in blood low-density lipoprotein cholesterol (LDL-C) or high-density lipoprotein cholesterol (HDL-C).

CONCLUSIONS:Tai Chi exercise lowered blood TG level with a trend to decrease blood TC level. Our data suggest that Tai Chi has the potential to implement meaningful blood lipid modification and serve as an adjunctive exercise modality. The relationship between Tai Chi exercise regimen and lipid profile change might have a scientific priority for future investigation.