Taylor-Piliae Ruth E, Hoke Tiffany M, Hepworth Joseph T, Latt L Daniel, Najafi Bijan, Coull Bruce M
College of Nursing, University of Arizona, Tucson, AZ.
College of Nursing, University of Arizona, Tucson, AZ.
Arch Phys Med Rehabil. 2014 May;95(5):816-24. doi: 10.1016/j.apmr.2014.01.001. Epub 2014 Jan 17.
To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life.
Single-blind, randomized controlled trial.
General community.
Community-dwelling survivors of stroke (N=145; 47% women; mean age, 70y; time poststroke: 3y; ischemic stroke: 66%; hemiparesis: 73%) who were aged ≥50 years and were ≥3 months poststroke.
Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS) (n=44), or usual care (UC) (n=48) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls.
Physical function: Short Physical Performance Battery, fall rates, and 2-minute step test; quality of life: Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index.
During the intervention, TC participants had two thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups (χ(2)=5.6, P=.06). There was a significant group by time interaction for the 2-minute step test (F2,142=4.69, P<.01). Post hoc tests indicated that the TC (t53=2.45, P=.02) and SS (t44=4.63, P<.01) groups had significantly better aerobic endurance over time, though not in the UC group (t48=1.58, P=.12). Intervention adherence rates were 85%.
TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention was more effective in reducing fall rates than SS or UC interventions. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling survivors of stroke are recommended.
探讨为期12周的太极拳（TC）干预对身体功能和生活质量的影响。
单盲随机对照试验。
普通社区。
年龄≥50岁且中风后≥3个月的社区居住中风幸存者（N = 145；47%为女性；平均年龄70岁；中风后时间：3年；缺血性中风：66%；偏瘫：73%）。
杨式24式简化太极拳（n = 53）、力量和活动范围锻炼（SS）（n = 44）或常规护理（UC）（n = 48），为期12周。TC组和SS组每周参加3次1小时课程，而UC组每周接受电话随访。
身体功能：简短体能状况量表、跌倒率和2分钟步行测试；生活质量：医学结局研究36项简短健康调查、流行病学研究中心抑郁量表和匹兹堡睡眠质量指数。
在干预期间，TC组参与者的跌倒次数（5次）比SS组（14次）和UC组（15次）少三分之二（χ(2)=5.6，P = .06）。2分钟步行测试存在显著的组×时间交互作用（F2,142 = 4.69，P < .01）。事后检验表明，随着时间推移，TC组（t53 = 2.45，P = .02）和SS组（t44 = 4.63，P < .01）的有氧耐力显著改善，而UC组没有（t48 = 1.58，P = .12）。干预依从率为85%。
TC和SS均可提高有氧耐力，二者都是合适的社区项目，可能有助于中风康复和重新融入社区。我们的数据表明，为期12周的TC干预在降低跌倒率方面比SS或UC干预更有效。建议未来开展研究，检验TC作为社区居住中风幸存者预防跌倒策略的有效性。
