Efficacy of Tai Chi on Pain, Stiffness and Function in Patients With Osteoarthritis: A Meta-Analysis.

Efficacy of tai chi on pain, stiffness and function in patients with osteoarthritis: a meta-analysis.

PLoS One. 2013; 8(4): e61672
Yan JH, Gu WJ, Sun J, Zhang WX, Li BW, Pan L

Whether Tai Chi benefits patients with osteoarthritis remains controversial. We performed a meta-analysis to assess the effectiveness of Tai Chi exercise for pain, stiffness, and physical function in patients with osteoarthritis.A computerized search of PubMed and Embase (up to Sept 2012) was performed to identify relevant studies. The outcome measures were pain, stiffness, and physical function. Two investigators identified eligible studies and extracted data independently. The quality of the included studies was assessed by the Jadad score. Standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and pooled using a random effects model. The change in outcomes from baseline was compared to the minimum clinically important difference.A total of seven randomized controlled trials involving 348 patients with osteoarthritis met the inclusion criteria. The mean Jadad score was 3.6. The pooled SMD was -0.45 (95% CI -0.70–0.20, P?=?0.0005) for pain, -0.31 (95% CI -0.60–0.02, P?=?0.04) for stiffness, and -0.61 (95% CI -0.85–0.37, P<0.00001) for physical function. A change of 32.2-36.4% in the outcomes was greater than the minimum clinically important difference.Twelve-week Tai Chi is beneficial for improving arthritic symptoms and physical function in patients with osteoarthritis and should be included in rehabilitation programs. However, the evidence may be limited by potential biases; thus, larger scale randomized controlled trials are needed to confirm the current findings and investigate the long-term effects of Tai Chi. HubMed – rehab


Agraphia caused by left thalamic hemorrhage.

Case Rep Neurol. 2013 Jan; 5(1): 74-80
Osawa A, Maeshima S, Yamane F, Uemiya N, Ochiai I, Yoshihara T, Ishihara S, Tanahashi N

A 71-year-old right-handed man was admitted to our hospital with right hemiparesis and sensory impairment associated with mild aphasia. Although aphasia gradually resolved within 2 weeks after stroke onset, his writing ability remained disturbed. A computed tomography (CT) scan at stroke onset revealed a hematoma in the left thalamus, but no cortical lesions were observed. Further, a single-photon emission CT (SPECT) scan showed decreased blood flow in the left thalamus, in the cortical region extending from the left superior temporal gyrus to the parietal lobe, and in the frontal lobe. It is possible that agraphia may have directly resulted from the thalamic lesion, but SPECT findings strongly suggested that a general decrease in left cortical function concomitant with a disruption of the thalamocortical and cortico-thalamocortical projection fibers produced these cognitive deficits. HubMed – rehab


The importance of daily physical activity for improved exercise tolerance in heart failure patients with limited access to centre-based cardiac rehabilitation.

Exp Clin Cardiol. 2012 Sep; 17(3): 121-4
Sato N, Origuchi H, Yamamoto U, Takanaga Y, Mohri M

Supervised cardiac rehabilitation provided at dedicated centres ameliorates exercise intolerance in patients with chronic heart failure.To correlate the amount of physical activity outside the hospital with improved exercise tolerance in patients with limited access to centre-based programs.Forty patients (median age 69 years) with stable heart failure due to systolic left ventricular dysfunction participated in cardiac rehabilitation once per week for five months. Using a validated single-axial accelerometer, the number of steps and physical activity-related energy expenditures on nonrehabilitation days were determined.Median (interquartile range) peak oxygen consumption was increased from 14.4 mL/kg/min (range 12.9 mL/kg/min to 17.8 mL/kg/min) to 16.4 mL/kg/min (range 13.9 mL/kg/min to 19.1 mL/kg/min); P<0.0001, in association with a decreased slope of the minute ventilation to carbon dioxide production plot (34.2 [range 31.3 to 38.1] versus 32.7 [range 30.3 to 36.5]; P<0.0001). Changes in peak oxygen consumption were correlated with the daily number of steps (P<0.01) and physical activity-related energy expenditures (P<0.05). Furthermore, these changes were significantly correlated with total exercise time per day and time spent for light (?3 metabolic equivalents) exercise, but not with time spent for moderate/vigorous (>3 metabolic equivalents) exercise.The number of steps and energy expenditures outside the hospital were correlated with improved exercise capacity. An accelerometer may be useful for guiding home-based cardiac rehabilitation. HubMed – rehab


The physiological Basis of Rehabilitation in Chronic Heart and Lung Disease.

J Appl Physiol. 2013 Apr 25;
Vogiatzis I, Zakynthinos SG

Cardiopulmonary rehabilitation is recognized as a core component of management of individuals with Congestive Heart Failure (CHF) or Chronic Obstructive Pulmonary Disease (COPD) which is designed to improve their physical and psychosocial condition without impacting on the primary organ impairment. This has lead scientific community increasingly to believe that the main effects of cardiopulmonary rehabilitative exercise training are focused on skeletal muscles that are regarded as dysfunctional in both CHF and COPD. Accordingly, following completion of a cardiopulmonary rehabilitative exercise training program there are important peripheral muscular adaptations in both disease entities namely, increased capillary density, blood flow, mitochondrial volume density, fiber size, distribution of slow twitch fibers, and decreased lactic acidosis and vascular resistance. Decreased lactic acidosis at a given level of sub-maximal exercise not only offsets the occurrence of peripheral muscle fatigue leading to muscle task failure and muscle discomfort, but also concurrently mitigates the additional burden on the respiratory muscles caused by the increased respiratory drive, thereby reducing dyspnea sensations. Furthermore in patients with COPD, exercise training reduces the degree of dynamic lung hyperinflation leading to improved arterial oxygen and central hemodynamic responses, thus increasing systemic muscle oxygen availability. In patients with CHF, exercise training has beneficial direct and reflex sympathoinhibitory effects, as well as favorable effects on normalization of neurohumoral excitation. These physiological benefits apply to all COPD and CHF patients independently of the degree of disease severity and are associated with improved exercise tolerance, functional capacity and quality of life. HubMed – rehab